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Evidence-based risk assessment and recommendations for physical activity clearance: diabetes mellitus and related comorbidities (1) (1) This paper is one of a selection of papers published in this Special Issue, entitled Evidence-based risk assessment and recommendations for physical activity clearance, and has undergone the Journal's usual peer review process.
MedLine Citation:
PMID:  21800941     Owner:  NLM     Status:  In-Data-Review    
Physical activity (PA) is one of the most powerful treatment options for persons with prediabetes or diabetes. However, some elevation in risk occurs with increased PA, at least initially, and certain precautions need to be made to lower these risks, particularly if these persons are unaccustomed to exercise. We conducted a standardized search of all adverse events associated with increased PA in persons with prediabetes or diabetes (type 1 or type 2) and provided evidence-based guidelines on PA screening in these apparently high-risk individuals. A systematic literature review was performed of all studies reporting on adverse events in persons with prediabetes or diabetes. Studies included were from all designs (retrospective and prospective including randomized controlled trials) and were assessed according to evaluation criteria adapted by a consensus panel. A total of 47 studies, involving >8000 individuals, were deemed eligible. A number of these studies identified a range of mild to severe acute risks with exercise (musculoskeletal injury, hypoglycemia, foot ulceration, proliferative retinopathy, hypotension, sudden death) but the overall prevalence was low. Based on several randomized controlled trials and prospective studies in which prescribed exercise was performed at a wide range of intensities, it appears that increased PA is a relatively safe procedure with no evidence of a loss of life. Based on our assessment of the available literature, we provide a new PA risk algorithm for persons with prediabetes and diabetes and comment on the role of the patient, the qualified exercise professional, and the patient's physician in the risk screening process.
Michael C Riddell; Jamie Burr
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Applied physiology, nutrition, and metabolism = Physiologie appliquée, nutrition et métabolisme     Volume:  36 Suppl 1     ISSN:  1715-5312     ISO Abbreviation:  Appl Physiol Nutr Metab     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-08-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101264333     Medline TA:  Appl Physiol Nutr Metab     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  S154-89     Citation Subset:  IM    
School of Kinesiology and Health Science, Muscle Health Research Centre, Physical Activity and Chronic Disease Unit, York University, 4700 Keele Street, Toronto, ON M3J 1P3, Canada.
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