New Report: Arthritis is a Potential Barrier to Physical Activity For Adults With Diabetes
May 08, 2008
May 8, 2008 (EurekAlert) - People with diagnosed diabetes are nearly twice as likely to have arthritis, and the inactivity caused by arthritis hinders the successful management of both diseases, according to a new Morbidity and Mortality Weekly Report (MMWR) study released today by the Centers for Disease Control and Prevention (CDC). This is one of the first studies of its kind to look at the relationship between arthritis and diabetes and the outcomes associated with physical activity.
The report finds that arthritis appears to be a barrier to being physically active for people with diabetes. Despite the fact that physical activity helps control blood glucose levels and reduces joint pain, people with both diseases are more likely to be physically inactive (29.8%) compared to those with diabetes alone (20.1%).
“Arthritis is a frequent co morbid condition for adults with diabetes,” said John H. Klippel, M.D., president and CEO, Arthritis Foundation. “But for both diseases, physical activity is key to effective management. A lack of physical activity actually results in undesirable consequences including increased pain, stiffness, inflammation, physical limitation and potential disability.”
Arthritis is the most common cause of disability in the U.S., affecting one in every five Americans (21 percent). Diabetes affects approximately 7 percent of the American population, with nearly a third unaware that they have the disease.
"Everyone faces the same common barriers to being more physically active, such as lack of time, competing responsibilities, lack of motivation and difficulty finding an enjoyable activity,” said Chad Helmick, M.D., CDC epidemiologist and co-author of the study. “Those who also have arthritis face additional disease-specific barriers, such as concerns about aggravating arthritis pain and causing further joint damage, and knowing which types and amounts of activity are safe for their joints."
The good news is that safe and effective self-management programs are available. People living with arthritis and diabetes can benefit from participating in one of the Arthritis Foundation’s exercise or self-management programs, such as the Arthritis Foundation Aquatic Program, the Arthritis Foundation Exercise Program and the Arthritis Foundation Self-Help Program,” said Klippel. “People should contact their local Arthritis Foundation chapter at www.arthritis.org for information about the resources available in their specific area.”
The Importance of Taking Action
Arthritis currently limits activity for 19 million Americans, taking a $128 billion toll on the U.S. economy annually in direct [medical expenditures] and indirect [lost earnings] costs. With the aging of the Baby Boomer population, the prevalence of arthritis is expected to rise by 40 percent in the next two decades alone.
“Despite evidence of the growing need for intervention to stop the rise of this disabling disease in our population, the level of federal funding for arthritis public health and research has declined steadily by nearly $28 million over the past six years,” said Klippel. “We are on the verge of a public health crisis and must take action now.”
The Arthritis Foundation is working to help address this ever-growing problem through the proposal of legislation. The Arthritis Prevention, Control and Cure Act (S. 626/H.R. 1283) proposes to strengthen arthritis public health initiatives, which would ensure that more people are diagnosed early and avoid pain and permanent disability.
Posted by dlife at 12:43 PM | Comments (0)
Tai Chi Exercises Improve Type 2 Diabetes Control
March 31, 2008
March 31, 2008 (Newswise) — Tai Chi exercises can improve the control of type 2 diabetes, suggests a small study, published ahead of print in the British Journal of Sports Medicine.
Tai Chi Chuan is a traditional Chinese martial art, which combines deep diaphragmatic breathing and relaxation with gentle movement.
The research team assessed the impact of a 12 week programme of Tai Chi exercises on the T helper cell activity of 30 patients with type 2 diabetes and 30 healthy people of the same age.
T cells are a key component of the body’s immune system, producing powerful chemicals, including interleukins, which alter the immune response.
Type 2 diabetes is associated with chronic inflammation, caused by excessive glucose in the blood (hyperglycaemia).
After the 12 week programme glycated haemoglobin (when excess blood sugar combines with the oxygen transporter in red blood cells) levels fell significantly from 7.59% to 7.16 in the diabetic patients.
And levels of interleukin-12, which boosts the immune response, doubled. Levels of interleukin-4, which suppresses the immune response, fell.
T cell activity also significantly increased.
Strenuous physical activity depresses the immune system response, but moderate exercise seems to have the opposite effect, say the authors. Tai Chi is classified as moderate exercise.
Previous research has shown that it boosts cardiovascular and respiratory function, as well as improving flexibility and relieving stress, they add.
Tai Chi may prompt a fall in blood glucose levels, or improve blood glucose metabolism, sparking a drop in the inflammatory response.
Alternatively, the exercise may boost fitness levels and the feeling of wellbeing, which may then boost the health of the immune system, they suggest.
In a separate study, also published ahead of print, a 12 week programme of Tai Chi and Qigong (another Chinese exercise) prompted a significant fall in blood glucose levels and significant improvements in other indicators of the metabolic syndrome in 11 middle aged to older adults.
