Not a Painless Condition: Rheumatological and Musculoskeletal Symptoms in Type 2 Diabetes, and the Implications for Exercise Participation

Author(s): Emily R. Cox*, Jeff S. Coombes, Shelley E. Keating, Nicola W. Burton, Brooke K. Coombes

Journal Name: Current Diabetes Reviews

Volume 16 , Issue 3 , 2020

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Objectives: People with type 2 diabetes (T2D) are more likely to develop a range of rheumatological and musculoskeletal symptoms (RMS), and experience both chronic and widespread pain, compared with the general population. However, these symptoms are not commonly acknowledged by researchers, which hampers our understanding of the impact on this population. Since exercise is a key lifestyle management strategy for T2D and participation levels are typically low, understanding the potential impact of RMS on exercise participation is critical. The aim of this review is to summarise the literature regarding the prevalence and pathophysiology of RMS in T2D, the evidence for the benefits and risks associated with exercise on RMS, and the currently available tools for the reporting of RMS in both research studies and community settings.

Methods: A narrative review.

Results: There are numerous exercise trials in T2D, but few have sufficiently reported pain-related adverse events and even fewer have investigated the effects of exercise on RMS and chronic pain.

Discussion: Recommendations for future research are provided.

Keywords: Type 2 diabetes, chronic pain, musculoskeletal symptoms, exercise, self-report tools, DSPN.

Merskey H. The definition of pain. Eur Psychiatry 1991; 6(4): 153-9.
Australian Bureau of Statistics.. 2012.
Australian Institute of Health and Welfare. The burden of musculoskeletal conditions in Austraila: a detailed analysis of the Australian Burden of Disease Study 2011. Australian Burden of Disease Study series no. 13. BOD 14. In: AIHW. Canberra. 2017.
Mäntyselkä P, Miettola J, Niskanen L, Kumpusalo E. Chronic pain, impaired glucose tolerance and diabetes: a community-based study. Pain 2008; 137(1): 34-40.
[] [PMID: 17869422]
Hoff OM, Midthjell K, Zwart J-A, Hagen K. The association between diabetes mellitus, glucose, and chronic musculoskeletal complaints. Results from the Nord-Trøndelag Health Study. BMC Musculoskelet Disord 2008; 9(1): 160.
[] [PMID: 19055732]
Arthritis as a potential barrier to physical activity among adults with diabetes--United States, 2005 and 2007. MMWR Morb Mortal Wkly Rep 2008; 57(18): 486-9.
[PMID: 18463606]
Wolak T, Weitzman S, Harman-Boehm I, Friger M, Sukenik S. Prevalence of fibromyalgia in type 2 diabetes mellitus. Harefuah 2001; 140(11): 1006-9.
Abaraogu UO, Ochi C, Umahi E, Ogbonnaya C, Onah I. Individuals with type 2 diabetes are at higher risk of chronic musculoskeletal pain: a study with diabetes cohort. Int J Diabetes Dev Ctries 2017; 37(3): 267-71.
Molsted S, Tribler J, Snorgaard O. Musculoskeletal pain in patients with type 2 diabetes. Diabetes Res Clin Pract 2012; 96(2): 135-40.
[] [PMID: 22244365]
Bair MJ, Brizendine EJ, Ackermann RT, Shen C, Kroenke K, Marrero DG. Prevalence of pain and association with quality of life, depression and glycaemic control in patients with diabetes. Diabet Med 2010; 27(5): 578-84.
[] [PMID: 20536955]
Tüzün EH. Quality of life in chronic musculoskeletal pain. Best Pract Res Clin Rheumatol 2007; 21(3): 567-79.
[] [PMID: 17603000]
World Health Organization. The burden of musculoskeletal conditions at the start of the new millenium: report of a WHO scientific group WHO Technical Report Series 2003.
Dueñas M, Ojeda B, Salazar A, Mico JA, Failde I. A review of chronic pain impact on patients, their social environment and the health care system. J Pain Res 2016; 9: 457-67.
