Working with a professional who is trained in exercise physiology is recommended. The ADA also stresses that the diabetes health care team should educate primary care physicians and others involved in the care of a given patient. Answers to This Issue's Clinical Quiz Q1. B, C Patients who have diabetes should undergo a detailed medical evaluation before beginning an exercise program. The examination should focus on the cardiovascular system, peripheral artery disease, retinopathy, nephropathy, and peripheral and autonomic neuropathy.
Physical activity plays a pivotal role in health promotion and disease prevention.
The ADA reports that the worldwide epidemic of type 2 diabetes is associated with decreasing levels of activity and an increasing rate of obesity. Exercise provides the greatest benefits in improvement of the metabolic abnormalities of type 2 diabetes when it is used early in the progression from insulin resistance to impaired glucose tolerance to overt hyperglycemia requiring treatment with oral glucose-lowering agents and finally to insulin. The therapeutic regimen of patients with type 1 diabetes should be adjusted to allow safe participation in all forms of physical activity. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference.