Motivate Your Patients to Improve Their Diabetes Care Using New Options in Exercise and Blood Glucose Monitoring

Supported by an unrestricted educational grant from BD Medical – Diabetes Care

Wed August 11, 2004
10:15 – 11:30 AM

Reviewed by Joelle Escoffery, PhD

This scientific theater session addressed the importance of blood glucose monitoring and physical activity for glycemic control in diabetes. Although the prevalence of diabetes is increasing, evidence-based trials have demonstrated that tight glycemic control can prevent or delay diabetes-related complications. Further, more frequent monitoring is associated with better glycemic control. Thus, monitoring is an important component of diabetes self management.

In terms of monitoring, no one regimen is right for all people with diabetes. The nature of type 1 diabetes may require these patients to monitor more frequently than patients with type 2 diabetes. Monitoring should be done at a variety of different times, including in the fasting state, preprandially, postprandially, and at bedtime. Frequent monitoring is a useful way to detect patterns of hyperglycemia or hypoglycemia so that appropriate changes to the treatment regimen can be made. The features provided by some blood glucose monitors, such as time-specific averaging (eg, the ability to examine the average blood glucose data for a given point in time, such as before breakfast), can be a useful way for patients to detect patterns and variability in blood glucose levels.

Self-monitoring is especially important around times of physical activity. Physical activity can increase insulin sensitivity, decrease blood glucose levels, and improve psychological well-being. Before patients undertake any activity regimen, they should have a thorough physical exam, glycemic control should be evaluated, patients at high risk for cardiovascular disease should have a stress test, and retinal and podiatric exams should be conducted. Ideal timing for physical activity is 1 to 3 hours after a meal for 20 to 30 minutes in duration. Some helpful tips for patients undertaking physical activity include monitoring blood glucose levels before, during, and after exercise; exercising with a friend in case assistance is needed; and if possible, exercising in a consistent manner with respect to time of day and relationship to meals. Adequate hydration and proper warm-up and cool down will also increase the likelihood of a safe physical activity experience. One specific type of activity that has been shown to be beneficial to people with diabetes is tai chi, an ancient martial art that is currently practiced as a form of exercise. It consists of gentle movement, it is easy to learn, and it can be practiced just about anywhere. Tai chi has been shown to lower blood pressure, improve immunity, and promote relaxation. This form of exercise has been used successfully among people with diabetes.