New diabetes management guidelines feature exercise

Regular physical activity may help persons prevent or manage type 2 diabetes mellitus (T2DM), improve a person’s overall health, and boost his or her quality of life, according to new guidelines issued jointly by the American College of Sports Medicine (ACSM) and the American Diabetes Association. Although research has established the importance of physical activity for all persons with DM, the new guidelines offer specific advice for those whose disease may limit vigorous exercise.

Only 39% of adults who have DM are physically active, compared with 58% of those who do not, it was noted. However, most persons with T2DM can perform exercises safely and effectively. The recommendations include the following:

•Perform aerobic exercise at least 3 days per week with no more than 2 consecutive days between bouts of activity. At least moderate-intensity activities (eg, brisk walking) are suggested. Additional benefits may be gained from vigorous exercise.

•Engage in a minimum of 150 minutes per week of exercise at a moderate or greater intensity level. (Most persons with DM require at least this much aerobic exercise to achieve optimal cardiovascular disease risk reduction.)

•Undertake a variety of modes of physical activity-any form of aerobic exercise that uses large muscle groups and causes sustained increases in heart rate probably is beneficial.

•Progress gradually in exercise intensity and volume to minimize the risk of injury, particularly if health complications are present, and to enhance compliance.

•Engage in weight control programs that involve combinations of exercise, diet, and behavior modification.

•Undertake resistance exercise at least twice weekly on nonconsecutive days but preferably 3 times a week along with regular aerobic activities. Training should be moderate or vigorous for optimal gains in strength and insulin action.

•Include in each training session at least 5 to 10 exercises that involve the major muscle groups and complete 10 to 15 repetitions to near fatigue per set early in training, progressing to heavier weights that can be lifted only 8 to 10 times. To avoid injury, make sure that progression of intensity, frequency, and duration of training sessions occurs slowly.

•Seek initial instruction and periodic supervision by a qualified exercise trainer, particularly for resistance exercise training.

•Include both aerobic and resistance exercise training.

The recommendations were published recently in Medicine & Science in Sports & Exercise, the official journal of the ACSM. For more information, visit the ACSM Web site at http://www.acsm.org. Or, contact the organization at American College of Sports Medicine, PO Box 1440, Indianapolis, IN 46206-1440; telephone: (317) 637-9200; fax: (317) 634-7817. For a discussion of exercise for managing arthritis, go to the “Osteoarthritis Resource Center” on www.musculoskeletalnetwork.com to hear the podcast “What role does physical activity play in the management of arthritis?” by Dr Leigh Callahan at the University of North Carolina at Chapel Hill.