Supervised exercise most effective for diabetics

CHICAGO Wed May 4, 2011 12:27pm EDT

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CHICAGO (Reuters) - Diabetics get the most benefit when they exercise more than 150 minutes per week in a supervised fitness or exercise program tailored to their needs, an analysis released on Tuesday suggests.

The findings, published in the Journal of the American Medical Association, suggest it may be time for policymakers to consider reimbursing patients for the cost of health club memberships and sessions with a personal trainer as a way to help control diabetes.

Diabetes and prediabetes will account for an estimated 10 percent of total health care spending by the end of the decade at an annual cost of almost $500 billion -- up from an estimated $194 billion this year, according to a report by health insurer UnitedHealth Group Inc.

In October, the U.S. Centers for Disease Control and Prevention projected that up to a third of U.S. adults could have diabetes by 2050 if Americans continue to gain weight and avoid exercise.

"Cost analyses have shown that use of a health plan-sponsored health club benefit by the general older population and by older adults with diabetes was associated with slower increases in total healthcare costs over two years," Dr. Marco Pahor of the University of Florida wrote in an editorial in the Journal of the American Medical Association.

In the study, Daniel Umpierre of the Hospital de Clinicas de Porto Alegre in Brazil and colleagues analyzed data from 47 clinical trials and more than 8,000 patients, looking for the best way for diabetics to control their blood sugar.

They found that diabetics who participated in a supervised exercise program for more than 150 minutes a week did a better job of lowering their blood sugar than those just advised to exercise.

Diabetics who did supervised exercise training cut a measure of blood sugar known as hemoglobin A1c by 0.67 percent compared with control group participants.

Pahor said clinical trials are needed to prove that supervised exercise programs help diabetics the most but he said it may be time to consider paying for these programs as a way to prevent larger health costs linked with the complications of diabetes.

Those complications can include heart and kidney disease, nerve damage, blindness and circulatory problems that can lead to wounds that will not heal and limb amputations.

Diabetes, which is reaching epidemic proportions and is one of the fastest-growing diseases in the United States, currently affects about 26 million Americans.

SOURCE: bit.ly/iGahcw JAMA, online May 3, 2011.

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