[] [PMID: 27418853]
O’Brien EM, Waxenberg LB, Atchison JW, et al. Intraindividual variability in daily sleep and pain ratings among chronic pain patients: bidirectional association and the role of negative mood. Clin J Pain 2011; 27(5): 425-33.
[] [PMID: 21415723]
Fishbain DA, Cole B, Cutler RB, Lewis J, Rosomoff HL, Fosomoff RS. Is pain fatiguing? A structured evidence-based review. Pain Med 2003; 4(1): 51-62.
[] [PMID: 12873278]
Jones J, Rutledge DN, Jones KD, Matallana L, Rooks DS. Self-assessed physical function levels of women with fibromyalgia: a national survey. Womens Health Issues 2008; 18(5): 406-12.
[] [PMID: 18723374]
Amris K, Wæhrens EE, Jespersen A, Bliddal H, Danneskiold-Samsøe B. Observation-based assessment of functional ability in patients with chronic widespread pain: a cross-sectional study. Pain 2011; 152(11): 2470-6.
[] [PMID: 21715094]
Patel AS, Farquharson R, Carroll D, et al. The impact and burden of chronic pain in the workplace: a qualitative systematic review. Pain Pract 2012; 12(7): 578-89.
[] [PMID: 22462774]
Stewart WF, Ricci JA, Chee E, Morganstein D, Lipton R. Lost productive time and cost due to common pain conditions in the US workforce. JAMA 2003; 290(18): 2443-54.
[] [PMID: 14612481]
Krein SL, Heisler M, Piette JD, Makki F, Kerr EA. The effect of chronic pain on diabetes patients’ self-management. Diabetes Care 2005; 28(1): 65-70.
[] [PMID: 15616235]
Pai L-W, Hung C-T, Li S-F, Chen LL, Chung Y, Liu HL. Musculoskeletal pain in people with and without type 2 diabetes in Taiwan: a population-based, retrospective cohort study. BMC Musculoskelet Disord 2015; 16(1): 364.
[] [PMID: 26589716]
van der Zee-Neuen A, Putrik P, Ramiro S, et al. Impact of Chronic Diseases and Multimorbidity on Health and Health Care Costs: The Additional Role of Musculoskeletal Disorders. Arthritis Care Res (Hoboken) 2016; 68(12): 1823-31.
[] [PMID: 27111195]
McBeth J, Nicholl BI, Cordingley L, Davies KA, Macfarlane GJ. Chronic widespread pain predicts physical inactivity: results from the prospective EPIFUND study. Eur J Pain 2010; 14(9): 972-9.
[] [PMID: 20400346]
Al-Homood IA. Rheumatic conditions in patients with diabetes mellitus. Clin Rheumatol 2013; 32(5): 527-33.
[] [PMID: 23247555]
Gore M, Brandenburg NA, Hoffman DL, Tai KS, Stacey B. Burden of illness in painful diabetic peripheral neuropathy: the patients’ perspectives. J Pain 2006; 7(12): 892-900.
[] [PMID: 17157775]
Crispin JC, Alcocer-Varela J. Rheumatologic manifestations of diabetes mellitus. Am J Med 2003; 114(9): 753-7.
[] [PMID: 12829202]
Cagliero E, Apruzzese W, Perlmutter GS, Nathan DM. Musculoskeletal disorders of the hand and shoulder in patients with diabetes mellitus. Am J Med 2002; 112(6): 487-90.
[] [PMID: 11959060]
Scott A, Zwerver J, Grewal N, et al. Lipids, adiposity and tendinopathy: is there a mechanistic link? Critical review. Br J Sports Med 2015; 49(15): 984-8.
[] [PMID: 25488953]
de Groot M, Anderson R, Freedland KE, Clouse RE, Lustman PJ. Association of depression and diabetes complications: a meta-analysis. Psychosom Med 2001; 63(4): 619-30.
