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Physiological effects of exercise in the diabetic.

Physical therapists frequently assess and treat patients with diabetes mellitus. Because exercise is often a component of the prescribed program, the physical therapist should have some understanding of the possible responses a diabetic may have to exercise. Diabetics can benefit from exercise and training, but exercise can have deleterious effects in some instances. This paper provides a review of the literature on the physiological effects of exercise and training in the diabetic. Effects of exercise and training on the cardiovascular and muscular systems are reviewed, and the role of insulin in regulating the production, mobilization, and utilization of energy substrates during exercise is examined. Additionally, this paper provides suggestions on the clinical relevance of the physiological findings in planning exercise programs and education for the diabetic patient.