American Diabetes Association Issues New Recommendations on Exercise Guidelines

The American Diabetes Association wants everyone with diabetes to get up and move around more often.

The ADA recently issued new recommendations on physical activity guidelines, among which is at least three minutes of moderate movement, such as walking, side lunges and stretching, every half hour of prolonged inactivity to help with blood sugar management. The ADA’s previous recommendation was movement every 90 minutes of idleness.

The new recommendation of movement every 30 minutes is especially for adults with type 2 diabetes, but the ADA’s updated position statement on physical activity address all types of diabetes, including prediabetes, a condition in which blood sugar levels are above the normal range but not high enough to warrant a diabetes diagnosis. Prediabetes affects more than 80 million Americans.

“We always tell our patients that exercise makes a big difference. The American Diabetes Association’s new recommendations reinforce the message that exercise—not just diet, not just medication—is a big part of diabetes management,” said Kelly O’Connor, a dietitian and diabetes educator at the Diabetes & Nutrition Center at Northwest Hospital. “Any activity helps. For example, we tell elderly patients that when they are watching TV and the commercial comes on to stand up and sit down during the commercials. The new recommendations validate the position that even minimal exercise makes some difference in your blood sugars and making people more insulin-sensitive.”

This is the first time the ADA has issued independent, comprehensive guidelines on exercise for all people with diabetes. The recommendations were based on an extensive review of the latest diabetes research as well as input from leaders at preeminent diabetes and exercise physiology research institutions in the United States, Canada and Australia.

In addition to movement that improves flexibility and balance, aerobic activity (jogging, cycling, swimming, etc.) benefits people with type 2 diabetes in that it helps them regulate blood sugar levels, reduce cardiovascular risk factors and lose weight. People with type 1 diabetes who engage in aerobic and resistance training activities (i.e. exercifemale-joggerses using weight machines or elastic resistance bands) can potentially improve their insulin sensitivity, cardiovascular fitness and muscle strength.

Physical activity “should be recommended and prescribed to all individuals with diabetes as part of management of glycemic control and overall health,” though recommendations and precautions will vary based on age, diabetes type and other health complications, the ADA’s position statement reads.

The ADA recommends that adults with diabetes complete 150 minutes or more of moderate- to vigorous-intensity exercise weekly, with no more than two consecutive days without activity. It is also recommended that children and adolescents with diabetes do at least 60 minutes of moderate- or vigorous-intensity aerobic and muscle- and bone-strengthening exercises at least three days a week. People with prediabetes are urged to combine physical activity and healthy lifestyle changes to delay or prevent a diagnosis. Structured lifestyle interventions that include at least 150 minutes of weekly exercise and dietary changes resulting in weight loss of 5 to 7 percent can help “prevent or delay the onset of type 2 diabetes in populations at high risk and with prediabetes,” the ADA says.

The ADA made specific recommendations on exercise during pregnancy, saying women with preexisting diabetes of any type should be advised to engage in regular physical activity before and during pregnancy, and that pregnant women with or at risk for gestational diabetes mellitus should be advised to engage in 20 to 30 minutes of moderate-intensity exercise on most or all days of the week. Women in general who are at risk for or have been diagnosed with gestational diabetes are encouraged to incorporate aerobic and resistance exercise into their lives most days of the week to improve the effects of insulin and maintain consistent blood sugar levels.

The ADA also made recommendations for minimizing exercise-related adverse events. Insulin regimen and carbohydrate intake changes, along with short sprints, activity timing and resistance exercise prior to aerobics, can help prevent exercise-related hypoglycemia (low blood sugar), according to the ADA, which also says the risk of nocturnal hypoglycemia following physical activity may be lessened with “reductions in basal insulin doses, inclusion of bedtime snacks, and/or use of continuous glucose monitoring.” In addition, the ADA says physically active people with peripheral neuropathy, a nerve-damaging condition commonly caused by diabetes, need proper foot care to avoid ulceration and amputation, and that people with severe nonproliferative and unstable proliferative diabetic retinopathy should avoid vigorous exercises and breath-holding.

weight-liftingO’Connor, who regularly hosts free information sessions in the community on diabetes, says with some patients, the initial challenge for practitioners isn’t getting them to adopt new eating and exercise habits, but helping them come to terms with their diagnosis. “One patient told me recently she was in denial for a year about being diagnosed with diabetes,” O’Connor said. “Some patients are really angry because they have diabetes and they don’t want it, or they think they did everything right.”

