CDC Looks At Exercise Limitations Among People With Diabetes And Arthritis

Brian McCurdy, Senior Editor

Getting patients with diabetes to exercise may be an uphill battle due to disease concerns. The combination of arthritis with diabetes can be an additional barrier to activity, according to a large survey conducted by the Centers for Disease Control and Prevention (CDC).
The CDC utilized 2005 and 2007 data from the Behavioral Risk Factor Surveillance System (BRFSS), which surveyed hundreds of thousands of people across the United States and its territories. The BRFSS survey indicated that the prevalence of arthritis in adults diagnosed with diabetes was 52 percent. Furthermore, researchers say the prevalence of physical inactivity was 28.9 percent among adults with diabetes and arthritis in comparison to 21 percent in adults with diabetes alone. The BRFSS survey notes that association was independent of age, sex or body mass index (BMI).
The study emphasizes that inactive people with diabetes who become more active benefit from improved physical function and glucose tolerance. However, researchers say such patients also face the same common barriers to being more physically active as most adults face.These barriers include a lack of time, competing responsibilities, lack of motivation and difficulty finding an enjoyable activity.
For people with arthritis, there are additional disease-specific barriers, according to the study. These barriers include patient concerns about potentially aggravating arthritis pain or causing further joint damage, as well as apprehension about which types and amounts of activity are safe for their joints.

Exploring Fitness Options For Patients With Diabetes And Arthritis
Researchers suggest that healthcare providers recommend exercise programs that are specific to arthritis or evidencebased self-management and exercise programs. Cherri Choate, DPM, advocates water exercises, which are non-weightbearing and decrease the pull of gravity for the patient. As she notes, more gyms and senior centers have water exercise programs like aqua aerobics and aqua cross-training.
For patients with diabetes and arthritis, Babak Baravarian, DPM, says lowimpact exercises would be safe. He notes that such exercises reduce both the chance for diabetes-related injury and the risk of arthritic pain. Dr. Baravarian also cites the efficacy of a recumbent bike, saying patients can raise their heart rate safely while putting little weight on the foot, knees and lower back.
Dr. Choate also recommends a recumbent bike or flat walking combined with light weights. In addition, she strongly suggests Pilates, which strengthens, stretches and tones patients so the body is better conditioned to handle weightbearing cardio activities.
“With a lack of activity, patients often will feel a level of depression for many reasons,” says Dr. Baravarian.“These reasons include a feeling of being handicapped, a feeling of remorse for their medical ailments and a feeling of less self-worth.”
Research has shown that the release of endorphins into the body increases psychological well being after exercise, according to Dr. Baravarian, an Assistant Clinical Professor at UCLA School of Medicine
“The depression related to chronic disease is overwhelming and often under-recognized,” says Dr. Choate, an Adjunct Assistant Professor in the Department of Applied Biomechanics at the California School of Podiatric Medicine at Samuel Merritt College. “The benefit of exercise is that it actually helps relieve some of the depression that many of these patients experience.”


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