[] [PMID: 11485116]
Ludman EJ, Katon W, Russo J, et al. Depression and diabetes symptom burden. Gen Hosp Psychiatry 2004; 26(6): 430-6.
[] [PMID: 15567208]
Huebschmann AG, Crane LA, Belansky ES, Scarbro S, Marshall JA, Regensteiner JG. Fear of injury with physical activity is greater in adults with diabetes than in adults without diabetes. Diabetes Care 2011; 34(8): 1717-22.
[] [PMID: 21700920]
Benbow SJ, Wallymahmed ME, MacFarlane IA. Diabetic peripheral neuropathy and quality of life. QJM 1998; 91(11): 733-7.
[] [PMID: 10024935]
Rodeo SA, Hannafin JA, Tom J, Warren RF, Wickiewicz TL. Immunolocalization of cytokines and their receptors in adhesive capsulitis of the shoulder. J Orthop Res 1997; 15(3): 427-36.
[] [PMID: 9246090]
Bunker TD, Anthony PP. The pathology of frozen shoulder. A Dupuytren-like disease. J Bone Joint Surg Br 1995; 77(5): 677-83.
[] [PMID: 7559688]
Calixto JB, Medeiros R, Fernandes ES, Ferreira J, Cabrini DA, Campos MM. Kinin B1 receptors: key G-protein-coupled receptors and their role in inflammatory and painful processes. Br J Pharmacol 2004; 143(7): 803-18.
[] [PMID: 15520046]
de Oliveira RR, de Lira KD, Silveira PV, et al. Mechanical properties of achilles tendon in rats induced to experimental diabetes. Ann Biomed Eng 2011; 39(5): 1528-34.
[] [PMID: 21225344]
Guney A, Vatansever F, Karaman I, Kafadar IH, Oner M, Turk CY. Biomechanical properties of Achilles tendon in diabetic vs. non-diabetic patients. Exp Clin Endocrinol Diabetes 2015; 123(7): 428-32.
[] [PMID: 25918879]
Abate M, Schiavone C, Pelotti P, Salini V. Limited joint mobility (LJM) in elderly subjects with type II diabetes mellitus. Arch Gerontol Geriatr 2011; 53(2): 135-40.
[] [PMID: 20940076]
Snedeker JG, Gautieri A. The role of collagen crosslinks in ageing and diabetes - the good, the bad, and the ugly. Muscles Ligaments Tendons J 2014; 4(3): 303-8.
[] [PMID: 25489547]
Kiss C, Szilágyi M, Paksy A, Poór G. Risk factors for diffuse idiopathic skeletal hyperostosis: a case-control study. Rheumatology (Oxford) 2002; 41(1): 27-30.
[] [PMID: 11792876]
Van Acker K, Bouhassira D, De Bacquer D, et al. Prevalence and impact on quality of life of peripheral neuropathy with or without neuropathic pain in type 1 and type 2 diabetic patients attending hospital outpatients clinics. Diabetes Metab 2009; 35(3): 206-13.
[] [PMID: 19297223]
Lebiedz-Odrobina D, Kay J. Rheumatic manifestations of diabetes mellitus. Rheum Dis Clin North Am 2010; 36(4): 681-99.
[] [PMID: 21092846]
Zreik NH, Malik RA, Charalambous CP. Adhesive capsulitis of the shoulder and diabetes: a meta-analysis of prevalence. Muscles Ligaments Tendons J 2016; 6(1): 26-34.
[] [PMID: 27331029]
Bridgman JF. Periarthritis of the shoulder and diabetes mellitus. Ann Rheum Dis 1972; 31(1): 69-71.
[] [PMID: 5008469]
Mavrikakis ME, Drimis S, Kontoyannis DA, Rasidakis A, Moulopoulou ES, Kontoyannis S. Calcific shoulder periarthritis (tendinitis) in adult onset diabetes mellitus: a controlled study. Ann Rheum Dis 1989; 48(3): 211-4.