The metabolic syndrome is a cluster of symptoms, including high blood pressure and high blood glucose that is associated with increased risks of cardiovascular disease and diabetes.
The 13 participants exercised for up to 1.5 hours, up to three times a week, and were also encouraged to practice the exercises at home.
At the end of the 12 weeks, they had lost an average of 3 kg in weight and their waist size had dropped by an average of almost 3 cm.
Their blood pressure also fell significantly, and by more than would have been expected from the weight loss alone, say the authors.
Insulin resistance-whereby cells stop responding to insulin http://www.medterms.com/script/main/art.asp?ArticleKey=3989 , a condition preceding full diabetes-also improved significantly.
Three people no longer met the criteria for metabolic syndrome.
Participants said they slept better, had more energy, felt less pain and had fewer food cravings while on the programme.
Posted by dlife at 10:18 AM | Comments (7)
Pedometers Motivate People with Diabetes to Walk More
November 19, 2007
Program that counts every step, not just steps taken during long walks, is more satisfying
November 19, 2007 (EurekAlert) — The use of a pedometer and a Web site that tracked physical activity levels proved to be powerful motivators for people with diabetes who participated in a recent walking study conducted by researchers from the University of Michigan Health System and VA Ann Arbor Healthcare System. The study also suggests that certain types of goal-setting may be more effective than others.
All participants in the study wore pedometers and received automated weekly goals that were based on their previous week’s walking activity. For half of the participants these goals were “lifestyle goals,” meaning that any step taken during the day counted. The other half received “structured goals,” in which only steps taken during long walks that lasted at least 10 minutes counted. These participants had a smaller target number of steps to take in a day than the lifestyle group.
Study participants in both groups increased their walking significantly during the program and there was no difference between the groups in terms of increased walking. However, the type of goals that participants were given in the six-week study strongly influenced their satisfaction with the program.
Those who received lifestyle goals were more satisfied with the walking program, and wore the pedometer more days during the study period and for more hours during each day than those who received structured goals.
The finding sheds light on a debate among exercise experts about the ways in which people should increase their levels of activity. Some have contended that the only effective walking programs are those in which long periods of activity (known as “bout steps” in this study) are counted. Others have said that counting every step is a better motivator and is just as effective as bout-step programs.
“Walkers in the group where every step counted experienced the same benefit as those who just had their bout steps recorded,” says lead author Caroline R. Richardson, M.D., assistant professor in the Department of Family Medicine at the U-M Medical School and research scientist at the Veterans Affairs Health Services Research and Development at the VA Ann Arbor Healthcare System. The study appears in the International Journal of Behavioral Nutrition and Physical Activity.
“The fact that they were also more satisfied with their program suggests that this approach may be more successful for many people than a program that only recognizes long periods of activity,” Richardson adds.
Study participants were 35 individuals with type 2 diabetes who were both sedentary and overweight, and who were interested in starting a walking program. All participants were given a pedometer that tracked walking and had a built in USB port so that the walking data could be automatically uploaded to the study Web site. Each participant could view his or her step count records and new goals, along with tailored motivational messages and tips about walking, on a personalized study home page.
The focus was on people with type 2 diabetes because exercise is thought to be essential to prevent a worsening of the condition and the development of complications such as nerve damage. That’s why a program that inspires adherence is so important, Richardson notes.
Among the 30 participants who completed the study, steps taken during longer walks lasting 10 minutes or more increased by about 1,900 to 2,700 steps a day, and the increases were roughly the same in both the lifestyle and structured groups. Even though the lifestyle-goals group had every step counted, they, like their counterparts in the other group, chose to increase their walking by taking longer walks rather than by accumulating more steps during many short walks.
In other words, a lifestyle group participant would have her steps counted whether she went for a half-hour walk or just walked outside to get the mail, while the structured group would only have the half-hour walk counted. But in both groups, the increase in the daily totals came from activities like half-hour walks, not by taking more short trips to the mailbox, to and from the car, or visiting a co-worker down the hall.
That means that the increases in both groups stemmed from longer walks – the type of walking that is most beneficial to one’s health. Yet the group that had every step counted was more inclined to enjoy the overall program and was more likely to stick with it.
Richardson’s team also is conducting further studies about the effectiveness of pedometers as tools for motivating people to increase their levels of physical activity. Richardson is a national leader in this area of research.
Posted by dlifenews at 12:08 PM | Comments (0)
Aerobic, Strength Training Greatly Improve Diabetes Numbers
September 18, 2007
Both Aerobic and Resistance Exercise Improved Blood Sugar Control in People with Diabetes
September 18, 2007 (ACP) - In a new randomized controlled trial, both aerobic and resistance exercise improved glycemic/blood sugar control in people with type 2 diabetes. The greatest improvements came from combined aerobic and resistance training.
