IMPACT OF PHYSICAL ACTIVITY ON DIABETIC NEPHROPATHY, RETINOPATHY, NEUROPATHY AND PERIPHERAL ARTERIAL DISEASE: A NARRATIVE REVIEW

Alicja Serafin; Aleksandra Kołodziej; Monika Skalska; Natalia Wojtachnio; Joanna Strzyż; Michał Bolek; Maciej Krzesimir Kuświk; Wiktoria Bajek; Dominik Chrzanowski; Izabela Kowalska

doi:10.31435/ijitss.2(50).2026.5536

Authors

Alicja Serafin Lower Silesia Oncology, Pulmonology and Haematology Center, Plac Hirszfelda 12, 53-413 Wrocław, Poland https://orcid.org/0009-0000-1060-7437
Aleksandra Kołodziej Lower Silesia Oncology, Pulmonology and Haematology Center, Grabiszyńska 105, 53-439 Wrocław, Poland https://orcid.org/0009-0004-8710-8053
Monika Skalska Graduate of the Medical University of Wrocław, Wybrzeże Ludwika Pasteura 1, 50-367 Wrocław, Poland https://orcid.org/0009-0008-0151-2215
Natalia Wojtachnio Medical University of Wrocław, Borowska 213, 50-556 Wrocław, Poland https://orcid.org/0009-0007-1187-9929
Joanna Strzyż Jan Mikulicz-Radecki University Clinical Hospital in Wrocław, Borowska 213, 50-556 Wrocław, Poland https://orcid.org/0009-0009-3604-8288
Michał Bolek MD, 4th Military Clinical Hospital in Wroclaw, Weigla 5, 53-114 Wroclaw, Poland https://orcid.org/0009-0004-7991-3212
Maciej Krzesimir Kuświk University Hospital in Poznań, Przybyszewskiego 49, 60-355 Poznań, Poland https://orcid.org/0009-0006-1925-204X
Wiktoria Bajek National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland https://orcid.org/0009-0004-6200-2471
Dominik Chrzanowski National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland https://orcid.org/0009-0000-7793-6315
Izabela Kowalska Graduate of Białystok Medical University, Jana Kilińskiego 1, 15-089 Białystok, Poland https://orcid.org/0009-0003-3803-5700

DOI:

https://doi.org/10.31435/ijitss.2(50).2026.5536

Keywords:

Physical Activity, Diabetes Mellitus, Diabetic Nephropathy, Diabetic Retinopathy, Diabetic Neuropathy, Peripheral Arterial Disease, Exercise, Chronic Complications

Abstract

Introduction: Physical activity is one of the fundamental components of diabetes management, with beneficial effects on glycemic control, metabolic profile, and cardiovascular risk. Increasing evidence also suggests that regular exercise may play an important role in modifying the course of chronic diabetic complications. This applies particularly to diabetic nephropathy, diabetic retinopathy, diabetic neuropathy, and peripheral arterial disease, which remain among the major causes of reduced quality of life, disability, and increased mortality in this patient population.

Objective: This paper aims to review the current scientific literature on the impact of physical activity on selected chronic complications of diabetes, with particular emphasis on diabetic nephropathy, diabetic retinopathy, diabetic neuropathy, and peripheral arterial disease.

Methods: This study is a narrative review of the literature. The analysis was based on publications available in PubMed/MEDLINE, Scopus, and Embase. Randomized controlled trials, observational studies, review articles, and systematic reviews concerning the effects of physical activity and exercise-based interventions on renal markers, retinopathy progression, peripheral nerve function, balance, functional performance, exercise tolerance, and gait parameters in patients with diabetes and peripheral arterial disease were included.

Conclusions: The available evidence indicates that physical activity may have a beneficial effect on selected chronic complications of diabetes, although the strength of the evidence varies depending on the complication analyzed. The most consistent benefits are observed in diabetic neuropathy, particularly in terms of balance, proprioception, functional performance, and symptom reduction. In diabetic nephropathy, physical activity may improve selected renal function parameters and reduce albuminuria, whereas in retinopathy and peripheral arterial disease, the findings are more heterogeneous, although they suggest a potential protective and functional effect. Physical activity should be regarded as an important component of comprehensive management in patients with diabetes; however, further studies are needed to define more precisely the optimal type, intensity, and duration of exercise interventions for individual complications.

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