Scientists led by Daniel Umpierre, MSc, of the Hospital de Clinica de Porto Alegre in Brazil, performed an analysis of studies looking at the effects of structured exercise programs of at least 12 weeks duration on lowering HbA1c. They also analyzed studies evaluating the effects of physical activity advice alone or along with nutritional counseling on HbA1c, a blood test that indicates average blood sugar levels over the past three months.
“Exercise is a cornerstone of diabetes management, along with dietary and pharmacological interventions,” according to the new analysis of previous studies, published in the May 3 issue of the Journal of the American Medical Association. “Current guidelines recommend that patients with type 2 diabetes should perform at least 150 minutes per week of moderate-intensity aerobic exercise and should perform resistance exercise three times per week.”
Umpierre and colleagues analyzed studies that included data on 8,538 people.
Structured exercise was associated with a significantly greater decline in HbA1c levels compared with those of participants in comparison groups.
And structured exercise durations of more than 150 minutes per week were associated with a reduction in HbA1c compared to working out for 150 minutes or less per week.
Advice about physical activity also was effective when combined with dietary counseling in lowering HbA1c levels compared with those in comparison groups. Advice about physical activity when given alone was not associated with changes in HbA1c.
The researchers write that structured exercise training may not be available to patients and thus doctors should provide counseling about what physical activities patients with type 2 diabetes should engage in.
“Structured exercise, consisting of aerobic training, resistance training or a combination of aerobic and resistance exercise training for at least 12 weeks is associated with improved glycemic control in type 2 diabetic patients,” the researchers write. “Physical activity advice is beneficial only if associated with dietary recommendations.”
Cutting Costs of Diabetes Treatment
Marco Pahor, MD, of the University of Florida, writes in an accompanying editorial that structured exercise programs for diabetes patients could reduce costs of their treatment over a two-year period.
He says the Umpierre study and studies “provide solid evidence for public policymakers to consider structured exercise and physical activity as worth of insurance reimbursement to promote health, especially in high-risk populations.”
Some insurance providers include a fitness benefit for members, such as a monthly membership at fitness centers or access to personal trainers. In one previous study, older adults who went to a health club two or more times a week over a two-year period incurred $1,252 less in health care costs in the second year, compared to people who visited a health club less than once a week.