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Do Diabetics Be..

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Diabetes mellitus (DM) is a common disease associated with significant morbidity and mortality. There are many management strategies for controlling diabetes to prevent complications and to preserve and extend quality of life. Management is usually focused on pharmacotherapy targeted at decreasing hyperglycemia, blood pressure and hyperlipidemia. However, focusing on the patient’s lifestyle habits (including physical activity) is another important method for managing DM.1 Physical activity, such as 150 minutes a week of moderate to intense aerobic exercise, is recommended to prevent the macrovascular and microvascular complications of the disease.1,2 The American Diabetes Association states that regular physical activity can help decrease glucose, blood pressure, and triglycerides, while increasing HDL. It also decreases the risk of heart attack and stroke and strengthens the muscles in the heart.3 Overall, engaging in physical activity can decrease the risk of cardiovascular disease (CVD). Since diabetics are at risk for CVD and physical activity can help improve glucose and other cardiovascular risk factors, it is important to consider incorporating exercise into daily routines of diabetics. Previous studies have shown that exercise may help improve glycemic control and decrease CVD and total mortality, but more conclusive evidence was needed.1

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Sluik and colleagues performed a prospective analysis and conducted a meta-analysis regarding the impact of physical activity on mortality. The prospective portion of the study was a cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC) trial, which is an ongoing study consisting of 519,978 patients aged 35-70 years located across 23 centers in 10 countries in Europe. This cohort used 6412 EPIC participants who had DM at baseline (either Type 1 or 2). Patients were excluded if they had no data for follow-up on physical activity or vital status or had implausible energy intake. A total of 5859 patients remained after exclusion. The objective was to investigate whether physical activity (total, leisure-time and walking) was associated with CVD and total mortality. A questionnaire was sent by mail to each participant concerning time and amount of physical activity over the past year. Physical activity evaluated included occupational, leisure-time (e.g., walking, gardening, housework), and recreational activities. Also, information concerning medications, diet, alcohol consumption, weight, height, blood pressure, HgA1C, smoking habits, education level, and histories of myocardial infarction, stroke, and cancer were gathered for further analysis. Based on the questionnaire individuals were placed in one of four categories for physical activity: inactive (e.g., sedentary job and no recreational activity), moderately inactive, moderately active, and active (e.g., sedentary job with > 1 hour of recreational activity per day, standing or a physical job and some recreational activity, or a heavy manual job). The meta-analysis portion of the study consisted of a literature search of MEDLINE for physical activity studies. Of the initial 4344 studies, twelve of these were included in this meta-analysis.1 

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In the prospective study between the four activity categories, the average age ranged from 56.6 to 58.5 years, average HbA1C was 8.1 to 8.3%, and ...

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