Effects of Core Strengthening Exercises With Diapgragmatic Breathing Versus Core Strengthening Exercises With Pilate Breathing in Diabetes Type II Patients

Diabetes type II is an expanding global problem linked to several factors such as obesity, unhealthy diet, and physical inactivity. The two most common causes are impaired insulin secretion or insulin resistance. Diabetes type II is a major health burden for the elderly population, affecting approximately 25% of individuals over the age of 65 years. Recently, increased attention has been paid to the loss of muscle power and sarcopenia in individuals with type II diabetes, as these conditions compromise both physical and psychological health, significantly affecting overall quality of life. Diabetes type II is a heterogeneous disorder affecting multiple organs. The alveolar capillary network, a large microvascular unit in the lungs, may be associated with the condition. Functional capacity is a strong predictor of survival in many diseases, including diabetes type II. Patients are more likely to experience functional impairments due to poor glycemic control and associated complications. Symptoms such as inadequate metabolic control, episodes of hypoglycemia, fear of hypoglycemia, and changes in lifestyle collectively lead to poor health-related quality of life, with reductions in functional performance. Activities of daily living and overall quality of life are often most affected by vascular complications in diabetes type II. Reduced lung function and impaired gas transfer are also linked to the disease. Chronic hyperglycemia causes the production of reactive oxygen species due to a process known as non-protein enzymatic glycation. Advanced glycation and continuous oxidative stress trigger a chronic inflammatory response. Additionally, there is a considerable decrease in glucose uptake in the skeletal muscles of patients with diabetes type II. Due to impaired insulin production and utilization, patients experience a constant state of elevated blood sugar levels that can lead to severe short-term and long-term consequences. Diabetes type II, therefore, represents a complex disorder characterized by defects in insulin production and utilization. Research also indicates that diets containing high sugar content, refined foods, and high-calorie foods significantly increase the risk of developing diabetes type II.

This study aims to explore the combined effects of treatment regimens on pulmonary function, functional capacity, random blood sugar levels, and quality of life. The investigation seeks to provide a deeper understanding of the effects of these interventions on various health variables.

Inclusion criteria

• Medically diagnosed patients with Type II diabetes confirmed by a medical specialist, general practitioner, or endocrinologist from FFH or private hospital settings in Rawalpindi and Islamabad.
• Age between 30 and 55 years.
• Both male and female patients.
• Willingness to participate in the exercise program and ability to provide informed consent.
• On a stable regimen of anti-diabetic medications for at least three months prior to the study.

Exclusion criteria

• Patients with Type I diabetes, diabetes insipidus, or gestational diabetes.
• Diagnosed chronic respiratory diseases such as COPD or asthma unrelated to diabetes.
• History of any abdominal, orthopedic, or spinal surgery that could interfere with balance.
• Uncontrolled cardiovascular conditions such as arrhythmias or recent myocardial infarction.
• Morbid obesity (BMI > 40).
• Pregnant women.