Table 6 Major DM complications with clinical manifestations and exercise recommendations (adapted from the American Diabetes Association [7], Sigal et al. [40], Vinik et al. [45], and Wilmore and Costil [51])
From: Regular physical exercise in patients with type II diabetes mellitus
 | Clinical manifestations | Exercise recommendation |
|---|---|---|
Peripheral neuropathy | Numbness, tingling, coldness, burning pain, hypersensitivity to touch | Non-weight-bearing exercise such as swimming, bicycling |
Autonomic neuropathy | Incomplete bladder emptying, stomach and bowel problems, orthostatic hypotension, sweating | Exercise stress test is necessary before starting an exercise program. |
Diabetic retinopathy | Scar tissue in the retina | Contraindication in vigorous aerobic and resistance exercise |
Cardiovascular disease | Occurrence of chest pain | Exercise stress test |
Hypertension | Blood pressure higher than 140/90Â mmHg | Breathing technique during resistance exercise should be trained |
Dyslipidemia | Increased plasma levels of VLDL and TG, decreased plasma level of HDL | Low intensity and prolonged exercise |