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Diabetes and Exercise

Type 2 diabetes (adult onset) is a major international health problem which degrades quality of life and is the 7th leading cause of death. Exercise is one of the major interventions for the treatment of diabetes. However, it requires time, energy, and commitment and what is the correct exercise? Medication is a crucial and effective treatment for diabetes and should be directed by your physician. The third major component of diabetes care is lifestyle and nutritional counseling.

A recent study of primary care clinics showed that the average time spent discussing exercise with diabetic patients is only 22 seconds (J Am Board Fam Med 2011;24:26-32). This is most likely an insufficient amount of time to motivate a patient to start an exercise program. Also, exercise is very sophisticated and includes aerobic, anaerobic, isotonic, eccentric, concentric, static, dynamic, balance, fitness, flexibility, and numerous other types of exercise activities. Additionally, each patient is unique in that some have osteoarthritis, back pain, neck pain, cardiovascular or cardiopulmonary disease, neurologic conditions, and possible nerve damage due to the diabetes that maylead to visual, sensory, or muscular changes.

The American Diabetes Association reports almost 26 million Americans have diabetes and another 79 million have pre-diabetes. Diabetes across the world has more than doubled since 1980 and now tallies at 347 million. Proper exercise is an important component of the self-management lifestyle changes necessary for controlling diabetes.

Researchers have recently shown (Arch Inter Med 2011;171:1951-1953) sedentary people with Type 2 diabetes can improve their quality of life through a structured supervised exercise program. This was measured on the Rand, Short Form-36 Health Survey,( SF-36). The exercise group trained twice weekly for 150 minutes per week (75 minutes per training session). The exercise included aerobic and anaerobic exercise. Additionally, each of the persons received structured individualized counseling. A controlled group was included which received counseling alone.

After 12 months, the exercise group improved in all but one of the quality of life measurements. In contrast, the controlled group was worse in all measurement areas.

Further evidence about the benefits of exercise intervention for persons with diabetes was provided in a systematic review published in a recent issue of the Journal of the American Medical Association (JAMA 2011;305:1790-1799). These researchers studied the mean plasma glucose concentration (blood sugar levels) and reported that structured exercise training involving aerobic exercise, anaerobic exercise and both combined, showed favorable improvements in blood sugar concentrations. In their studies people who exercised more than 150 minutes per week had greater decline in blood sugar concentration but even persons who exercised 150 minutes or less also showed benefits.

Exercise is a key component in diabetes management along with dietary and pharmacological interventions.

Kauffman Physical Therapy is keenly interested in starting a guided exercise program for all patients with Type 2 adult onset diabetes. Our exercise programs will emphasize aerobic and anaerobic exercise and will be tailored to each individual person.

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