[] [PMID: 2930276]
Balci N, Balci MK, Tüzüner S. Shoulder adhesive capsulitis and shoulder range of motion in type II diabetes mellitus: association with diabetic complications. J Diabetes Complications 1999; 13(3): 135-40.
[] [PMID: 10509873]
Smith LL, Burnet SP, McNeil JD. Musculoskeletal manifestations of diabetes mellitus. Br J Sports Med 2003; 37(1): 30-5.
[] [PMID: 12547740]
Ranger TA, Wong AMY, Cook JL, Gaida JE. Is there an association between tendinopathy and diabetes mellitus? A systematic review with meta-analysis. Br J Sports Med 2016; 50(16): 982-9.
[] [PMID: 26598716]
Akturk M, Karaahmetoglu S, Kacar M, Muftuoglu O. Thickness of the supraspinatus and biceps tendons in diabetic patients. Diabetes Care 2002; 25(2): 408.
[] [PMID: 11815529]
Akturk M, Ozdemir A, Maral I, Yetkin I, Arslan M. Evaluation of Achilles tendon thickening in type 2 diabetes mellitus. Exp Clin Endocrinol Diabetes 2007; 115(2): 92-6.
[] [PMID: 17318767]
Marie I, Delafenêtre H, Massy N, Thuillez C, Noblet C. Tendinous disorders attributed to statins: a study on ninety-six spontaneous reports in the period 1990-2005 and review of the literature. Arthritis Rheum 2008; 59(3): 367-72.
[] [PMID: 18311771]
Franceschi F, Papalia R, Paciotti M, et al. Obesity as a risk factor for tendinopathy: a systematic review. Int J Endocrinol 2014; 2014670262
[] [PMID: 25214839]
Zakaria MH, Davis WA, Davis TM. Incidence and predictors of hospitalization for tendon rupture in type 2 diabetes: the Fremantle diabetes study. Diabet Med 2014; 31(4): 425-30.
[] [PMID: 24151882]
Sencan D, Elden H, Nacitarhan V, Sencan M, Kaptanoglu E. The prevalence of diffuse idiopathic skeletal hyperostosis in patients with diabetes mellitus. Rheumatol Int 2005; 25(7): 518-21.
[] [PMID: 16167164]
Belanger TA, Rowe DE. Diffuse idiopathic skeletal hyperostosis: musculoskeletal manifestations. J Am Acad Orthop Surg 2001; 9(4): 258-67.
[] [PMID: 11476536]
Cammisa M, De Serio A, Guglielmi G. Diffuse idiopathic skeletal hyperostosis. Eur J Radiol 1998; 27(Suppl. 1): S7-S11.
[] [PMID: 9652495]
Mustafa KN, Khader YS, Bsoul AK, Ajlouni K. Musculoskeletal disorders of the hand in type 2 diabetes mellitus: prevalence and its associated factors. Int J Rheum Dis 2016; 19(7): 730-5.
[] [PMID: 26259148]
Ravindran Rajendran S, Bhansali A, Walia R, Dutta P, Bansal V, Shanmugasundar G. Prevalence and pattern of hand soft-tissue changes in type 2 diabetes mellitus. Diabetes Metab 2011; 37(4): 312-7.
[] [PMID: 21917496]
Arkkila PE, Gautier J-F. Musculoskeletal disorders in diabetes mellitus: an update. Best Pract Res Clin Rheumatol 2003; 17(6): 945-70.
[] [PMID: 15123045]
Noble J, Heathcote JG, Cohen H. Diabetes mellitus in the aetiology of Dupuytren’s disease. J Bone Joint Surg Br 1984; 66(3): 322-5.
[] [PMID: 6725338]
Kameyama M, Meguro S, Funae O, Atsumi Y, Ikegami H. The presence of limited joint mobility is significantly associated with multiple digit involvement by stenosing flexor tenosynovitis in diabetics. J Rheumatol 2009; 36(8): 1686-90.
