Physical Activity

and Weight in Diabetes

Defining Overweight & Obesity
o kg/m
2
.or
o (lb/ln
2
) x 703
!"#$%& ()&"$*+, -./ 01$23
4
5
underwelghL < 18.3
normal welghL 18.3 - 24.9
CverwelghL 23.0 - 29.9
Cbese > 30
Type 2 Diabetes and Weight
67"+8"#$%&
8Ml: 23.0-29.9
69":"
8Ml > 30
uS Men wlLh 1ype 2 86.3 33
uS Women wlLh 1ype 2 84.2 38
MMwk Motb Mottol weekly kep 2004,5J(45).1066-1068.
Weight and Insul in Resistance
o CverwelghL/welghL galn ^ lnsulln reslsLance
o WelghL loss Lowards healLhy welghL ^ lnsulln
sensluvlLy
Research: Di abet es Pr event i on Pr ogram
o llrsL large-scale Lrlal Lo assess 2 Lechnlques ln prevenung or
delaylng developmenL of 1ype 2, 10 years, publlshed 2002
o n=3,234, overwelghL, lC1, 43 were from hlgh rlsk groups:
AA, Plspanlc, Aslan-A, ac-lslander, nA
o 8andomlzed Lo 1 of 3: llfesLyle (dleL & exerclse, 130 mln/
week, 7 welghL loss) or meuormln (830 mg bld) or
placebo
o ;":<=&:> ? +#:1 @"7"=*A B. *C DEF C*+ GH( 0IJF #K LMN5O
DF #K GH( $+*<A @"7"=*A"@ B.O JJF C*+ K*KPGH( $+*<A:
o Meuormln helpful Lo delay onseL of uM (31 88)
N oql I MeJ 2002, J46.J9J-40J
Research: Type 2 Diabetes & Weight
o 3 body welghL loss assoclaLed wlLh j lnsulln
reslsLance, lmproved glycemla and llpemla and j
8
o Look APLAu (Acuon for PealLh ln ulabeLes) 1 year
resulLs show LhaL aL average 8.6 welghL loss from
lnLenslve llfesLyle lnLervenuon group had j 8, j
1C, ^ PuL & overall beuer dlabeLes and Cvu rlsk
facLor proles Lhan supporL & ed group
ulobetes cote. 2004 Aoq,27(8).2067-7J, ulobetes cote. 2007 Ioo,J0(6).1J74-8J
Prediabetes Recommendations
o redlabeLes: aL hlgh rlsk for developlng
dlabeLes
o SLrucLured program LhaL emphaslze llfesLyle
changes, LhaL lnclude:
7 body welghL loss
8egular physlcal acuvlLy (130 mln/week)
8educed calorles and reduced faL lnLake
ulobetes cote. Iooooty 2012 vol J5 oo 5opplemeot 1 511-56J.
Physical Activity Recommendations
eople wlLh dlabeLes should perform:
o AL leasL 130 mln/week
o ModeraLe-lnLenslLy physlcal acuvlLy
o 30-70 maxlmum hearL raLe
o Spread over aL leasL 3 days/week
o no more Lhan 2 consecuuve days w/o acuvlLy
ulobetes cote. Iooooty 2012 vol J5 oo 5opplemeot 1 511-56J.
Target Hear t Rate
Maxlmum age-relaLed hearL raLe: 220 - age ln yr
o WhaL ls a 30 year old person's esumaLed
maxlmum hearL raLe?
o WhaL ls 30-70 of Lhls esumaLed maxlmum
hearL raLe?
cuc, lbyslcol Acuvlty, 1otqet neott kote ooJ sumoteJ Moxlmom neott kote, ovolloble ot.
bup.//www.cJc.qov/pbyslcolocuvlty/evetyooe/meosotloq/beotttote.btml
Physical Activity Recommendations
eople wlLh Lype 2 dlabeLes:
o 8eslsLance Lralnlng aL leasL Lwlce per week
o Cnly ln absence of conLralndlcauons
ulobetes cote. Iooooty 2012 vol J5 oo 5opplemeot 1 511-56J.
Research: Exercise and Diabetes
o SLrucLured exerclse lnLervenuons of aL leasL 8-
weeks ln durauon:
Lower A1c by average 0.66 ln Lhose wlLh 1ype 2
Cccurs even wlLh no slgnlcanL change ln 8Ml
o 8egular exerclse has been shown Lo:
lmprove blood glucose conLrol and well-belng
8educe Cvu rlsk facLors and promoLe welghL loss
N oql I MeJ 2002, J46.J9J-40J, IAMA 2001,5ep 12,286(10).1218-27
Hypogl ycemia
lor Lhose on lnsulln or lnsulln secreLagogues:
o hyslcal acuvlLy can cause hypoglycemla lf medlcauon
dose or carbohydraLe consumpuon noL alLered
o CarbohydraLe should be Laken lf preexerclse glucose
levels are < 100 mg/dL (3.6 mmol/L)
o Pypoglycemla rare ln dlabeuc lndlvlduals noL LeraLed
wlLh lnsulln or secreLagogues - no prevenuve measure
for Lhem
ulobetes cote. Iooooty 2012 vol J5 oo 5opplemeot 1 511-56J.
For More Infor mation
o ulabeLes revenuon rogram:
hup://dlabeLes.nlddk.nlh.gov/dm/pubs/prevenuonprogram/
o CuC - revenL ulabeLes:
hup://www.cdc.gov/dlabeLes/consumer/prevenL.hLm
o WPC - 1he CosL of ulabeLes:
hup://www.who.lnL/medlacenLre/facLsheeLs/fs236/en/
o nauonal ulabeLes lnformauon Clearlnghouse - WhaL l need Lo know
abouL hyslcal AcuvlLy and ulabeLes:
hup://dlabeLes.nlddk.nlh.gov/dm/pubs/physlcal_ez/