Exercise and Diabetes-Related Cardiovascular Disease: Systematic Review of Published Evidence from Observational Studies and Clinical Trials

Abstract

The cost of treating cardiovascular disease (CVD) and diabetes is enormous and is set to rise in the coming years. Physical inactivity and sedentary behaviors are major risk factors for these diseases and are estimated to account for several million global deaths annually. Lifestyle interventions, particularly those aimed at enhancing physical activity levels, have a substantial favorable impact on diabetes progression in people at high risk of the disease. Although observational studies and small intervention studies suggest that physical activity might also prevent CVD in people with diabetes, this is not supported by the results of larger randomized controlled trials of lifestyle intervention. The purpose of this review is to provide an overview of the published studies focused on the role of physical activity in CVD prevention in persons with diabetes, and to discuss the implications of these studies' findings. Our review identified almost 100 studies published in the past decade relevant to this topic.

SGLT2 inhibitors: their potential reduction in blood pressure

“…While exercise and lifestyle choices are the best preventative measures for the conditions(65,66), the SGLT2 inhibitors hold promise as effective treatment for both data suggests that the inhibitors are moderately effective at reducing blood pressure, and trials are underway to see if these drugs' antidiabetic and antihypertensive properties translate into cardiovascular benefit. At the same time, the SGLT2 inhibitors elucidate the link between the metabolic, pathologic, and hemodynamic derangements of diabetes.Continued research into mechanisms underlying this drug class's antihypertensive effect could provide insight into the pathophysiology of diabetic nephropathy and diabetes-related hypertension as well as suggest new drug targets for all these conditions.…”

The Role of Lifestyle Change for Prevention of Cardiovascular Disease in Diabetes

“…A recent review of exercise and diabetes-related CVD identified nearly 100 published studies from the last decade, concluding that it is unclear why lifestyle intervention in people with diabetes reduces established CVD risk factor levels but have no obvious effect on CVD event rates [38]. However, healthy lifestyle behaviors may positively impact CVD event rates by reducing glucose toxicity, something glucose-lowering drugs do not achieve [38]. Exercise training ameliorates adverse vascular changes including endothelial dysfunction and arterial remodeling and stiffness, changes that are typically present during diabetes.…”

“…It improves the redox state through the absolute increase in nitric oxide concentrations, making nitric oxide bioavailable for the reduction of oxidative compounds found in cardiometabolic diseases [39,40]. Interestingly, the legacy effect of exercise (protective effect even after exercise is stopped) observed in the prevention of diabetes is not apparent in the prevention of CVD events [38].…”

"Diabetes Associated Genes from the Dark Matter of the Human Proteome"

“…[45][46][47] Hence, it was of interest to investigate the relationship of the diabetes ORFs with other diseases. The diabetes ORFs from the GAD were analyzed using the MeSH and the broad terms filters.…”