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Physio findings: diabetes, blood sugar and exercise

Janet Wright looks at new research of interest to physiotherapy staff.

Frequent exercise keeps blood glucose steady

People with diabetes can improve control of their blood sugar levels by exercising more often, rather than more intensely, say researchers.

Exercise is already known to reduce the risk of developing diabetes. And for people who already have the condition, it can improve insulin action and reduce the risk of cardiovascular disease.

To find out more, a Brazilian team reviewed 26 randomised controlled trials of supervised exercise among 2,253 patients.  All had type 2 diabetes – the form that can often be controlled by lifestyle changes rather than insulin injections.

‘The frequency of exercise is the specific factor more likely to underlie the beneficial effects of aerobic training, meaning that the repetition of exercise sessions may be more important than longer or more intense sessions,’ say Daniel Umpierre of the Hospital de Clínicas de Porto Alegre and colleagues.

An Australian team reviewed the Brazilian study for the physiotherapy evidence database, PEDro.  Alison Harmer and Mark Elkins point out that patients who don’t keep up with their recommended exercise often cite lack of time, poor motivation and uncertainty about how to do the exercises. So they recommend helping patients feel more involved, setting goals and using problem-solving techniques.

For patients whose ability may be limited by other health conditions or diabetic complications, they say ‘The clinician’s role here is to tailor a feasible exercise programme, perhaps supplemented with other interventions to control glycaemia such as passive stretching and referral to a dietician.’ Umpierre D et al. Volume of supervised exercise training impacts glycaemic control in patients with type 2 diabetes: a systematic review with meta-regression analysis. Diabetologia 2013; Harmer AR & Elkins MR. Amount and frequency of exercise affect glycaemic control more than exercise mode or intensity - PEDro systematic review update. British Journal of Sports Medicine 2014.

Member benefit: Read all about it – free of charge

Has a Physio Findings story left you wanting to know more? The CSP library may be able to help.

The reference at the end of each story includes a link to the online paper.  Wherever possible, this is a digital object identifier (DOI), or permanent address – ensuring that the paper you want will always be available at that address.

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But you may be able to avoid the cost. Some organisations, such as the Public Library of Science and BioMed Central, make all their content available free of charge, on the principle of ‘open access’; see for example, PLOS Medicine or BMC Musculoskeletal Disorders. And the CSP journal, Physiotherapy, is free to all CSP members.  You can find further details on how to access it here.  

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Otherwise, the CSP library has arranged free access for members to numerous journals, e-journals and databases. So before buying a research paper, it’s worth checking the CSP library catalogue – you may be able to click straight through.

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Comments &  Conclusions

  • Clinical balance testing may not tell the whole story for patients with amyotrophic lateral sclerosis (ALS). In a small study of ALS patients, who could walk and had passed normal balance tests, more than a third relied on visual cues because they could not use normal vestibular input – putting them at higher risk of falling. Sanjak M et al. Archives of Physical Medicine and Rehabilitation 2014.
  • Ballet students have a significantly higher risk of scoliosis than non-dancers of the same age, say Australian researchers who studied girls aged nine to 16. ‘Vigilant screening and improved education for dance teachers and parents of dance students may be beneficial in earlier detection,’ they conclude. Longworth B et al. Archives of Physical Medicine and Rehabilitation 2014.
  • Women with numerous moles on their skin are 34 per cent more likely to develop breast cancer than those with none, two large-scale long-term studies reveal. Though better known as a risk factor for skin cancer, moles have also been linked with hormone levels. et al. PLOS Medicine 2014.
  • Only 44 per cent of knee replacements carried out in the United States are definitely ‘appropriate’, according to a patient classification system, with 34 per cent classed as inappropriate and the rest inconclusive. Riddle DL et al. Arthritis & Rheumatology 2014.

 

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