[] [PMID: 19531745]
Wyatt LH, Ferrance RJ. The musculoskeletal effects of diabetes mellitus. J Can Chiropr Assoc 2006; 50(1): 43-50.
[PMID: 17549168]
Pal B, Anderson J, Dick WC, Griffiths ID. Limitation of joint mobility and shoulder capsulitis in insulin- and non-insulin-dependent diabetes mellitus. Br J Rheumatol 1986; 25(2): 147-51.
[] [PMID: 3708230]
Gerrits EG, Landman GW, Nijenhuis-Rosien L, Bilo HJ. Limited joint mobility syndrome in diabetes mellitus: A minireview. World J Diabetes 2015; 6(9): 1108-12.
[] [PMID: 26265997]
Mäntyselkä P, Miettola J, Niskanen L, Kumpusalo E. Persistent pain at multiple sites--connection to glucose derangement. Diabetes Res Clin Pract 2009; 84(2): e30-2.
[] [PMID: 19250695]
Tishler M, Smorodin T, Vazina-Amit M, Ramot Y, Koffler M, Fishel B. Fibromyalgia in diabetes mellitus. Rheumatol Int 2003; 23(4): 171-3.
[] [PMID: 12756495]
Hoy D, Bain C, Williams G, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum 2012; 64(6): 2028-37.
[] [PMID: 22231424]
Dario A, Ferreira M, Refshauge K, et al. Mapping the association between back pain and type 2 diabetes: A cross-sectional and longitudinal study of adult Spanish twins. PLoS One 2017; 12(4)e0174757
[] [PMID: 28369107]
Heuch I, Heuch I, Hagen K, Sørgjerd EP, Åsvold BO, Zwart JA. Is chronic low back pain a risk factor for diabetes? The Nord-Trøndelag Health Study. BMJ Open Diabetes Res Care 2018; 6(1)e000569
[] [PMID: 30397493]
Courties A, Sellam J. Osteoarthritis and type 2 diabetes mellitus: What are the links? Diabetes Res Clin Pract 2016; 122: 198-206.
[] [PMID: 27889689]
Williams MF, London DA, Husni EM, Navaneethan S, Kashyap SR. Type 2 diabetes and osteoarthritis: a systematic review and meta-analysis. J Diabetes Complications 2016; 30(5): 944-50.
[] [PMID: 27114387]
Louati K, Vidal C, Berenbaum F, Sellam J. Association between diabetes mellitus and osteoarthritis: systematic literature review and meta-analysis. RMD Open 2015; 1(1) e000077
[] [PMID: 26535137]
Davies M, Brophy S, Williams R, Taylor A. The prevalence, severity, and impact of painful diabetic peripheral neuropathy in type 2 diabetes. Diabetes Care 2006; 29(7): 1518-22.
[] [PMID: 16801572]
Kirwan JP, Sacks J, Nieuwoudt S. The essential role of exercise in the management of type 2 diabetes. Cleve Clin J Med 2017; 84(7)(Suppl. 1): S15-21.
[] [PMID: 28708479]
Colberg SR, Sigal RJ, Fernhall B, et al. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care 2010; 33(12): e147-67.
[] [PMID: 21115758]
Thomas DE, Elliott EJ, Naughton GA. Exercise for type 2 diabetes mellitus. Cochrane Database Syst Rev 2006; (3): CD002968
[PMID: 16855995 ]
Boulé NG, Haddad E, Kenny GP, Wells GA, Sigal RJ. Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: a meta-analysis of controlled clinical trials. JAMA 2001; 286(10): 1218-27.
[] [PMID: 11559268]
Boulé NG, Kenny GP, Haddad E, Wells GA, Sigal RJ. Meta-analysis of the effect of structured exercise training on cardiorespiratory fitness in Type 2 diabetes mellitus. Diabetologia 2003; 46(8): 1071-81.
