"We always tell patients, even those without diabetes, that it's important to exercise, but we don't tell them how. We don't provide a good structure on what to do," said Dr. Joel Zonszein, director of the clinical diabetes center at Montefiore Medical Center in New York City. "It would be good if we were able to prescribe an exercise program for our patients to follow."
The current analysis compared a group of people with type 2 diabetes who participated in a structured exercise program with a control group that received advice about exercise. A structured exercise program was one that engaged people in planned, individualized exercise. All of the structured programs were supervised.
People in the exercise advice-only groups were told that they needed to exercise and were given advice on how to do so, but they were not engaged in a supervised program, or they were involved in a partially supervised program, according to the study.
People in structured training classes that included both aerobic and strength training lowered their HbA1C by 0.67 percent more than control participants. And structured exercise programs that lasted more than 150 minutes per week resulted in an average drop of 0.89 percent over control participants.
Physical activity advice programs, on the other hand, had an average HbA1C reduction of 0.43 percent versus controls. When combined with dietary advice, physical activity advice lowered HbA1C levels by 0.58 percent over the controls.
"Exercise improves insulin sensitivity; it makes insulin work better," explained Zonszein.
In an accompanying editorial, Dr. Marco Pahor from the University of Florida, Gainesville, suggested that insurance companies should consider paying for the costs of structured exercise programs or fitness center memberships. He notes that in one study, when older adults went to a
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