canadian diabetes association clinical practice guidelines physical activity and diabetes
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Canadian Diabetes Association Clinical Practice Guidelines Physical Activity and Diabetes. Chapter 10 Ronald J Sigal , Marni J Armstrong, Pam Colby, Glen P Kenny, Ronald C Plotnikoff , Sonja M Reichert, Michael C Riddell . Physical Activity Checklist. 2013. - PowerPoint PPT PresentationTRANSCRIPT
Canadian Diabetes Association Clinical Practice Guidelines
Physical Activity and Diabetes
Chapter 10
Ronald J Sigal, Marni J Armstrong, Pam Colby, Glen P Kenny, Ronald C Plotnikoff, Sonja M Reichert, Michael C Riddell
guidelines.diabetes.ca | 1-800-BANTING (226-8464) | diabetes.caCopyright © 2013 Canadian Diabetes Association
Physical Activity Checklist
DO a minimum of 150 minutes of moderate-to
vigorous-intensity aerobic exercise per week
INCLUDE resistance exercise ≥ 2 times a week
SET physical activity goals and INVOLVE a multi-
disciplinary team
ASSESS patient’s health before prescribing an
exercise regimen
2013
guidelines.diabetes.ca | 1-800-BANTING (226-8464) | diabetes.caCopyright © 2013 Canadian Diabetes Association
Physical Activity: Bridging the Gap
Problems SolutionsLack of knowledge of resources
Increase awareness among health care professionals of community resources
Time constraints during physician-patient encounter
Involve a multi-disciplinary team of Physical Therapists, Diabetes Educators and Case Workers who can help motivate patients
Pre-existing or suspected heart disease
If patient wishes to take on activity more vigorous than walking, evaluate with a history and physical, resting ECG and possibly exercise ECG stress test.
guidelines.diabetes.ca | 1-800-BANTING (226-8464) | diabetes.caCopyright © 2013 Canadian Diabetes Association
Know your Community Resources and Advertise Them
Speak to your patients about community
resources:
Community pools, gyms, safe walking
trails, weight loss smart phone apps etc.
guidelines.diabetes.ca | 1-800-BANTING (226-8464) | diabetes.caCopyright © 2013 Canadian Diabetes Association
Pre-exercise Assessment
• Assess for conditions that can predispose to injury before prescribing an exercise regimen:– Neuropathy (autonomic and peripheral)– Retinopathy– Coronary artery disease – resting ECG +/-
exercise stress test (see CPG Chapter 23)– Peripheral arterial disease
guidelines.diabetes.ca | 1-800-BANTING (226-8464) | diabetes.caCopyright © 2013 Canadian Diabetes Association
www.guidelines.diabetes.ca
guidelines.diabetes.ca | 1-800-BANTING (226-8464) | diabetes.caCopyright © 2013 Canadian Diabetes Association
guidelines.diabetes.ca | 1-800-BANTING (226-8464) | diabetes.caCopyright © 2013 Canadian Diabetes Association
Recommendation 1
1. People with diabetes should accumulate a minimum of 150 minutes of moderate to vigorous intensity aerobic exercise each week, spread over at least 3 days of the week, with no more than 2 consecutive days without exercise [Grade B, Level 2, for
T2DM; Grade C, Level 3 for T1DM]
guidelines.diabetes.ca | 1-800-BANTING (226-8464) | diabetes.caCopyright © 2013 Canadian Diabetes Association
Recommendation 2
2. People with diabetes (including elderly people) should perform resistance exercise at least twice a week, and preferably 3 times per week [Grade B, Level
2] in addition to aerobic exercise [Grade B, Level 2]. Initial instruction and periodic supervision by an exercise specialist are recommended [Grade C, level 3]
guidelines.diabetes.ca | 1-800-BANTING (226-8464) | diabetes.caCopyright © 2013 Canadian Diabetes Association
Recommendations 3 and 43. People with diabetes should set specific physical
activity goals, anticipate likely barriers to physical activity (e.g. weather, competing commitments), develop strategies to overcome these barriers [Grade B,
Level 2], and keep records of their physical activity [Grade B, Level 2]
4. Structured exercise programs supervised by qualified trainers should be implemented when feasible for people with type 2 diabetes to improve glycemic control, CVD risk factors, and physical fitness [Grade B, Level 2]
2013
2013
guidelines.diabetes.ca | 1-800-BANTING (226-8464) | diabetes.caCopyright © 2013 Canadian Diabetes Association
Recommendation 5
5. People with diabetes with possible cardiovascular disease or microvascular complications of diabetes, who wish to undertake exercise that is substantially more vigorous than brisk walking, should have medical evaluation for conditions that might increase exercise-associated risk. The evaluation would include history, physical examination (including fundoscopic exam, foot exam, and neuropathy screening), resting ECG, and, possibly, exercise ECG stress testing [Grade D, consensus]
2013
guidelines.diabetes.ca | 1-800-BANTING (226-8464) | diabetes.caCopyright © 2013 Canadian Diabetes Association
CDA Clinical Practice Guidelines
http://guidelines.diabetes.ca – for professionals
1-800-BANTING (226-8464)
http://diabetes.ca – for patients