Exercise training can modify the natural history of diabetic peripheral neuropathy

Do diabetic neuropathy patients benefit from balance training?

“…These findings support the idea that balance training can improve the balance ability of neuropathic diabetic patients. Previous studies have also emphasized the positive effects of balance training exercises on stability and body stability [16,[19][20][21][22][23][24]. The effect of vibration and passive sensory cues on improving balance abilities among diabetic patients also have been reported [16][17][18].…”

“…Aerobic exercise is also effective in reducing the risk or severity of peripheral neuropathy in patients [19]. Exercise therapy, including balance exercises, leads to increased oxygen pressure in the lower limbs, skin, and chests of diabetic patients, improving skin blood flow [20].…”

How to prevent the microvascular complications of type 2 diabetes beyond glucose control

“…165 A small subsequent study randomized 78 patients without baseline PDN to a supervised aerobic exercise intervention group (brisk walking) or control. 167 After four years of specialized testing (vibration perception threshold, nerve distal latency, nerve conduction velocity, nerve action potential amplitude), results favored the exercise group, as much greater percentages of patients in the control group developed motor neuropathy (0% v 17%; P<0.05) and sensory neuropathy (6.45% v 29.8%; P<0.05). The authors acknowledged several limitations related to confounders (glycemic control, among others), although their results highlighted the effect of exercise training in the natural history of PDN.…”

Prescribing Exercise for Individuals with Type 2 Diabetes: Recommendations and Precautions

“…105,106 Mild-to-moderate exercise may help prevent the onset of peripheral neuropathy. 3 Individuals without acute foot ulcers can undertake moderate weightbearing exercise using proper footwear, including appropriate socks and shoes, although a foot injury, open sore, or ulcer requires non-weightbearing physical activity. Daily inspection of the feet can prevent or detect sores or ulcers early.…”

“…13 Moreover, large cohort studies have shown that higher levels of aerobic fi tness and/or aerobic physical activity are associated with 40% to 70% reductions in risk of subsequent cardiovascular (CV) morbidity and mortality. [14][15][16][17] Many types of physical movement positively impact physical fi tness, morbidity, and mortality in individuals with type 2 diabetes, [3][4][5][6][7][8] and although exercise has long been considered a cornerstone of diabetes management, many physicians fail to prescribe it. The purpose of this article, therefore, is to highlight the recommended types and quantities of physical activities that can and should be undertaken by individuals with type 2 diabetes, along with precautions related to medication use and diabetes-related health complications.…”