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Encouraging Patients to Be Physically Active: What Busy Practitioners Need to Know

The first 300 words of the full text of this article appear below.

	Introduction

 
Although exercise is one of the cornerstones of diabetes management, it remains by far the most underused. Undeniably, its beneficial health effects for almost everyone are well established and include improvements in glycemic control, insulin action, cardiovascular fitness, systemic inflammation, diabetes-related health complications, and mental health. Given its positive health impact, it is critical that practitioners encourage almost all of their diabetic and prediabetic patients to become and remain regularly physically active.

Making physical activity recommendations is a crucial part of effective care for people with diabetes. A recent meta-analysis examining the effect of diabetes self-management interventions including recommendations to increase exercise reported that such interventions improve metabolic control in individuals with type 2 diabetes, although the magnitude of the effect varies.¹ Moreover, interventions that recommend and emphasize exercise alone appear to be especially effective for improving glycemic control, even more so than changing exercise, diet, and medication behaviors simultaneously.

Given typical medical office time constraints, it is tempting simply to tell patients to "be regularly active" to achieve better control of their diabetes. But is this strategy effective? Although numerous studies demonstrating that diabetes control can be improved by regular exercise, others have shown no effect on overall glycemic control or body weight. One problem is that exercise interventions vary widely in their duration (of both individual exercise sessions and overall length of participation), exercise intensity, and mode of physical activity, which explains some of these conflicting results. Another meta-analysis, which examined exercise fitness outcomes in patients with type 1 or type 2 diabetes, found that positive changes in physical fitness levels were greater for patients given an actual exercise prescription that included a detailed regimen.² They also fared better when they had their physical fitness levels tested beforehand, participated in supervised exercise programs and group exercise sessions, . . . [Full Text of this Article]

	Challenges to Making Exercise Recommendations

 

	Getting Patients Started With Physical Activity

 

	Keeping Patients Moving More—Safely

 

	Creating Sustained Behaviors

 

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