Thursday, June 11, 2009

AHA Urges Exercise to Cut CV Risk in Diabetics

by Steve Stiles

June 10, 2009 (Dallas, Texas) — At least two and half hours per week, spread out over at least three sessions--that's the amount of moderate-intensity exercise recommended by the American Heart Association for reducing cardiovascular risk in people with type 2 diabetes, according to a scientific statement published online June 8, 2009 in Circulation [1].

Ninety minutes per week of "vigorous-intensity cardiorespiratory exercise" can be an alternative for some patients, but both options are considered minimums, according to the document, from a writing group chaired by Dr Thomas H Marwick (University of Queensland School of Medicine, Brisbane, Australia). In addition, "moderate- to high-intensity" resistance training three times per week is highly recommended.

The document is rich with evidence from the literature to support the recommendations, but "unfortunately, only a few large-scale, randomized, controlled trials are available."

Still, it reviews likely physiologic mechanisms by which exercise improves CV risk factors, such as improvements in insulin sensitivity and vascular function, as well as potential CV risks of exercise training. Recommendations on counseling and other strategies for promoting adherence are included. And it describes how some patients, especially the many who may start out deconditioned or are limited by comorbidities, can begin lightly and work their way up to the training goals.

http://www.medscape.com/viewarticle/704205?sssdmh=dm1.483760&src=nldne

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