Exercise For Diabetes

Standing Up for Diabetes

Besides eating wisely, what could be the best way to manage diabetes than getting a lot of exercise? For years the experts have been telling us that we need to work out regularly and to get our required dose of both aerobic and anaerobic exercise.

Exercise helps, but just getting off our butts now seems to be even more important. Stand up please!

This is the message of two recent reports in peer-reviewed professional journals. One of them focuses on people with pre-diabetes and other other on those of us who have type 2 diabetes. But the message is appropriate for all of us.

People with pre-diabetes are just like people with diabetes except that they have a choice because they still have enough beta cells in their pancreas. If they manage their condition now, they won’t have to manage diabetes all the rest of their lives.

The study of people with pre-diabetes analyzed 153 people in two earlier studies who had known risk factors for type 2 diabetes. This is the first study that has examined the effects of a sedentary lifestyle on diabetes. The new study, “Associations of objectively measured sedentary behaviour and physical activity with markers of cardiometabolic health,” appears in the May 2013 issue of Diabetologia, the official journal of the European Association for the Study of Diabetes. The full-text is free online.

The researchers from England’s University of Leicester found that for these people the time they spent sedentary is strongly — and adversely — associated with their heart health. More time spent sedentary also meant higher blood sugar levels. Further, their triglyceride levels were higher and their level of the good cholesterol, HDL, was lower.

Researchers do have a technical definition of sedentary (equal to or less than 1.5 metabolic equivalents or METs), where one MET is the same as a typical metabolism at rest. Since even the minds of researchers tend to boggle at that, an operational definition is any non-exercise time spent sitting or lying down.

“These studies provide preliminary evidence that sedentary behavior may be a more effective way to target the prevention of type 2 diabetes, rather than just solely focusing on moderate-to-vigorous physical activity,” says lead author Joseph Henson. “Moreover, sedentary time occupies large portions of the day.”

The second new article focuses on people with type 2 diabetes. This review article has a catchy title, “Type 2 diabetes sits in a chair.” Only the abstract is free online at the journal, Diabetes, Obesity and Metabolism, which published it ahead of print on April 22. But one of the authors, John Thyfault, Ph.D., at the University of Missouri, kindly sent me a copy of the full text.

This article notes that American adults typically spend 7.7 hours a day sedentary, in other words sitting or lying down. That is 50 to 60 percent of our day.

Exercise certainly helps. “Evidence is very clear that implementing moderate/vigorous physical activity can significantly improve glycemic control [among people with type 2 diabetes],” Dr. Thyfault and his co-author, Thomas P.J. Solomon, write. But, they add, “A sedentary lifestyle plays and significant and permissive role in its [diabetes] development” and “Increased physical activity does not necessarily lead to…lower sitting time.”

They suggest that we need to get past the idea that all of us should have “scheduled” exercise sessions, like gym membership or carving out an hour of our day for nothing but exercise. They suggest that instead that we make “very modest levels of lifestyle changes,” like breaking up the time we spend sitting with small bouts of physical activity.

In a concluding statement they wrote that, “The authors of this article have highly adhered to office worker habits while writing this review.” Since I didn’t quite understand this enigmatic note, I asked Dr. Thyfault for clarification. He replied that they did sit down while writing this article, but that he has a standing desk with a treadmill, and that while he doesn’t use the treadmill much, he does stand a lot.

Earlier, I decided not to get a treadmill, but I do have a standing desk that I use for much of my writing, moving back and forth from my sitting and standing desks. I also stand a lot:

This article is based on an earlier version of my article published by HealthCentral.

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