Ok, now before you read below, what recommendations would you make for our participant? What exercise suggestions, medication changes, or anything else? How will she keep her motivation up? Where can she exercise? What exercises should she do?

My recommendations:

It's clear she needs to lose weight. And we can see from the above information that she is socially active and lives in a city. This makes her an ideal candidate for walking in the local shopping mall.

Frequency: And because she is already there each workday for her job, it is convenient for her to do this activity. And she should be able to do it nearly every day.

Intensity: She should be instructed to walk fast enough that she is able to talk, but not sing. This will make the walks more fun if she is able to talk with friends as she walks.

Duration: She is new to exercise, so she can start easy with 10-15 minutes per day.

Progression: As she progresses she can add 1 minute each day, building up to 45 or even 60 minutes, time permitting.

Timing: She can do this in segments, such as some of her walking time before work, and some perhaps during her lunch break.

Adjustments: As she gets in better shape she may find that she needs to discontinue her glyburide 'IF' glucose levels begin falling below 80 mg/dl.

Motivation: She’s a social butterfly, so to help her to stick with her exercise prescription maybe she can find a group to walk with—or even a new friend from the mall. And by encouraging her walk she may find it nice to reward herself with new clothes, or something else she has wanted.

Did you have similar recommendations? Were you on the right track? And did you think about her medication dosing as she gets in better shape down the road?

These are the types of things you should be thinking about as you make exercise prescriptions. It's not a simple as telling your patients to "get more exercise". You need to make it reasonable for them, as well as something they want to do. Just because you want them to exercise more doesn't mean they are going to do it. And just because you have given them some reasons to make their prescribed lifestyle changes doesn't mean they are going to follow through. You need to make it something they want to do for themselves. You need to think about each situation from your patient's point of view--like we did with the case study just a minute ago. We had to think about what would work for Betsy, and how she was going to do it.

So that's where we are. We discussed how to develop an exercise prescription, how to individualize it, how to sell it to your patients, and how to follow-through so that your patients ultimately achieve success. You can use these ideas with your patients with diabetes to see them get on the right track--the track to success!