CE Course

•

Physical Activity

While there are many key benefits associated with exercise for people with diabetes, It is important consider the risks that come with it – including the risk of injury and both high and low glucose levels. Thus, a customized approach is necessary when prescribing physical activity to people with diabetes in order to mitigate these risks while maximizing the benefits.

Is important because:

It's CRITICAL to diabetes care and overall health

It comes with certain risks

It requires individualization

What is a Physical Activity Prescription?

An exercise prescription is a documented plan of action designed to enhance safety and improve outcomes.

It is usually in written form, but may be transmitted electronically as well.

Providing an individualized plan of action can greatly enhance the user’s safety and improve both long-term and short-term outcomes and enjoyment.

Detailed, specific plan of action

Enhances safety

Improves outcomes

Effectiveness of Physical Activity Advice and Prescription by Physicians in Primary Care

The study by Grandes, et al. was designed to compare the efficacy of different methods of providing physical activity guidance. It was a randomized, controlled, multi-center study to see if detailed, individualized exercise guidance produces better outcomes than traditional methods of recommending exercise.

Randomized

Controlled

Multi-Center

Blinded Analysis

Take a look at this chart that summarizes the findings from the Grandes, et al. study. This is a comparison of methods for controlling diabetes through the various means reviewed.

In this example, the “control” group received standard care… most were simply encouraged to increase their walking.

•The “advice only” group received computer-generated education and a brochure describing the benefits of regular exercise.

•The Advice + Prescription group also received computer-generated education and a brochure describing the benefits of regular exercise. In addition, they were counseled on goal setting & overcoming barriers, received a workout logbook, and developed a 3-month exercise prescription.

•There were more than 4000 participants who completed the study, and dozens of physicians and physician groups who were involved in the implementation and administration. This is important to ensure that the results can be applied to a diverse population and implemented by a variety of healthcare providers in a variety of settings.

Control

Advice-Only

Advice + Prescription

•Provider training

•Standard care

•Provider training

•Used web software re: benefits, risks, general activity suggestions

•Summary pamphlet

•Same as advice group, +

•Goal setting

•Barriers addressed

•3-month Plan

•Printed exercise prescription (mode, freq., duration, intensity, progression)

•Self-monitoring log

N=2069

MDs=2

N=1565

MDs=29

N=683

MDs=29