ACSM, American Diabetes Association guidelines make strong case for physical activity
New guidelines on exercise for people with diabetes are likely to open some eyes — and, for those who follow them, help prevent or manage diabetes, improve overall health and boost quality of life. A panel of nine experts developed the recommendations, published this month in Medicine & Science in Sports & Exercise®, the official journal of the American College of Sports Medicine (ACSM). ACSM and the American Diabetes Association issued the guidelines as a Joint Position Statement.
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."
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