ORLANDO — With exercise a critical piece of diabetes lifestyle modification, and mounting research on what types of exercise most improve the disease’s state, the best option is one a patient will continue and enjoy, according to a presenter at the American Association of Diabetes Educators Annual Meeting.
“In terms of preventing diabetes with aging, and living long and well with any type of diabetes or prediabetes, physical activity is really essential,” Sheri R. Colberg, PhD, FACSM, professor of exercise science at Old Dominion University, Virginia, said during a presentation.
Results from the Diabetes Prevention Program showed weight loss was the most important factor to preventing diabetes, with risk dropping along with pounds. But Colberg noted physical inactivity itself poses a greater risk for insulin resistance than excess body fat.
“We know that being regularly physically active is going to help insulin action,” Colberg said. “It doesn’t matter how old you are, it’s still going to have a positive effect. It may even have a more lasting effect than dietary changes, genetics or fat loss.”
A healthy combination
Moderate exercise several times a week including walking has been associated with reduced risk for diabetes, Colberg said. Research has also shown the incidence of diabetes decreased with an increase in short bouts of vigorous exercise, but Colberg noted this may not be for everyone.
“The three reasons people drop out of exercise programs are perceived lack of time, perceived lack of enjoyment or injury,” Colberg said. She added “If it’s really hard, they’re going to get injured, demotivated and stop doing it anyway.”
Nine months of resistance training and aerobic training were both helpful in improving HbA1c, but the best results were seen with a combination, Colberg said. Interval training is also proving beneficial, she added, whether training at high or easier levels.
“Doing any kind of interval will help lower glucose more quickly and it will have more of a lasting effect,” Colberg said.
Strength and safety
Core strength is a key factor for patients living well into old age, Colberg explained. She also recommends flexibilty training a few times a week, but not in exclusion of other types of exercise, as well as balance training.
“A lot of research has shifted into falls prevention and what we can do to prevent falls in patients with type 2 diabetes, who are actually at a higher risk of falling,” Colberg said. A study she conducted showed a decrease in falls risk with low-level training over just 6 weeks.
Today’s array of exercise options, and time segments required, are taking away the opportunities for excuses, Colberg said. Doing anything is better than nothing for everyone, she guarantees, including patients with diabetes.
“There’s not an inevitable loss of insulin action with aging, there’s a loss when you lose muscle mass,” Colberg said. “So if you preserve muscle mass, you preserve insulin action.”
When encouraging patients to be regularly physically active, Colberg said health care providers could help patients achieve results based on their approach.
“If you present it to patients differently by asking ‘Do you think you could fit in a walk after a meal?’ and requesting that they take small steps in the right direction, they’ll find that they actually feel better and will be more likely to continue,” Colberg said.
Although taking for time for spontaneous physical activity, or leisure time, may not offer athletic gains, it does produces health benefits, Colberg said, and should be prioritized.
“Just spending more time being active, on your feet, not sitting, can have a big impact if you’re starting from completely sedentary, in particular.” — by Allegra Tiver
For More Information: Colberg SR. W09. Presented at: The American Association of Diabetes Educators Annual Meeting 2014; August 6-9, 2014; Orlando, Fla.
Disclosure: Colberg reported being an Advisory Board Member for Perrigo Diabetes Care.