PHILADELPHIA — Individualized exercise protocols may vary depending on the specific diabetic condition a person has, according to a presenter here at the annual meeting of the American Association of Nurse Practitioners.
“There is no excuse for not exercising if you have diabetes and if you have a comorbidity. There’s just no excuse,” Geraldine Q. Young, DNP, APRN, FNP-BC, CDE, Alcorn State University, Natchez, Mississippi, told Healio Family Medicine in an interview. “This protocol is designed to help patients with diabetes [engage in] exercise regardless of what comorbidities they may have.”
Young stated diabetes is currently the seventh leading cause of the death in the U.S., and that based on current trends, 1 in 3 Americans will have diabetes by 2050. In addition, the American Diabetes Association states that the total estimated cost of diagnosed diabetes in 2012 was $176 billion in direct medical costs and $69 billion in lower productivity.
Young said she originally recruited 30 patients with type 2 diabetes for her study. The mean age of these participants was 57.5 years, 80% were female, and 96% were black. Participants were given a questionnaire that assessed for prior related behaviors, personal factors, as well as benefits and barriers to exercise. A1C, BMI and waist circumferences were all measured at baseline.
According to Young's poster:
•patients with diabetic retinopathy in the study received an exercise protocol of walking, swimming and/or riding a stationary bicycle and were told to avoid jogging, body contact sports, heavy lifting and/or any jarring or rapid head movements;
•patients with diabetic nephropathy in the study received an exercise protocol of walking, swimming and/or exercise of mild to moderate intensity and told to avoid strenuous and/or prolonged exercise;
•patients with diabetes in the study who did not have complications received an exercise protocol of walking briskly, water aerobics, bicycling, tennis, and ballroom and/or line dancing;
•patients with diabetic peripheral neuropathy in the study received an exercise protocol of swimming, riding a stationary bike and/or a rowing machine, and told to avoid jogging, brisk walking and/or climbing; and
•patients with diabetic autonomic neuropathy in the study received an exercise protocol of walking, swimming and using a treadmill, and told to avoid strenuous or prolonged exercise.
Young wrote that 24 of the participants came back for an 8-week follow-up examination. Of these, 54% had lower A1Cs, and 50% had decreases in their BMI and weight circumferences.
“The proof is in the pudding with the results,” she said. “The benefits of exercise, based on the proportion that answered, increased, and the barriers to exercise decreased, based on the prescription that caters to the patient,” she said. – by Janel Miller
American Diabetes Association Statistics Webpage (accessed 06-25-17)
Young G. Poster: “Diabetes exercise protocol based on comorbidities in primary care.” Presented at: American Association of Nurse Practitioners National Conference; Jun. 20-25, 2017; Philadelphia.
Disclosure: Healio Family Medicine was unable to confirm relevant financial disclosures prior to publication.