Exercise interventions in polypathological aging patients that coexist with diabetes mellitus: improving functional status and quality of life
Open accessAbstract
In elderly populations, diabetes is associated with reduced muscle strength, poor muscle quality, and accelerated loss of muscle mass. In addition, diabetes mellitus increases risk for accelerated aging and for the development of frailty syndrome. This disease is also associated with a polypathological condition, and its complications progressively affect quality of life and survival. Exercise interventions, including resistance training, represent the cornerstones of diabetes management, especially in patients at severe functional decline. This review manuscript aimed to describe the beneficial effects of different exercise interventions on the functional capacity of elderly diabetics, including those at polypathological condition. The SciELO, Science Citation Index, MEDLINE, Scopus, SPORTDiscus, and ScienceDirect databases were searched from 1980 to 2015 for articles published from original scientific investigations. In addition to the beneficial effects of exercise interventions on glycemic control, and on the cardiovascular risk factors associated with diabetes, physical exercise is an effective intervention to improve muscle strength, power output, and aerobic power and functional capacity in elderly diabetic patients. Thus, a combination of resistance and endurance training is the most effective exercise intervention to promote overall physical fitness in these patients. In addition, in diabetic patients with frailty and severe functional decline, a multicomponent exercise program including strength and power training, balance exercises, and gait retraining may be an effective intervention to reduce falls and improve functional capacity and quality of life in these patients.
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PA and exercise improve muscle function, mental health, and quality of life.
“Substantial evidence supports PA and exercise as preventive and therapeutic measures for CVD, T2D, and obesity; these activities improve muscle function, mental health, and quality of life and reduce mortality [107,108].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [108]
PA and exercise are preventive and therapeutic measures for CVD, T2D, and obesity.
“Substantial evidence supports PA and exercise as preventive and therapeutic measures for CVD, T2D, and obesity; these activities improve muscle function, mental health, and quality of life and reduce mortality [107,108].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [108]
PA and exercise reduce mortality.
“Substantial evidence supports PA and exercise as preventive and therapeutic measures for CVD, T2D, and obesity; these activities improve muscle function, mental health, and quality of life and reduce mortality [107,108].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [108]
Higher exercise frequencies may benefit clinical populations such as diabetes patients by helping manage glucose levels.
“However, higher frequencies may benefit clinical populations like diabetes patients [108,191,192], in whom more frequent exercise may help better manage glucose levels, or those with depression who benefit psychologically from higher doses of exercise [193].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [108]
PRT is safe for older adults, including those who are frail or have multiple chronic conditions.
“Despite the proven safety of PRT for older adults [108,285,287], including those who are frail [288,289], or have multiple chronic conditions [108], clinicians often hesitate to prescribe this exercise modality [108,285,[287], [288], [289]].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [108]
Loss of visceral fat through resistance or aerobic training improves insulin resistance and complements dietary and pharmacological management in older adults with T2D and central obesity.
“Loss of visceral fat through resistance or aerobic training improves insulin resistance and complements dietary and pharmacological management in older adults with T2D and central obesity [108].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [108]
Clinical management of obese individuals with T2D is often complicated by multiple comorbid conditions, such as cognitive impairment, osteoarthritis, ischemic heart disease, peripheral vascular disease, renal failure, peripheral neuropathy, and hypertension, which may impede adherence to dietary and aerobic exercise recommendations.
“the clinical management of obese individuals with T2D is often complicated by multiple comorbid conditions, such as cognitive impairment, osteoarthritis, ischemic heart disease, peripheral vascular disease, renal failure, peripheral neuropathy, and hypertension, which may impede adherence to dietary and aerobic exercise recommendations [108].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [108]
Substantial evidence supports PA and exercise as preventive and therapeutic measures for CVD, T2D, and obesity; these activities improve muscle function, mental health, and quality of life and reduce mortality.
“Substantial evidence supports PA and exercise as preventive and therapeutic measures for CVD, T2D, and obesity; these activities improve muscle function, mental health, and quality of life and reduce mortality [107,108].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [108]
Higher frequencies of exercise may benefit clinical populations like diabetes patients, in whom more frequent exercise may help better manage glucose levels, or those with depression who benefit psychologically from higher doses of exercise.
“However, higher frequencies may benefit clinical populations like diabetes patients [108,191,192], in whom more frequent exercise may help better manage glucose levels, or those with depression who benefit psychologically from higher doses of exercise [193].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [108]
Despite proven safety of PRT for older adults, including those who are frail or have multiple chronic conditions, clinicians often hesitate to prescribe this exercise modality.
“Despite the proven safety of PRT for older adults [108,285,287], including those who are frail [288,289], or have multiple chronic conditions [108], clinicians often hesitate to prescribe this exercise modality [108,285,[287], [288], [289]].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [108]
The clinical management of obese individuals with T2D is often complicated by multiple comorbid conditions, such as cognitive impairment, osteoarthritis, ischemic heart disease, peripheral vascular disease, renal failure, peripheral neuropathy, and hypertension, which may impede adherence to dietary and aerobic exercise recommendations.
“the clinical management of obese individuals with T2D is often complicated by multiple comorbid conditions, such as cognitive impairment, osteoarthritis, ischemic heart disease, peripheral vascular disease, renal failure, peripheral neuropathy, and hypertension, which may impede adherence to dietary and aerobic exercise recommendations [108].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [108]
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- Authors
- Cadore, E. L., & Izquierdo, M.
- Affiliations
- Universidade Federal do Rio Grande do Sul (BR)
- ORCID
- Cadore, Eduardo Lusa
- Venue
- AGE
- Published
- 2015-06
- Volume
- 37
- Issue
- 3
- Pages
- 64-64
- ISSN
- 0161-9152 (ISSN-L)
- 1574-4647
- PMC
- PMC4493714
- OpenAlex
- W1885543022
- Cited by
- 93
- References
- 72
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 13 · 2023: 11 · 2022: 7 · 2021: 8 · 2020: 13 · 2019: 6 · 2018: 12 · 2017: 7 · 2016: 8 · 2015: 1
- FWCI
- 1.14
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- AGE (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- European Commission
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Keywords
- exercise intervention, diabetes mellitus, older adults, resistance training, endurance training, frailty, functional capacity, quality of life, muscle strength, glycemic control, falls, balance training, gait retraining, multicomponent exercise
- MeSH terms
- Cardiac Rehabilitation, Aging, Cardiovascular Diseases, Diabetes Mellitus, Exercise Therapy, Humans, Physical Endurance, Quality of Life, Resistance Training
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