“Doc, how important is exercise in helping me to improve my diabetes control?”

We have all, at some point in our careers as physicians or exercise specialists counseled a patient that “regular exercise can improve diabetes control.” Some of us truly meant it. In others, telling a patient to regularly exercise and improve diet was simply routine. Can you blame those that are not true advocates of exercise for diabetic control? Besides, there has not really been good research to prove the effectiveness of exercise for diabetes control.

Thankfully, JAMA, also recognized the lack of a randomized control trial that can give us some direction and confidence in recommending exercise to our patients. The November 24, 2010 issue finally provides us with some direction in whether or not exercise is effective in an article titled “Combined Aerobic and Resistance Exercise for Patients With Type Two Diabetes.”

Forty-one participants were assigned to the non-exercise control group; 73 to resistance training sessions; 72 to aerobic exercise sessions; and 76 to combined aerobic and resistance training. HBA1C levels were assessed after nine months of intervention.

Interestingly, it took both resistance and aerobic training to reduce HBA1C levels by -0.34 percent. Resistance training alone reduce HBA1C by -0.16 and aerobic by -0.24 percent, both statistically insignificant.  Both groups lost about 1 inch in waist circumference and a total of three to four pounds.

To keep it in perspective, 0.34 percent HBA1c corresponds roughly to a reduction in fasting blood sugar of about 10 points.

Thank you Dr. Blair et al for giving us some confidence in recommending exercise to our patients.