Developing a Physical Activity Prescription for People with Diabetes

Below are listed the specific elements of an exercise prescription: Mode or type of activity, duration, intensity, frequency, progression, timing, motivation, and adjustments for managing glucose levels.

The items marked with an asterisk:  "Timing" and "Adjustments" -- are unique to the diabetes population – particularly those who take mealtime insulin.

Tips for an Effective Plan

Many people think that their general daily activities provide enough exercise to improve cardiovascular fitness. However, this is incorrect.  Very, very few people get enough exercise performing their usual daily activities to reduce heart disease risks. 

In order to provide cardiovascular gains, the activity must meet certain criteria. It must be at least moderately challenging, and use large muscle groups continuously over a period of at least 15 to 20 minutes. This means that the heart rate increases, respiration increases, and energy expenditure increases for a sufficiently long time period.

Not that typical daily activities play no role! Common chores, hobbies and work activities help to burn calories and help to maintain one’s functional capacity. 

The real goal is to minimize the amount of sitting a person does throughout the course of the day.

The Physical Activity Prescription

Now let's take a look at some examples of exercises that improve cardiovascular fitness. They use large muscle groups – especially those in the legs and torso; and are continuous with only minimal pauses. “Low impact” activities are preferred because they are less likely to lead to soreness and injuries. Low impact means that no part of the body is hitting an immovable object with significant force. For example, walking is low-impact because there is always at least one foot on the ground, whereas running is considered high-impact because each foot hits the ground with considerable force. 

Cross training, or performing a variety of different activities that use several muscle groups, is desirable to improve overall fitness and keep the participants interested in their program.

Strength Training Benefits

Strength training offers unique benefits for certain populations, including those who are overweight and elderly.  Adding skeletal muscle helps to raise one’s base metabolic rate since muscle is metabolically active tissue and burns calories even at rest.  Strength training also helps to improve insulin sensitivity, functional capacity for performing usual daily activities, reduces the risk of falls/injuries, and contributes to improvements in self-esteem.