Spotlight on activity

The American Diabetes Association (ADA) issued a new position statement on physical activity and exercise, and a recent study offered some additional advice on the topic.

The statement included the organization's first independent, comprehensive guidelines on physical activity and exercise for all people with diabetes, but it also updated previous recommendations. One significant change, noted in a press release, was that the ADA now calls for 3 or more minutes of light activity, such as walking, leg extensions, or overhead arm stretches, every 30 minutes during prolonged sedentary activities. Previously, physical movement every 90 minutes of sedentary time had been recommended. The statement also recommends 150 minutes or more of moderate-to-vigorous activity, spread over at least 3 days per week, with no more than 2 consecutive days without activity, as well as 2 to 3 sessions per week of resistance exercise for patients with type 1 or type 2 diabetes. Flexibility and balance training are recommended for older adults 2 to 3 times per week. The position statement also contains recommendations for children and adolescents and pregnant women with diabetes, as well as advice on minimizing exercise-related adverse events, managing physical activity with health complications, and promoting the adoption and maintenance of physical activity. The recommendations were published online Oct. 25 and in the November Diabetes Care.

Physicians might want to also consider advising patients to walk after meals, according to a study published by Diabetologia on Oct. 17. The randomized crossover study included 41 adults with type 2 diabetes in New Zealand. For periods of 2 weeks, the participants were advised either to walk 30 minutes each day or to walk 10 minutes after each main meal. The primary outcome was postprandial glycemia, assessed during the 3 hours after a meal by the incremental area under the blood glucose curve (iAUC), measured using continuous glucose monitoring in 5-minute intervals. The study found that the iAUC was significantly lower when the participants walked after meals, with particular improvement after the evening meal, when the most carbohydrates were consumed and the sedentary behaviors were highest. Monitoring by accelerometry showed that the advice to walk after each meal resulted in greater overall activity, the authors noted. The results “suggest that current guidelines should be amended to specify post-meal activity, particularly when meals contain a substantial amount of carbohydrate,” they concluded.