While research has solidly established the importance of physical activity to health for all individuals, the new guidelines provide specific advice for those whose diabetes may limit vigorous exercise. The recommendations call for at least 150 minutes a week of moderate-to-vigorous aerobic exercise spread out at least three days during the week, with no more than two consecutive days between bouts of aerobic activity. "Most people with type 2 diabetes do not have sufficient aerobic capacity to undertake sustained vigorous activity for that weekly duration, and they may have orthopedic or other health limitations," says Sheri R. Colberg, Ph.D., FACSM, who chaired the writing group. Hence, she explains, the group calls for a regimen of moderate-to-vigorous activity and makes no recommendation for a lesser amount of vigorous activity.
Strength training, too
Aerobic activity alone cannot give full benefit of exercise to diabetic individuals, say the experts. Recent research has shown that resistance exercise (strength training) is as important as — and perhaps even more important than — aerobic training in diabetes management. The latest studies, says Colberg, have reinforced the additional benefit of combining aerobic and resistance training for people with diabetes.
No excuses: Physicians should prescribe exercise
According to Colberg, "Many physicians appear unwilling or cautious about prescribing exercise to individuals with type 2 diabetes for a variety of reasons, such as excessive body weight or the presence of health-related complications. However, the majority of people with type 2 diabetes can exercise safely, as long as certain precautions are taken. The presence of diabetes complications should not be used as an excuse to avoid participation in physical activity." In keeping with the philosophy of ACSM's Exercise is Medicine® initiative, Colberg urges that physical activity be a conscious part of every person's health plan, as appropriate for age and physical condition.
High stakes, high yield
The benefits far exceed considerations of an individual's health and quality of life, say Colberg and other experts. Predictions that one in three Americans will have diabetes by 2050 (Centers for Disease Control and Prevention) are accompanied by estimates that diabetes and prediabetes in the U.S. will cost almost $500 billion a year by 2020 (UnitedHealth Group, Inc.). According to Colberg, "If current trends go unabated, we are in fact doomed to higher health care costs and drastically reduced quality and length of life due to diabetes-related complications such as heart disease and kidney failure. As individuals, as communities and as part of a nation and world, we have to work collectively to stop diabetes before it stops us."
The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More than 40,000 international, national and regional members and certified professionals are dedicated to advancing and integrating scientific research to provide educational and practical applications of exercise science and sports medicine. Medicine & Science in Sports & Exercise® is the official journal of the American College of Sports Medicine, and is available from Lippincott Williams & Wilkins at 1-800-638-6423.
The American Diabetes Association is leading the fight to stop diabetes and its deadly consequences and fighting for those affected by diabetes. The Association funds research to prevent, cure and manage diabetes; delivers services to hundreds of communities; provides objective and credible information; and gives voice to those denied their rights because of diabetes. Founded in 1940, our mission is to prevent and cure diabetes and to improve the lives of all people affected by diabetes. For more information please call the American Diabetes Association at 1-800-DIABETES (1-800-342-2383)or visit www.diabetes.org. Information from both these sources is available in English and Spanish.