There is also the matter of dispelling the belief that effective diabetes management is all about deprivation and seclusion.

“There is so much misinformation about diabetes. Some people have grandparents with diabetes who, perhaps because they didn’t have access to the advanced technology we have today, had a leg amputated or suffer from vision loss, and they think they will have a similar fate. But that never has to happen anymore,” O’Connor said. “The biggest thing I think most people think is, ‘l have to give up all my favorite foods, I’ll never be able to go have fun with my friends, and I won’t be able to have Thanksgiving.’ Yes, you should make some lifestyle changes, but you don’t necessarily have to give up your favorite foods or social activities entirely.”

Recognized by the ADA as meeting the national standards for diabetes self-management education, the Diabetes and Nutrition Center at Northwest Hospital has certified educators that help patients identify and reduce their risk for diabetes, and introduce those who are diagnosed to healthier lifestyles. Care strategies are customized according to each patient’s individuals needs and may include medication management, glucose monitoring, meal planning, foot care and physical activity. The center offers one-on-one counseling as well as free diabetes education classes.

In January 2017, LifeBridge Health will begin a free, monthly diabetes support group program at the Weinberg Park Heights Jewish Community Center of Greater Baltimore. The monthly group will be led by a team of certified diabetes educators from Sinai and Northwest hospitals. “I think it helps a lot for patients with diabetes to hear from each other. It’s encouraging to hear someone with the disease say, ‘I go out with my friends, my blood sugars are still good, and I still enjoy holidays.’ For someone who is newly diagnosed, it makes a big impression to hear that,” O’Connor said.

Check the community calendar for upcoming LifeBridge Health Diabetes Support Group meeting dates and times. For more information on the Diabetes & Nutrition Center or to schedule an appointment, call 410-521-8383. To learn more about the support group, call 410-701-4482.

To schedule an appointment with one of our highly trained physicians and find out why LifeBridge Health is Baltimore's premier health care organization, call 410-601-WELL.

Print this entry

No Comments Yet.

Leave a comment

*

Facebook

Twitter

YouTube

LinkedId

Instagram

Follow Me on Instagram
  • As part of national #EMSweek (May 20-26), #LifeBridgeHealth is proud to recognize and thank our many wonderful partners who work in Emergency Medical Services. We held celebration events across our system, including breakfasts at #SinaiHospital and #NorthwestHospital.

    lifebridgehealth: "As part of national #EMSweek (May 20-26), #LifeBridgeHealth is proud to recognize and thank our many wonderful partners who work in Emergency Medical Services. We held celebration events across our system, including breakfasts at #SinaiHospital and #NorthwestHospital."
    34
    0
  • The pictures are in from #SinaiHospital's annual employee picnic where hospital managers take a turn serving the food, handing out plates and greeting guests. The annual event is a way to say "thank you" to our employees for the amazing work that they do! They are the reason #LifeBridgeHealth is a great place to work! #Work #employees

    lifebridgehealth: "The pictures are in from #SinaiHospital's annual employee picnic where hospital managers take a turn serving the food, handing out plates and greeting guests. The annual event is a way to say "thank you" to our employees for the amazing work that they do! They are the reason #LifeBridgeHealth is a great place to work!  #Work #employees"
    20
    0
  • Big congratulations to this month’s #LifeBridgeHealth Superstars - #SinaiHospital's Denise Rouse-Meekins, #NorthwestHospital's Cindy Slocum, #Levindale’s Colleen Russo, and @carroll_hospital’s Hospital's Lisa Henson. #congrats

    lifebridgehealth: "Big congratulations to this month’s #LifeBridgeHealth Superstars - #SinaiHospital's Denise Rouse-Meekins, #NorthwestHospital's Cindy Slocum, #Levindale’s Colleen Russo, and @carroll_hospital’s Hospital's Lisa Henson. #congrats"
    8
    0
  • Some teams at #SinaiHospital swapped scrubs for uniforms as the "O.R. Blades" took on the "Radiology Renegades" in a recent charity basketball game. The Renegades defended their title and toppled the Blades 75-45. The game raised $1,300 to benefit the Pediatric Hematology/Oncology at the Herman & Walter Samuelson Children's Hospital at Sinai. Thanks to everyone who played, served as referees and came out to support the teams for this great cause! #Community #Team

