Along with medications, lifestyle modifications—changes to diet and physical activity—form the core of diabetes management. Physical activity is critical for managing weight, controlling blood glucose levels, reducing cardiovascular risk, and improving the overall wellbeing of the patient.1,2 According to current ADA guidelines, adults with diabetes should be encouraged to perform at least 150 minutes per week of moderate-intensity aerobic physical activity (50–70% of maximum heart rate), spread over at least 3 days/week with no more than 2 consecutive days without exercise.2 In addition, all individuals, including those with diabetes, should be encouraged to reduce the amount of time spent being sedentary by breaking up extended amounts of time spent sitting.2 Prolonged sitting should be interrupted every 30 minutes with light physical activity, such as standing or walking.1
Implementing and sustaining a program of physical activity can prove difficult for many patients with diabetes, especially seniors. Patients may start a program, but adherence over the long term is challenging. In part, this may be because these changes require time, and fitting exercise into a patient’s schedule on a regular basis can be difficult. Thus, diabetes self-management education (DSME) should always include reinforcement of the value of physical activity and strategies for overcoming obstacles to exercise. Patients should understand that even small changes can be effective, and even a little extra physical activity is better than none at all.
There is no “one size fits all” plan for physical activity that is suitable for all patients and all situations—and special considerations should be made for senior patients. Nurse Practitioners can play a role in ensuring that patients understand the positive impact of lifestyle and exercise changes, helping patients develop a tailored plan that is appropriate for their individual circumstances, and helping patients stick to their plan over the short and long term. Here, you’ll find tips on helping your patients stay active and what to consider when planning an exercise regimen with senior patients.