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Canadian Diabetes Association Clinical Practice Guidelines Physical Activity and Diabetes

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.

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Canadian Diabetes Association Clinical Practice Guidelines Physical Activity and Diabetes

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  1. Canadian Diabetes Association Clinical Practice GuidelinesPhysical 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

  2. Physical Activity Checklist 2013 • 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

  3. Physical Activity: Bridging the Gap

  4. 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.

  5. 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

  6. www.guidelines.diabetes.ca

  7. Recommendation 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]

  8. Recommendation 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]

  9. Recommendations 3 and 4 • 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] • 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

  10. Recommendation 5 2013 • 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]

  11. CDA Clinical Practice Guidelines http://guidelines.diabetes.ca – for professionals 1-800-BANTING (226-8464) http://diabetes.ca – for patients

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