    lifebridgehealth: "Some teams at #SinaiHospital swapped scrubs for uniforms as the "O.R. Blades" took on the "Radiology Renegades" in a recent charity basketball game. The Renegades defended their title and toppled the Blades 75-45. The game raised $1,300 to benefit the Pediatric Hematology/Oncology at the Herman & Walter Samuelson Children's Hospital at Sinai. Thanks to everyone who played, served as referees and came out to support the teams for this great cause! #Community #Team"
    24
    1
  • We just got some pictures from Nurses Week! Take a look at just a few of the #NursesWeek events as we celebrated and thanked our amazing #LifeBridgeHealth nurses! #nurse #nursesweek2018

    lifebridgehealth: "We just got some pictures from Nurses Week! Take a look at just a few of the #NursesWeek events as we celebrated and thanked our amazing #LifeBridgeHealth nurses! #nurse #nursesweek2018"
    23
    0
  • #LifeBridgeHealth goes green! Thanks to everyone who came out for our recent Earth Day events. More than 2,100 pounds of paper was collected at both the Sinai/Levindale and #NorthwestHospital sites. The next LifeBridge Health Shred-It Day is in November. #earthday #earthday2018

    lifebridgehealth: "#LifeBridgeHealth goes green! Thanks to everyone who came out for our recent Earth Day events. More than 2,100 pounds of paper was collected at both the Sinai/Levindale and #NorthwestHospital sites. The next LifeBridge Health Shred-It Day is in November. #earthday #earthday2018"
    11
    0
  • Dogs may be man’s best friend, but thanks to the incredible generosity of the Adam Michael Kodeck Fund, a dog named Buddy and his handler Gigi will become best friends with families at the Herman & Walter Samuelson Children’s Hospital at Sinai. Buddy is the first dog in the pediatric pet therapy program. The fund was established in Adam Kodeck’s memory to help children and their families going through difficult illnesses. #doglovers #dog #mansbestfriend

    lifebridgehealth: "Dogs may be man’s best friend, but thanks to the incredible generosity of the Adam Michael Kodeck Fund, a dog named Buddy and his handler Gigi will become best friends with families at the Herman & Walter Samuelson Children’s Hospital at Sinai. Buddy is the first dog in the pediatric pet therapy program.  The fund was established in Adam Kodeck’s memory to help children and their families going through difficult illnesses. #doglovers #dog #mansbestfriend"
    14
    0
  • Members of the #LifeBridgeHealth Leadership Academy recently installed more than 35 smoke detectors in homes as part of the American Red Cross “Sound the Alarm” initiative, a campaign to end house fires. The teams also tested smoke detectors and provided fire safety education, including evacuation plans, to families along the Liberty Road/Northern Parkway corridor. #EndHomeFires #community @americanredcross

    lifebridgehealth: "Members of the #LifeBridgeHealth Leadership Academy recently installed more than 35 smoke detectors in homes as part of the American Red Cross “Sound the Alarm” initiative, a campaign to end house fires. The teams also tested smoke detectors and provided fire safety education, including evacuation plans, to families along the Liberty Road/Northern Parkway corridor. #EndHomeFires #community @americanredcross"
    10
    0
  • The #LifeBridgeHealth Sports Medicine Institute hit a home run with the recent Wine and Cheese: Brains and Knees event. Dr. Crutchfield and Dr. Bennett talked about concussions, ACL tears, and staying safe on and off the field. Check out some pictures from the event. #SportsMedicine #Sports

    lifebridgehealth: "The #LifeBridgeHealth Sports Medicine Institute hit a home run with the recent Wine and Cheese: Brains and Knees event.  Dr. Crutchfield and Dr. Bennett talked about concussions, ACL tears, and staying safe on and off the field. Check out some pictures from the event. #SportsMedicine #Sports"
    22
    0
  • As part of #LifeBridgeHealth's community initiatives, we recently partnered with the Baltimore JCC and the Chizuk Amuno Congregation on an event for grandparents and grandchildren. For "Fly High, Fall Safe," families first flew kites outside, then came indoors for obstacle courses and other exercises, including fall risk training with team members from LifeBridge Health's trauma prevention team and the Berman Brain & Spine Institute. @jccbaltimore

    lifebridgehealth: "As part of #LifeBridgeHealth's community initiatives, we recently partnered with the Baltimore JCC and the Chizuk Amuno Congregation on an event for grandparents and grandchildren. For "Fly High, Fall Safe," families first flew kites outside, then came indoors for obstacle courses and other exercises, including fall risk training with team members from LifeBridge Health's trauma prevention team and the Berman Brain & Spine Institute. @jccbaltimore"
    7
    0