the Effect of Aerobic Training on Insulin Sensitivity on Diabetic Patients During Tobacco Cessation

Prevalence of smoking in men and women ages 15 and over who currently smoke any tobacco product on a daily or non-daily basis Egypt smoking rate for 2018 was 21.40%, a 0.1% increase from 2016.According to WHO reports, smoking is currently responsible for six million premature deaths every year, of which 600 000 individuals die from the effects of second-hand smoke.Egypt is one of the 21 countries and territories of the International Diabetes Federation Middle East and North Africa (MENA) region. 463 million people have diabetes in the world and 55 million people in the MENA Region; by 2045 this will rise to 108 million.The most profound impact of smoking in diabetic patients is on insulin sensitivity, Cigarette smoking worsens insulin-resistance in patients with diabetes, as smoking decreases subcutaneous absorption of insulin, resulting in increased dosing requirements. When the action of insulin is impaired chronically in smokers, a dose response relationship can be seen between the number of cigarettes smoked and the degree of insulin resistance. Consequently, quitting smoking should improve glycemic control.Therefore diabetic patients can get huge benefits from tobacco cessation as they give their bodies chance to decrease percentage of nicotine and increase percentage of insulin so decrease risk of getting atherosclerosis, so smoking cessation improve glycemic control and insulin sensitivity.

Inclusion Criteria:According to the following:All patients will be male.Their age between 40-50 years oldTheir BMI 18.5-29.9 kg/m2They are diagnosed as type II diabetes for more than 5 yearsTheir HbA1c value from > 6.5%Smokers for more than10-15 yearsTheir smoking index will be moderate and heavyAll patients are under full medical supervisionAll patients will quit smoking 1-7 days before undergoes aerobic training programExclusion Criteria:All patients will not have:Any patient is known to have any unstable medical condition.Any musculoskeletal or neurological disorderHepatic diseases.Kidney disordersType I diabetes mellitusType II insulinUncontrolled hypertensionUnstable angina pectorisUncompensated heart failureRecent myocardial infarctionHeart blockCerebrovascular diseaseAnemiaPatients whose smoking index lightTobacco smokers less than 20 years