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The Role of Physical Activity in Managing Diabetes

Approximately 463 million adults are living with diabetes worldwide.¹⁰ By 2045, the number of adults diagnosed with diabetes is projected to be 700 million.¹⁰ In the U.S., 34.1 million adults have diabetes, with type 2 diabetes responsible for 90-95% of these cases.⁵

The Center for Disease Control ranks diabetes as the 7th-leading cause of death in the U.S. and the leading cause of new cases of blindness and end-stage renal disease among adults.⁵ Health care costs for diagnosed diabetes in the U.S. amount to $327 billion, and patients with this disease pay on average $9,600 yearly to manage the condition on top of their other medical costs.² The indirect cost of having diabetes includes decreased productivity, work absences, unemployment from chronic disability, and early death.² Type 2 diabetes is a serious illness, but it is preventable and can be managed through a combination of a healthy diet with physical activity.⁸


The Role of Physical Activity

Physical activity can increase cardiovascular fitness, which plays an important role in improving the physiologic functions of the respiratory, circulatory, nervous, skeletal, and muscular systems.¹⁸ For diabetes specifically, studies show that physical activity can acutely improve insulin actions within the body for two to 72 hours afterward and help with blood glucose control and fat oxidation/storage.²⁰ However, it is estimated that only 24.2% of adults with diabetes actually engage in the recommended 150 minutes of physical activity per week, and 38% are not physically active at all.⁵


Barriers and Facilitators to Physical Activity

Some common barriers patients with diabetes face to participating in daily physical activity include:

  • Lack of time¹,¹⁶due to work, family life, or other obligations¹
  • Lack of energy¹,¹⁶
  • Lack of infrastructure (unsafe roads or limited parks/recreational areas)¹,¹⁶
  • Fear of being judged when exercising in public¹
  • Embarrassment of self-appearance¹⁶
  • Limited support from family and friends¹⁶
  • Not finding physical activity interesting¹⁶
  • Physical discomfort, especially for older patients or patients with a higher BMI¹⁶
  • Lack of adequate information on the subject (Ex., patients not realizing that their blood sugar can be influenced by physical activity or even recognizing that obesity is a health concern because they have been desensitized due to their family history.¹ )

Some common facilitators to engaging in daily physical activity that patients report include:

  • More knowledge about the benefits of physical activity, such as blood sugar level control (with reduced associated complications), weight loss, and increase in self-esteem¹
  • Support from family members and guidance from health care professionals emphasizing the significance of physical activity¹
  • Preventing diseases and pain²¹
  • Increasing physical fitness²¹


The Role of Physicians in Promoting Physical Activity

Patients have reported not having enough guidance from their doctors about the importance of engaging in physical activity.¹ According to the National Center for Health Statistics data brief report in 2012, 32.4% of adults (and more than half of adults with diabetes) were recommended to start or continue physical activity by their health provider within the last year.¹⁵ However, a study published by the American Diabetes Association revealed that patients who have diabetes were less likely to adhere to physical activity routines and more likely to take part in weight-loss routines or improve medication compliances when counseled by a doctor on lifestyle interventions.¹⁷ With this in mind, how can we encourage more meaningful conversations among patients and their doctors on the topic of physical activity?

To begin, it’s essential to raise the topic of physical activity in clinics. A physician’s role is to ask the patient about their lifestyle habits, particularly regarding physical activity. Healthcare providers should be encouraged to use the Exercise is Medicine framework www.exerciseismedicine.org to assess, counsel, and prescribe physical activity. Research has shown that walking for about 20 minutes after meals has great benefits in terms of lowering glucose levels. It is helpful for health care professionals to provide simple activity recommendations.²² Barriers to engaging in appropriate physical activity should be addressed during the visit to assist the patient in finding the best starting point. Additionally, facilitators should also be discussed to find out what matters most to the patient and what they hope to gain from becoming more physically active.

In summary, diabetes is an illness that causes many complications including blindness,⁵ end-stage renal disease,⁵ high healthcare costs,² increased indirect costs from decreased productivity and unemployment from chronic disability,² and early death.² Fortunately, diabetes can be managed with a focus on diet and physical activity interventions. Physical activity positively impacts diabetes prevention and control, and with the right physician support, patients can achieve better health outcomes. To find out more information on free and low-cost exercise opportunities around Seattle, check out ExerciseRx. For helpful ways to get active from wherever, Exercise Anywhere is a good place to start.