[] [PMID: 12856082]
Balducci S, Iacobellis G, Parisi L, et al. Exercise training can modify the natural history of diabetic peripheral neuropathy. J Diabetes Complications 2006; 20(4): 216-23.
[] [PMID: 16798472]
Zoppini G, Targher G, Zamboni C, et al. Effects of moderate-intensity exercise training on plasma biomarkers of inflammation and endothelial dysfunction in older patients with type 2 diabetes. Nutr Metab Cardiovasc Dis 2006; 16(8): 543-9.
[] [PMID: 17126770]
Loimaala A, Huikuri HV, Kööbi T, Rinne M, Nenonen A, Vuori I. Exercise training improves baroreflex sensitivity in type 2 diabetes. Diabetes 2003; 52(7): 1837-42.
[] [PMID: 12829654]
Finelli C, Tarantino G. Have guidelines addressing physical activity been established in nonalcoholic fatty liver disease? World J Gastroenterol 2012; 18(46): 6790-800.
[] [PMID: 23239917]
Kluding PM, Pasnoor M, Singh R, et al. The effect of exercise on neuropathic symptoms, nerve function, and cutaneous innervation in people with diabetic peripheral neuropathy. J Diabetes Complications 2012; 26(5): 424-9.
[] [PMID: 22717465]
Yoo M, D’Silva LJ, Martin K, et al. Pilot study of exercise therapy on painful diabetic peripheral neuropathy. Pain Med 2015; 16(8): 1482-9.
[] [PMID: 25800666]
Balducci S, Vulpiani MC, Pugliese L, et al. Effect of supervised exercise training on musculoskeletal symptoms and function in patients with type 2 diabetes: the Italian Diabetes Exercise Study (IDES). Acta Diabetol 2014; 51(4): 647-54.
[] [PMID: 24566991]
Ambrose KR, Golightly YM. Physical exercise as non-pharmacological treatment of chronic pain: Why and when. Best Pract Res Clin Rheumatol 2015; 29(1): 120-30.
[] [PMID: 26267006]
Geneen LJ, Moore RA, Clarke C, et al. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database Syst Rev 2017; (4): CD011279
Naugle KM, Riley JL III. Self-reported physical activity predicts pain inhibitory and facilitatory function. Med Sci Sports Exerc 2014; 46(3): 622-9.
[] [PMID: 23899890]
Naugle KM, Ohlman T, Naugle KE, Riley ZA, Keith NR. Physical activity behavior predicts endogenous pain modulation in older adults. Pain 2017; 158(3): 383-90.
[] [PMID: 28187102]
Häuser W, Klose P, Langhorst J, et al. Efficacy of different types of aerobic exercise in fibromyalgia syndrome: a systematic review and meta-analysis of randomised controlled trials. Arthritis Res Ther 2010; 12(3): R79.
[] [PMID: 20459730]
Jones KD, Adams D, Winters-Stone K, Burckhardt CS. A comprehensive review of 46 exercise treatment studies in fibromyalgia (1988-2005). Health Qual Life Outcomes 2006; 4: 67.
[] [PMID: 16999856]
Busch AJ, Barber KAR, Overend TJ, Peloso PMJ, Schachter CL. Exercise for treating fibromyalgia syndrome. Cochrane Database Syst Rev 2007; (4): CD003786
[PMID: 17943797]
Gu Y, Dennis SM, Kiernan MC, Harmer AR. Aerobic exercise training may improve nerve function in type 2 diabetes and pre-diabetes: A systematic review. Diabetes Metab Res Rev 2019; 35(2) e3099
[PMID: 30462877]
Pescatello LS, Arena R, Riebe D, Thompson PD. ACSM’s guidelines for exercise testing and prescription. In: Medicine ACoS 456. 2014.
Brown WJ, Bauman AE, Bull FC, Burton NW. Development of evidence-based physical activity recommendations for adults (18- 64 years): report prepared for the Australian Government Department of Health. Report No: 1741860695 2013.
Messier SP, Gutekunst DJ, Davis C, DeVita P. Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis Rheum 2005; 52(7): 2026-32.
