Physical activity is a therapy for type-2 diabetes

Doctors must prescribe exercise in the same way as medications

Patients with type 2 diabetes should be prescribed individual physical activity therapies, as is done with pharmacological therapies. A recent article provides practical advice to help doctors motivate their type 2 diabetes patients to exercise, and suggests that this should be the responsibility of national health systems and insurance companies.

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Sedentary lifestyles and unhealthy diets are the main causal factors for the increasing number of patients with type 2 diabetes and cardiovascular problems. Diabetes doubles the risk of mortality, but the more patients improve their physical fitness, the more they manage to lower this risk. Unfortunately, most patients do not engage in physical activity programs. A position paper published in the European Journal of Preventive Cardiology magazine provides practical recommendations for physicians on how to motivate patients to integrate physical activity into their daily routines, set achievable and measurable goals, and design customized training programs to achieve these goals.

"Just advising patients to exercise, which is what doctors usually do, is not enough," said Dr. Hareld Kemps. "Patients should be assessed for comorbidities, exercise risks, and personal preferences. This will be beneficial in the long run. Governments and health insurance companies must, therefore, be urged to reimburse patients for physical activity programmes. According to Kemps, patients should consult their doctor to define a personalized training plan. Long-term participation can be improved by setting gradual and measurable goals and adapting training plans for patients' preferences.

In terms of clinical objectives, cardiorespiratory fitness and glycemic control are the first two. Both improve with training, changes can be measured and are directly related to well-being, morbidity, and mortality. Exercise also helps to lower blood pressure and cholesterol levels.

Dr. Kemps noted that weight loss may not be the best goal for training. "It is difficult to lose weight only with physical exercise and if this is the main objective, patients can lose motivation and stop training", said. "Weight loss is important, but it has to be part of a multidisciplinary intervention that includes nutrition." Dr. Kemps concluded: "Even a slight increase in physical activity can be of great benefit to patients with type 2 diabetes and heart problems.

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