The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) recently conducted an NIDDK-sponsored research project in the US that compared the effects of a control program (the Control for Diabetes Program) with an exercise program (the Exercise in Diabetes Program) on blood pressure, insulin levels and the diabetes symptoms in adults with diabetes. In a primary analysis, they found no significant differences in the fasting blood glucose levels and the diabetes symptoms between the two groups. However, the investigators did find that the exercise group had a significantly greater improvement in their total physical functioning. And the exercise group also had a greater improvement in their mental health, depression, anxiety and fatigue.
In the second analysis, the investigators repeated the exercise and control group comparisons using data from the Women’s Health Initiative Adult Follow-up Study. They found that the exercise program had a significant improvement in both mean daily glucose levels and the mean disability rating for the control group. However, the exercise group had a significant improvement only in the depression anxiety section of the composite score. That is, those in the exercise group who were significantly depressed were not less depressed than those in the control group. The depression anxiety section was included separately from the glucose control section so that the findings for this latter set of results could be adjusted for the other factors associated with the Women’s Health Initiative.
From these comparisons it is clear that exercise can have a positive effect on the health of obese and diabetic women. And the improvements in the physical functioning are likely to be clinically relevant for many women with diabetes. However, we know very little about how to make exercise more effective in promoting weight loss and other wellness improvements in people with diabetes.
Perhaps the most important point from these comparisons is that exercise programs designed for obese people often are ineffective because they do not emphasize long-term maintenance of fitness. Most exercise programs for people with diabetes only address the improvement of the symptoms. No mention is made of maintaining a reasonable exercise regimen that can be part of the treatment. And this leads to both an increase in weight and the potential for harmful side effects that reduce the benefits of an exercise program.
There is one class of diabetes that is particularly affected by short-term exercise programs. This class includes women with gestational diabetes. These women should carefully consider any short-term exercise plan to make sure it is designed to improve pregnancy outcomes. Some researchers now believe that exercise can have adverse effects on pregnancy. This is true not only because of the potential threat to the fetus, but also because of the potential harm to the mother through increased blood pressure and fatigue. It is possible that an adequate exercise regimen could reduce the risks of these complications, although this has not been proven in the research reviewed above.
But what about exercise programs designed for obese or diabetic women? The Women’s Health Initiative followed up with a large group of these women after an exercise program and found that exercise was associated with an increased satisfaction with diet and exercise and a decreased risk of fracture. For the control group, there was no significant decrease in fractures.
This study did not take into account any potential interactions between exercise and medications and thus was inconclusive. Any improvements seen would probably be small and not clinically relevant. It is important for any woman who wishes to participate in an exercise regimen to talk with her doctor about the safety concerns related to exercise programs. It is also important for any woman who chooses to participate in an exercise program to check with her doctor if she is a candidate for any type of medication before she starts any type of exercise regimen. Exercise programs do not automatically reduce the risks of diseases and medications simultaneously.
Of course, all exercise programs carry some risk. Any program involving extended periods of standing, moving around, or being intensely physical should be carefully considered as a potential cause of harm. Any woman who has a history of diabetes should speak with her doctor before beginning any type of exercise program, whether it be mild or vigorous one. MS After Study in USA emphasizes the importance of following a well-balanced healthy diet and regular exercise. A good diet and regular exercise program will have positive benefits for almost every woman with diabetes.