Browsing by Author "Denis Bwayo"

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    Diabetes and exercise: unlocking the potential for effective management and prevention
    (Advances in Health and Exercise, 2025-09-07) Nicholas, Mwebaze; Timothy Makubuya; Mark Kamwebaze; Richard Katungye; Victoria Nekesa; Denis Bwayo; Linika Lumbuye; Ricky Richard Ojara
    Diabetes mellitus is a progressive, chronic metabolic disorder predominantly defined by glucose dysregulation, insulin resistance, and defective insulin secretion. It affects more than 460 million individuals globally with a heavy burden on health sector, economy, and individual's life. This narrative review paper looks at a cost-effective intervention with a potential to contribute to prevention of the disease, regulate condition, and prevent complications. Exercising regularly has a positive impact on glycemic control, improved insulin sensitivity and cardiovascular risk factors like lipid profiles, blood pressure, and promoting overall cardiovascular and psychological well-being. It addresses critical function of exercise in the management of diabetes through consideration of its physiological mechanisms, exercise type, and clinical benefits of regular exercise. It investigated safe and effective exercise prescription protocols for diabetic patients from aerobic, resistance to flexibility and high-intensity interval training. Although the benefits have been demonstrated, barriers such as physical impairment, comorbidities, low knowledge and motivation prevent individuals from exercising. Addressing these barriers need a multi-sectoral solution to reconcile behavioral support, patient education, electronic health interventions, and policy advocacy. It calls for personalized exercise regimens, longer interventions focusing on diabetes complications, and interprofessional collaboration between healthcare, fitness, and mental health professionals. It highlights research gaps the impact of exercise on durable glycemic control.
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    Exercise as a preventive and therapeutic strategy for non- communicable diseases in people living with HIV: evidence, mechanisms and clinical implications
    (BMJ Open Sport & Exercise Medicine, 2026-03-30) Mwebaze, Nicholas; Timothy Makubuya; Loyce Nahwera; Annet Nankwanga; Denis Bwayo; Evert Verhagen
    Objective To synthesise evidence on exercise for preventing and managing non- communicable diseases (NCDs) among HIV clients, emphasising sub- Saharan Africa. Design Narrative review. Data sources Meta- analyses, randomised trials, cohort studies, mechanistic investigations and implementation reports involving adolescents and adults aged 15+ Priority was given to cardiometabolic, musculoskeletal, neurocognitive, immunological, behavioural, safety, feasibility and low- and middle- income country outcomes. Rationale People living with HIV face elevated risk of cardiovascular disease, heart failure and type 2 diabetes due to persistent immune activation, chronic inflammation and treatment related metabolic effects. Exercise is a scalable, low- cost intervention with broad benefits. Results Aerobic and combined aerobic plus resistance training performed ≥3 times weekly for ≥5 weeks improves cardiorespiratory fitness and functional capacity with moderate effects, without adverse effects on CD4 or viral load. Resistance and concurrent training increase strength and lean mass and may attenuate bone mineral density loss. Exercise reduces depressive symptoms, improves quality of life and benefits attention and executive function. Mechanistic studies report reduced pro inflammation, improved endothelial function, enhanced mitochondrial capacity and greater antioxidant defence. Feasibility is high with appropriate screening and progression and with adaptations for neuropathy, frailty, pregnancy, low bone density and multimorbidity. Task shifting, digital or community delivery improve uptake despite limited evidence. Conclusions Exercise should be integrated into HIV and NCD care using frequency, intensity, time and type principles. Programmes require risk stratification, age and sex sensitivity and behaviour change support. Further research should evaluate mechanistic endpoints, high- intensity interval training dosing, pragmatic delivery models and economic outcomes in low- and middle- income countries.