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Helping Your Patients Become Active

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Exercise and physical activity are major contributors to the prevention and management of diabetes. Dating back as far as 1000 AD, Greek physicians prescribed exercise as a way to improve health. Dr. Elliot P. Joslin encouraged his patients to become more physically active; one method was to get a dog from a local shelter and walk it a few times a day.¹ In the present era of medicine, exercise is a cornerstone of diabetes care. It is prescribed to prevent diabetes, improve diabetes control, and promote weight loss. People with type 2 and some people with type 1 diabetes are often sedentary and in most cases are overweight or obese. These struggles usually have a negative impact on diabetes control. People with diabetes benefit greatly from consistent physical activity because activity helps in managing glucose levels, losing weight, preventing and controlling comorbidities and complications, and improving quality of life.²

Thus, health care providers should and often do encourage their patients to become physically active. However, clinicians' lack of knowledge with regard to exercise often presents a challenge. Exercise advice must include proper guidance about the appropriate type, duration, and frequency of exercise and about blood glucose management with exercise. This article discusses the basic physiology and glucose metabolism with exercise, barriers to becoming physically active and solutions to those barriers, options for exercise with the presence of diabetes complications and orthopedic issues, and guidance for blood glucose management with exercise.

Glucose is the energy source for the muscles. Type 2 diabetes, with its associated insulin resistance, obesity, hyperinsulinemia, and hypertension, interferes with the glucose supply to the muscles. In type 1 diabetes, lack of insulin production by the β-cells in the pancreas is associated with hyperglycemia, polyuria, polydipsia, polyphagia, blurred vision, and weight loss. An inadequate supply of glucose because . . . [Full Text of this Article]

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