The study included 251 adults, between ages 39 and 70, who were not exercising regularly and had type 2 diabetes. Participants were assigned to one of four groups: performing 45 minutes of aerobic training three times per week, 45 minutes of resistance training three times per week, 45 minutes each of both three times per week, or no exercise.
Each participant was evaluated on changes in A1c value, a number that reflects blood sugar concentrations over the previous two or three months, and is expressed as a percent. An absolute decrease of 1.0 percent in A1c value (e.g. from 8.5 percent to 7.5 percent) would be associated with a 15 percent to 20 percent decrease in risk of heart attack or stroke, and a 25 percent to 40 percent decrease in risk of diabetes-related eye disease or kidney disease.
Both the aerobic and the resistance training groups had improved blood sugar control; their A1c values decreased by about 0.5 percent. The group that did both kinds of exercise had about twice as much improvement as either of the other group alone; A1c value decreased by 0.97 percent compared to the control group. The control group, which did not exercise, had no change in A1c value.
"We know that aerobic exercise improves glycemic control," said Ronald Sigal, MD, the lead author of the study. "But we didn't know much about what kind of exercise is the most beneficial and how much of it. In particular not much was known about resistance exercises when we started planning this study. At the time, some thought that resistance exercise is not useful or is even dangerous for some people with diabetes."
Dr. Sigal, now an associate professor of medicine and cardiac sciences at University of Calgary, oversaw the 26-week study, conducted in centers in Canada.
"And even for people who had fairly good blood sugar control at the beginning of our study, those who did both aerobic and resistance exercise had further improvements in glucose control."
"The bottom line," said Dr. Sigal, "is that doing both aerobic and resistance exercise is the way to maximize the effects of exercise on blood glucose control in type 2 diabetes."
In an accompanying editorial, William E. Kraus, MD, and Benjamin D. Levine, MD, say, "Imagine an inexpensive pill that could decrease the hemoglobin A1c value by 1 percentage point, reduce cardiovascular death by 25 percent, and substantially improve functional capacity (strength, endurance, and bone density). Diabetes experts would be quick to incorporate this pill into practice guidelines and performance measures for diabetes. (These) study results should simulate all clinicians to include exercise assessment and counseling into every clinic visit."
The study, "Effects of Aerobic Training, Resistance Training, or Both on Glycemic Control in Type 2 Diabetes," and the editorial, "Exercise Training for Diabetes: The 'Strength' of the Evidence," will be published in the in the Sept. 18, 2007, edition of Annals of Internal Medicine.
Annals of Internal Medicine (www.annals.org) is one of the most widely cited peer-reviewed medical journals in the world. The journal has been published for 80 years and accepts only seven percent of the original research studies submitted for publication. Annals of Internal Medicine is published by the American College of Physicians (www.acponline.org), the largest medical specialty organization and the second-largest physician group in the United States.
ACP members include 124,000 internal medicine physicians (internists), related subspecialists, and medical students. Internists specialize in the prevention, detection, and treatment of illness in adults.
Posted by dlifenews at 03:25 PM | Comments (0)
People with Diabetes Fail to Get Enough Physical Activity
February 06, 2007
February 6, 2007 (ADA) - According to a study by researchers at the University of Colorado at Denver and Health Sciences Center, just 39 percent of adults with diabetes are physically active, compared to 58 percent of adults who don’t have diabetes. As the number of risk factors for type 2 diabetes (such as obesity and hypertension) increase, the amount of physical activity decreases, the study found.
The results reinforce the need for Americans to become more physically active in general, but also suggest a need to better tailor exercise programs for people who may have physical limitations as a result of their disease, said lead researcher Dr. Elaine Morrato.
“Everyone can benefit from regular, daily physical activity,” she said. “But people who have diabetes, or who are at greatest risk for it, have even greater incentive to get out there and exercise. We know for a fact that increased physical activity can greatly reduce the risk for type 2 diabetes and its numerous complications. We need to do a better job reaching, motivating and helping these people to stay active.”
The study looked at activity levels for adults with both type 1 and type 2 diabetes. While increased physical activity can’t prevent type 1 diabetes (the least common form of diabetes), it can help to prevent complications in both type 1 and type 2 diabetes. Numerous studies have shown that regular physical activity does help to prevent type 2 diabetes, the most common form of this disease.
Studies show that exercising for 30 minutes a day, at least five days per week, along with moderate weight loss, can reduce the risk of developing type 2 diabetes by nearly 60 percent. Dr. Morrato said people who have diabetes may have a harder time exercising because of complications from the disease, such as painful peripheral neuropathy. The challenge is to encourage people to work exercise into their routine before diabetes and its complications develop, or to find ways to help them stay active if complications have already set in.
To reach Dr. Morrato, email: Elaine.Morrato@uchsc.edu or phone: 303-724-1535.
Posted by dlife at 12:00 PM | Comments (2)