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Jan. 27, 2007 -- Exercise is among the best things people with diabetesdiabetes can do to manage their disease, but most either are not getting the message or are ignoring it, a new report confirms.
Only 39% of surveyed adults with diabetes engaged in regular physical activity, compared with 58% of adults who did not have the disease, according to a report in the February issue of Diabetes Care.
And activity levels declined as risk factors for type 2 diabetes increased.
The national survey of more than 23,000 adults with diabetes, those at high risk for the disease, and people without diabetes was conducted by researchers from the University of Colorado Health Sciences Center.
Lead researcher Elaine Morrato, MPH, DRPH, tells WebMD she was not surprised to find that those with diabetes were more sedentary than the general public. But she was surprised so few at-risk people were physically active.
"Exercise has been shown to be instrumental in preventing diabetes among people at high risk and in helping to manage symptoms in people with the disease," she says.
Troubling Findings
Study after study has confirmed that regular exercise, combined with modest weight lossweight loss and a healthy diet, can lower type 2 diabetes risk and improve outcomes once people have the disease.
In one of the most persuasive, researchers from the Diabetes Prevention Program Research Group concluded that diet and regular exercise were more effective than one of the most widely prescribed drug treatments for preventing type 2 diabetes.
The American Diabetes Association recommends 30 minutes a day of aerobic exercise, at least five times a week. Prevention guidelines released by the ADA last August recommend 2.5 hours of regular physical activity a week.
People at high risk for developing diabetes should be even more physically active, depending on their ability to exercise.
Survey Results
In the newly reported study, people who engaged in moderate or vigorous activity of 30 minutes or more, three times a week, were considered physically active.
Morrato and colleagues surveyed 23,283 adults across the nation in 2003 and found that those with the fewest risk factors for type 2 diabetesdiabetes were the most likely to be physically active; those with the most risk factors were the least.
The finding that fewer than 40% of adults with diabetes exercised regularly was particularly troubling, the researchers say, because it suggests no increase in activity levels among this high-risk population within the last decade.
"It is difficult to be optimistic about addressing the twin epidemics of obesityobesity and diabetes without success in increasing physical activity in the population," they write.
Tailoring the Message
Morrato tells WebMD the challenge is twofold.
Motivating people who may have been sedentary all their lives to get active is critical.
So is giving people who are disabled because of diabetes or obesity better exercise options.
"I think health care professionals could do a better job of telling people with disabilities how they can exercise," she says.
"Not everyone can get out and walk. People with mobility problems may need to do chair exercises," says Morrato.
Diabetes prevention expert Mark Molitch, MD, tells WebMD most people have gotten the message exercise is good for them.
But he adds there are fewer and fewer opportunities to be physically active.
"Our elementary and middle schools are doing away with recess and gym class. We tell our kids to exercise, but don't give them the chance to do it," says Moltich, who directs the endocrinology clinic at Northwestern University's Feinberg School of Medicine.
"The best way to prevent [type 2] diabetes is to prevent obesity," says Moltich. "It is really hard to lose weight once you are obese."
SOURCES: Morrato, E. Diabetes Care, February 2007; vol 30: pp 203-209. Elaine Morrato, MPH, DRPH, assistant professor, University of Colorado Health Sciences Center, Denver. Knowler, W. The New England Journal of Medicine, Feb. 7, 2002; vol 346: pp 393-403. WebMD Medical News: "Diabetes Prevention: 6 New Guidelines." Mark Molitch, MD, professor of medicine, Northwestern University Feinberg School of Medicine, Chicago.