Regular exercise and avoidance of a sedentary lifestyle by diabetic patients results in improved blood sugar control and a healthier heart and reduces the risk of death according to a recent position paper from Máxima Medical Centre, Veldhoven, the Netherlands.

The recommendations of the position paper appear in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).

Doctors Role in Motivating Diabetics to Exercise Regularly

Doctors should play a key role and motivate their patients to do regular exercise and design customized activity programs for each patient as appropriate for maximum benefit and a favorable patient outcome.

Dr Kemps cardiologist at Máxima Medical Centre, Veldhoven, the Netherlands, said: "Just advising patients to exercise, which is what doctors typically do, is not enough. Patients must be assessed for comorbidities, risks related to exercise, and personal preferences. This will be cost effective in the long run so we have to wake up policymakers and healthcare insurers to pay for it. That needs clinicians to take the lead and call for programmes to be reimbursed."

Ways to Make Diabetics Continue Exercise Programs Long Term

• Firstly, patients must consult their doctor for an exercise plan and know if exercise programs are covered in health insurance
• Even without a doctor's intervention, patients can engage in mild to moderate forms of exercise such as walking and cycling
• Set realistic and achievable goals that can be measured so that patients feel encouraged to continue the exercise regimen long term
• Set exercise programs that patients prefer and enjoy doing to improve compliance
• Using modern technology such as smart watches is also beneficial to track activity and the recorded data can be sent to the health professional for suggestions and feedback
• Improved blood sugar control and heart fitness should be the main aim of exercising and not weight loss since if weight loss is not achieved, many patients lose motivation to continue with the exercise program.
• Also, the possibility of reducing intake of medicines with regular exercise can motivate many patients.
• The intensity and duration of exercise must be designed keeping in mind the age and heart condition of the patient. For instance, alternating moderate and intensive walking may be suitable for younger patients but unsafe in older patients, patients with arrhythmias and reduced blood flow to heart.
• The elderly can try climbing up the stairs in their home or walking to the nearby grocers, activities which will improve their fitness levels and glycemic control.

Dr. Kemps said: "I can't stress enough how effective even small increases in activity can benefit patients with type 2 diabetes and heart problems. Interrupting sitting with brief bouts of walking improves glucose control, while two hours of brisk walking per week reduces the risk of further heart problems."

Measuring the Beneficial Effects of Exercise Clinically

The benefits of regular exercise in controlling blood sugar and improved heart health can be measured clinically by estimation of blood sugar and fitness tests such as the treadmill test and Rockport fitness test which assess the heart's ability to adapt to exercise by measuring blood pressure and heart rate before and after exercise.

‘Patients with diabetes have nearly double the risk of mortality but regular exercise and keeping fit reduces this risk and improves survival. Unfortunately, many diabetics do not engage in regular physical activity and doctors should address this key issue.’
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