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Diabetics Ignoring Exercise Advice

The higher the A1c, the less likely they will increase their physical activity. Bad news when it comes to diabetics and exercise: Most people with Type 2 diabetes or at risk for it apparently ignore their doctors’ advice to be active.

Fewer than 40 percent get exercise, a new study found, and the more in danger the patients are, the less likely they are to be active.

That’s despite an earlier study that found nearly three-quarters of diabetics said their doctors had advised them to exercise. The patients who got the strongest warnings to get moving were the least likely to listen, according to new research released Friday.
“People should exercise more, that story is out,” said Dr. Elaine Morrato, who led both studies. “What we’re saying is, ‘Here’s a high-risk population that can benefit from exercise, and they’re even ”less likely to exercise.’ Without exercise, Type 2 diabetics are doomed for failure and will face complications ranging from nerve damage to high blood pressure.

Morrato, an assistant professor at the University of Colorado Denver with a doctorate in public health and epidemiology, said researchers surveyed more than 22,000 patients for the new survey. The federal Centers for Disease Control and Prevention estimates more than 20 million Americans have diabetes, about 90 percent of them Type 2, which is linked with obesity.

Dr. Larry Deeb, president of medicine and science at the American Diabetes Association, said by the time patients have Type 2 diabetes or are at risk of getting it, the deck is stacked against them. They may already have problems with mobility as a result of obesity or foot and circulatory disorders that make exercise difficult.

“We have to be careful not to blame the victims,” he said. “There’s a difference between being unable and being unwilling.”
Even for the most disabled, there’s hope, said author and fitness expert Charlotte Hayes, but health professionals must do more.
Hayes, who wrote “The I Hate to Exercise Book For People With Diabetes,” said telling patients to exercise is different from telling them how. Every step of exercise is important, she said. For those who can walk, a few steps a day helps. For those who can’t, there are alternatives. “We take a small-steps approach,” she said.

Morrato said she doesn’t know the answer, only that the results of her study are disappointing. “It is difficult to be optimistic about addressing the twin epidemics of obesity and diabetes without success in increasing physical activity in the population,” her study concludes. “The results of this study provide very pessimistic data.”

“When you ask a family what they’re doing, the answer is all about time. They know what’s good for their families, but both parents are working, and sometimes the only time they have is to pick up fast food,” he said. “They have to understand, your health depends on it.

“We will not give up,” he said. “We can’t give up.”
Diabetes Care, Feb. 2007

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