Recommendations
The American Heart Association, the American Diabetes Association, and the American College of Sports Medicine recommend at least 150 minutes of moderate-intensity aerobic activity per week for patients with diabetes. This activity does not need to be done all at the same time but may be broken up into smaller segments. There is some data to suggest that walking briskly even 1-2 hours weekly (15-20 min/d) starts to decrease chance of myocardial infarction (MI), stroke, diabetes mellitus (DM), or premature death despite the fact that to lose weight, as much as 60 minutes daily may be required (1).
Making practical recommendations to patients involves helping them make the effort to move when ever possible. The best exercise is the one that the individual will do. There is not necessarily one type of exercise that is "best". In fact, Hatha yoga has been shown to reduce HbA1c to the same effect as regular aerobic exercise (2,3).
In their book, "Superfoods Healthstyle," authors Pratt and Matthews discuss that each moment is an opportunity for physical activity (4).
Their book is a good resource for patients. They suggest many activities, including the following:
Walking
Lifting hand weights during TV
Walking faster
Leg lifting at work
Walking more
Using a manual can opener
Carrying packages instead of using shopping carts
1. Jakicic JM, Marcus BH, Gallagher KI, et al. Effect of exercise dose and intensity on weight loss in overweight, sedentary women: A randomized trial. JAMA, Sep 2003; 290:1323-1330.
2. Aljasir, M. Bryson, B. Al-Shehri: Yoga practice for the management of type II diabetes mellitus in adults: a systematic review. Evid Based Complement Alternat Med. 7:399-408 2010
3. Gordon, E.Y. Morrison, D.A. McGrowder: Changes in clinical and metabolic parameters after exercise therapy in patients with type 2 diabetes. Arch Med Sci. 4:427-437 2008
4. Pratt SG, Matthews K. Superfoods healthstyle: Proven strategies for lifelong health. 2006; New York: William Morrow Publishers.