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A New Prescription for Diabetes

Exercise guidelines to help fight the disease

by John Hanc, AARP Bulletin, February 1, 2011

En español | If you're one of the 12.2 million Americans age 60-plus with diabetes, the American Diabetes Association and the American College of Sports Medicine have a new prescription for you.

An exercise prescription.

The first guidelines for physical activity that are aimed specifically at diabetics have been released jointly by the two organizations. They detail an approach to physical activity that is similar to, but distinct from, the federal government's guidelines for the public.

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Those guidelines, released with much fanfare in 2008, recommended a total of 150 minutes per week of moderately intense physical activity for all Americans, or 75 minutes per week of vigorous activity. For diabetics, particularly the 23.6 million Americans — most of them older adults — with type 2 or onset diabetics, that "vigorous" option is … well, not an option.

"I don't think many people with type 2 diabetes would be able to sustain that recommendation," says exercise scientist Sheri Colberg-Ochs, a professor at Old Dominion University in Norfolk, Va., and the lead author of the guidelines.

On the other hand, while running or biking at top speed might not be advisable for older diabetics, recent research shows that pumping iron is, hence its inclusion in the guidelines. Resistance training helps offset the loss of muscle mass that comes with aging — and causes particular problems to diabetics. "The muscles are the main storage place for carbohydrates," says Colberg-Ochs. "So when your muscle mass decreases, blood sugar goes up because it can't be stored."

Maintaining your muscle mass through exercise, then, will help control your blood sugar — as will exercise in general, which is why diabetes experts see these new guidelines as an important development. "Giving people with diabetes the tools to plan an exercise program is crucial for long-term success and diabetes control," says endocrinologist Steven Edelman, M.D., of the University of California, San Diego School of Medicine.

Noticeably missing in the guidelines are yoga and tai chi — both "mind-body" activities popular with older adults. "The studies were mixed on this," says Colberg-Ochs. That said, she notes, "I think they are both beneficial activities for different reasons. One thing that can affect type 2 diabetic blood control is stress. And both yoga and tai chi are very beneficial ways to manage stress."

John Hanc writes about fitness and health.

New Exercise Guidelines for Diabetics

diabetes and exercise
  • 150 minutes per week of moderately intense aerobic activity, such as walking. Ideally, this activity should be done over the course of at least three days per week, and with no more than two consecutive days off.
  • Resistance training, two to three times a week. A good strength workout should encompass at least five to 10 exercises (10 to 15 repetitions per exercise) that work all the major muscle groups.
  • Daily lifestyle activity: Get up and move, as part of your day-to-day activities. "A lot of [people with diabetes] cut that out, because of fear of falling or balance," says Sheri Colberg-Ochs. "But if you simply start with standing more, that helps. Then take more steps as you're able. Then you can add in aerobic or resistance training."