[] [PMID: 15986358]
Baillet A, Vaillant M, Guinot M, Juvin R, Gaudin P. Efficacy of resistance exercises in rheumatoid arthritis: meta-analysis of randomized controlled trials. Rheumatology (Oxford) 2012; 51(3): 519-27.
[] [PMID: 22120463]
Gavi MB, Vassalo DV, Amaral FT, et al. Strengthening exercises improve symptoms and quality of life but do not change autonomic modulation in fibromyalgia: a randomized clinical trial. PLoS One 2014; 9(3) e90767
[] [PMID: 24651512]
Busch AJ, Webber SC, Richards RS, et al. Resistance exercise training for fibromyalgia. Cochrane Database Syst Rev 2013; (12): CD010884
[PMID: 24362925]
Jones KD, Sherman CA, Mist SD, Carson JW, Bennett RM, Li F. A randomized controlled trial of 8-form Tai chi improves symptoms and functional mobility in fibromyalgia patients. Clin Rheumatol 2012; 31(8): 1205-14.
[] [PMID: 22581278]
Wang C. Role of Tai Chi in the treatment of rheumatologic diseases. Curr Rheumatol Rep 2012; 14(6): 598-603.
[] [PMID: 23055009]
Tul Y, Unruh A, Dick BD. Yoga for chronic pain management: a qualitative exploration. Scand J Caring Sci 2011; 25(3): 435-43.
[] [PMID: 21058970]
Johansen MY, MacDonald CS, Hansen KB, et al. Effect of an Intensive Lifestyle Intervention on Glycemic Control in Patients With Type 2 Diabetes: A Randomized Clinical Trial. JAMA 2017; 318(7): 637-46.
[] [PMID: 28810024]
Balducci S, Zanuso S, Nicolucci A, et al. Effect of an intensive exercise intervention strategy on modifiable cardiovascular risk factors in subjects with type 2 diabetes mellitus: a randomized controlled trial: the Italian Diabetes and Exercise Study (IDES). Arch Intern Med 2010; 170(20): 1794-803.
[] [PMID: 21059972]
Praet SF, Jonkers RA, Schep G, et al. Long-standing, insulin-treated type 2 diabetes patients with complications respond well to short-term resistance and interval exercise training. Eur J Endocrinol 2008; 158(2): 163-72.
[] [PMID: 18230822]
Fatone C, Guescini M, Balducci S, et al. Two weekly sessions of combined aerobic and resistance exercise are sufficient to provide beneficial effects in subjects with Type 2 diabetes mellitus and metabolic syndrome. J Endocrinol Invest 2010; 33(7): 489-95.
[] [PMID: 20142634]
Lambers S, Van Laethem C, Van Acker K, Calders P. Influence of combined exercise training on indices of obesity, diabetes and cardiovascular risk in type 2 diabetes patients. Clin Rehabil 2008; 22(6): 483-92.
[] [PMID: 18511528]
Lee SF, Pei D, Chi MJ, Jeng C. An investigation and comparison of the effectiveness of different exercise programmes in improving glucose metabolism and pancreatic β cell function of type 2 diabetes patients. Int J Clin Pract 2015; 69(10): 1159-70.
[] [PMID: 26119968]
Madsen SM, Thorup AC, Overgaard K, Jeppesen PB. High Intensity Interval Training Improves Glycaemic Control and Pancreatic β Cell Function of Type 2 Diabetes Patients. PLoS One 2015; 10(8) e0133286
[] [PMID: 26258597]
Riva JJ, Wong JJ, Brunarski DJ, et al. Consideration of chronic pain in trials to promote physical activity for diabetes: a systematic review of randomized controlled trials. PLoS One 2013; 8(8) e71021
[] [PMID: 23940683]

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Year: 2020
Published on: 20 March, 2020
Page: [211 - 219]
Pages: 9
DOI: 10.2174/1573399815666190531083504
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