PURPOSE: This review has evaluated the effectiveness of physical activity in the treatment and prevention of type 2 diabetes mellitus (DM). METHODS: The available literature was reviewed through a computerized search (Medline, 1966 to 2000) to classify studies examining the influence of physical activity on the treatment and prevention of type 2 DM. Additional studies were reviewed through ancestral searches from their bibliographies. RESULTS: It is not possible at the present time to discern from the available literature whether a dose-response relationship exists between exercise volume or intensity and improvements in glucose control in type 2 DM. Large-scale, prospective studies indicate that higher levels of physical activity are clearly associated with a lower incidence of type 2 DM. However, no randomized controlled trials have been conducted to address the dose-response effect of exercise or physical activity on diabetes treatment or prevention. CONCLUSION: It is uncertain whether there is a dose-response effect of exercise on improved glucose control in type 2 DM. There does appear to be, however, a limited amount of evidence suggesting that increasing levels of physical activity contribute to better diabetes prevention. Clearly, additional studies are needed to determine the influence of physical activity on the treatment and prevention of type 2 DM.

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