3.2. Physiotherapy management of physical impairments and associated complications with diabetes mellitus

#### 3.2.1. Both aerobic and resistance exercises help to improve metabolic control

Clinical trials have provided strong evidence that a combination of both aerobic and resistance exercise has a significant effect in glycemic control than either aerobic exercise only or resistance exercise only [27, 37]. These two studies added that both aerobic exercise and resistance training have better outcomes in glycemic control than advice through phone call and maintaining present life style. Progressive resistance training was also found to be helpful in improving glycemic control [38, 39].

A RCT comparing aerobic exercise and resistance training found that both exercises have similar effects in reducing HbA1c. However, there is a chance of potential increase in lateonset hypoglycemia risk after aerobic exercise [40]. It is also been found that physical activities using Physio ball among type 2 diabetes has also its own result in improving glycemic control and blood pressure [41].

Generally, the major benefits of resistance training in individuals with diabetes are:

#### 1. improved blood cholesterol profiles,


#### 3.2.2. Both aerobic and resistance training helps to improve muscular strength

An evidence done on the comparison of muscle strength and short-term endurance in the different periods of type 2 diabetes suggested that patients suffering from diabetes mellitus have less muscular strength than people without type 2 DM [42]. This further leads to reduced physical activity unless it is properly managed. However, physical activities in form of aerobic/ resistance or combination of both resulted in increase in strength in persons with diabetes mellitus.
