According to the American Diabetes Association, nearly 29.1 million Americans were diagnosed with diabetes. That is nearly 9.3% of the population. That was up 25.8 million from 2010 statistics (American Diabetes Association, 2014). Exercise has long been considered one of the most important factors in controlling diabetes in any age group. Convincing a sedentary adult to exercise can be a difficult task. A recent study examined variability in the response to exercise in acute type 2 diabetes patients in a group of 55-75 year olds (Terada, Friesen, & Chahal, et al, 2013). This research will support the thesis that exercise is as important as diet in older adults with type 2 diabetes.
The study used exercise-induced acute capillary glucose (CapBG) as a means to explore changes in a group of older adults with type 2 diabetes. The study participants were divided into three groups. They were assigned to high intensity interval exercise and moderate intensity continuous exercise. These two groups performed a prescribed exercise program for a 12 week period. The duration of the exercise progressed from 30 minute sessions to 60 minute sessions as the study continued. CapBG was measured before and after each session for both groups. The study also took into consideration the timing of food and medication in relation to the exercise.
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The results of the study indicate that the preexercise CapBG, medication, food intake, exercise duration, and exercise intensity were all found to have an impact on CapBG levels. The study found that CapBG levels were lowered by 1.9 mmol/L in the groups that exercised. The study found the most dramatic changes were seen in those that had the highest pretest CapBG scores (Terada, Friesen, & Chalal, et al, 2013). This may mean that exercise is even more important in individuals with greater elevations in diabetes.
The study also examined lower blood glucose can be achieve with moderate intensity exercise. It also found that brief periods of high intensity exercise accentuate the reduction in blood glucose. This is an important finding for the older population, as they are more likely to be able to engage in longer periods of moderate intensity exercise, rather than higher intensity exercise. Other health problems may make high intensity exercise difficult. The connection between moderate intensity exercise and diabetes was not well understood until this study. Another finding of this study is that exercising after eating meals or taking one’s antihyperglycemic medication increased the effectiveness of exercise on lowering one’s CapBG (Terada, Friesen, & Chahal et al, 2013).
Prior to this clinical study, there had been extensive research on the effects of exercise on type 2 diabetes. The studies indicated that exercise had the ability to lower glucose. However, it was not known if differences in the intensity or duration of the exercise had an impact on the degree with which glucose was lowered. These studies found that exercise had a long term effect on lowering glucose levels, and that this effect was the result of each successive bout of exercise (Duclos, Virally, & Dejager, 2011). Surprisingly, studies that used high intensity exercise demonstrated more variability in the results than studies that used moderate exercise. This study corroborated these previous studies in its findings that moderate exercise had an effect on lowering blood glucose. The authors found evidence to support the concept that it is the total volume of exercise, rather than the intensity of the exercise. One can achieve amount of benefit from exercising at a moderate intensity for a longer period of time (Terada, Friesen, & Chahal et al, 2013).
The study by Terada, Friesen, Chalal and associates did to examine which types of exercise are better for improving outcomes in diabetic patients. Evidence supports the role of exercise in control of type 2 diabetes, but little is known about whether specific types of exercise are better than others. Structured exercise of over 150 minutes per week that consisted of aerobic exercise, resistance training or a combination of both resulted in a reduction in HbA (1c) in type two diabetes patients (Umpiere, Ribeiro, & Kramer, 2011). The study further found that exercise alone is not enough, one must combine diet and exercise in order to achieve the maximum improvements in their diabetes.
The main strength of this study is that it used empirical methods and a factor that was easily measurable. The study took into account many variables that can affect the degree with which exercise lowers glucose. The study supported previous studies on exercise and glucose levels it increased the depth of knowledge on this topic. The study made use of internal controls to account for variations in food and medicine schedules.
One of the main weaknesses of the study is that it took place over a short time period. The study lasted 12 weeks. However, the effects the intensity of the effects that were demonstrated supports that validity of the experiment. Another weakness of the study is that it used a small sample population. Although studies with small sample populations are typically unable to be used for extrapolating the results to the larger audience, this study is supported by other studies that also investigated this topic.
In conclusion, the findings of the study support the thesis of Terada, Friesen, & Chahal et al (2013) in that exercise is as important as diet in older adults with type 2 diabetes. Although it is possible to get control of diabetes with diet and medication, adding exercise to the mix helps to increase the amount of control significantly. The effect is even greater with those that have a higher glucose level. It was once thought that high intensity was best for controlling type 2diabetes in the elderly. This study indicates that moderate level exercise with short high intensity bursts may be the most effective in controlling diabetes. This research study challenged old paradigms about exercise and diabetes control.
- American Diabetes Association (2014). Statistics about Diabetes. Retrieved from http://www.diabetes.org/diabetes-basics/statistics/
- Duclos M, Virally M-L, Dejager S. (2011). Exercise in the management of type 2 diabetes mellitus: what are the benefits and how does it work? Physician and
Sportsmedicine. 39(2):98–106. - Terada, T., Friesen, A., & Chahal, B. et al. (2013). Exploring the Variability in Acute Glycemic Responses to Exercise in Type 2 Diabetes. Journal of Diabetes Research. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3745832/
- Umpierre D, Ribeiro PAB, Kramer CK, et al. (2011). Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. Journal of the American Medical Association. 305 (17):1790– 1799.
