Overview of Exercise Prescription for Diabetes Patients and Its Application in Japan

In recent years, the Westernization of dietary habits and increasingly sedentary lifestyle have contributed to a marked increase in the number of type 2 diabetes patients. Sedentary behavior may play a significant role in the development and aggravation of type 2 diabetes. The results of various follow-up studies have demonstrated that proper diet combined with physical exercise is useful in the prevention and treatment of type 2 diabetes. A nationwide survey regarding exercise therapy for diabetes patients in Japan revealed that relatively few physicians provide patients with exercise guidance because of time constraints, that the physicians do not receive additional consultation fee, and that there is a lack of specialized physical exercise educators. Physical exercise promotes the utilization of glucose and free fatty acids in the muscles, and thus lowers blood glucose (BG) levels. Dietary restriction and physical exercise are effective in the prevention and treatment of type 2 diabetes by improving the in vivo sensitivity to insulin. Most adults with diabetes should engage in 150 min or more of moderate-to-vigorous intensity aerobic activity per week, spread out over at least 3 days/week, with no more than two consecutive days without activity. Mild-intensity resistance training such as half squat and calf raise is recommended for elderly individuals who have decreased muscle strength and mass (sarcopenia). Prolonged sitting should be interrupted every 30 min for BG benefits, particularly in adults with type 2 diabetes. Individuals with type 2 diabetes are also encouraged to increase their total daily unstructured physical activity (daily movement).