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Purpose: We have a limited understanding of the objectively determined physical activity levels by weight control status (i.e., trying to lose weight, trying to maintain weight, and neither trying to lose or maintain weight) among U.S. adults with diabetes. Therefore, this study assessed the association between physical activity and weight control status among U.S. adults with diabetes., Design: Cross-sectional survey., Setting: The 2003-2006 National Health and Nutrition Examination Survey (NHANES) was used, which is representative of the U.S. population., Subjects: Subjects were 733 adults (≥20 years) with diabetes., Measures: Participants wore an accelerometer to assess physical activity, and questionnaires were used to assess weight control status and covariates., Analysis: Multivariate negative binomial regressions were used., Results: After adjustments, and compared to those not trying to lose or maintain their weight, women trying to lose weight engaged in 74% more physical activity (rate ratio = 1.74; 95% confidence interval [CI]: 1.14 to 2.65). Although findings were not significant for men, men were more likely than women to meet physical activity recommendations., Conclusion: Diabetic women trying to lose weight engaged in more physical activity than did their female counterparts not trying to lose or maintain their weight. Although men were more active than women, no differences in activity estimates occurred across weight control status for men.

Background: To examine the association between accelerometer-assessed physical activity and visual acuity among a nationally representative sample of adults with evidence of diabetes., Methods: Six hundred seventy adult participants with diabetes (age 20 to 85) from the 2003-2006 NHANES cycles constituted the analyzed sample. Participants wore an accelerometer for 7 days to quantify time spent in sedentary behavior, light-intensity physical activity and moderate-to-vigorous physical activity. Visual acuity was objectively assessed for each eye., Results: In multivariable models, every 1-hour increment in daily sedentary behavior was associated with 23% greater likelihood (OR = 1.23; 95% CI: 1.01-1.52) of having uncorrected refractive error as opposed to normal sight. Performing more than 5 minutes of daily moderate-to-vigorous physical activity was associated with a 82% lower likelihood of having vision impairment as opposed to normal sight (OR = 0.18; 95% CI: 0.06-0.50) while every 1-hour increment in daily light-intensity physical activity was, after adjustments, independently associated with a 38% lower likelihood of vision impairment (OR = 0.62; 95% CI: 0.42-0.92)., Conclusion: People with diabetes spending more time in sedentary behavior and less time performing light or moderate-to-vigorous physical activity are more likely to have poorer vision.

Purpose: The purpose of this study was to examine the effects of Active Steps for Diabetes (ASD), a self-management education (DSME) program for aging adults with diabetes and frailty, on blood glucose control (A1C) and level of frailty of participants., Methods: Fifty females (62.2 ± 10.1 years old) with type 2 diabetes and frailty completed the program; 16 used a walking aid. Outcome measures included A1C and the modified Physical Performance Test (mPPT). Repeated measures analysis of variance was used to compare outcomes before and after the program and between participants who did and did not use a walking aid., Results: ASD was effective in reducing A1C and frailty in participants who did and did not use a walking aid. The reduction in A1C was similar for the 2 groups. The reduction in frailty was greater for the group that used a walking aid., Conclusion: Physical activity, a keystone for blood glucose control, is difficult for older adults who are frail. ASD provides a model for DSME that may reduce frailty of participants and increase their capacity for physical activity.

Purpose: The purpose of this study is to report cardiorespiratory fitness levels among adults with diabetes and report differences by demographic (eg, body mass index) and behavioral (eg, physical activity) variables., Methods: Data from the 1999-2004 National Health and Nutrition Examination Survey (NHANES) were used in the analyses. Cardiorespiratory fitness was assessed using a non-exercise prediction equation and through a submaximal treadmill-based test using heart rate extrapolation. Participants completed a questionnaire to assess various demographic and behavior variables. Seventy eight participants met inclusion criteria and constituted the analyzed sample., Results: The majority (55.1%) of participants were estimated as having low or moderate cardiorespiratory fitness. Results showed that for both methods normal weight individuals had greater cardiorespiratory fitness than obese individuals, and for the non-exercise prediction equation, participants who sat during the day and did not walk very much had lower cardiorespiratory fitness (mean = 26.1 mL/kg/min [95% CI: 18.9-33.4]) than those doing heavy work or carrying heavy loads (mean = 34.6 mL/kg/min [95% CI: 30.2-39.1])., Conclusion: These results suggest that obese and inactive adults with diabetes may be at an increased risk for morbidities and mortality associated with low cardiorespiratory fitness. Physical therapists are encouraged to apply evidence-based principles for exercise prescription and physical activity counseling to help patients with diabetes regulate their blood glucose control and improve cardiorespiratory fitness.

Epidemiological studies demonstrate a beneficial effect of physical activity (PA) on various biological health outcomes associated with diabetes; however, these studies have been limited by the use of self-report measures of PA. To provide the most accurate association between PA and health among adults with diabetes, the purpose of this study was to examine the association between accelerometer-assessed PA and numerous biological markers associated with diabetes. Data from the 2003-2006 National Health and Nutrition Examination Survey were used. Adult participants with diabetes were included in the present study and wore an ActiGraph 7164 accelerometer. Light and moderate-to-vigorous PA (MVPA) intensity was determined from accelerometer-derived estimates. Various biological measures, such as triglycerides and C-reactive protein, were measured from a blood sample. Results showed that both light-intensity and MVPA were inversely associated with several biological health outcomes. Additionally, active adults were less likely to have multiple cardiovascular disease risk factors. Findings also differed by age and gender, suggesting that PA interventions may need to consider the influence that age and gender may have on the efficacy of physical activity interventions., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Purpose: Some adults with type 2 diabetes mellitus (T2DM) have comorbidities and mobility impairments that limit their exercise capacity. In consideration of this, we developed and piloted a program called Active Steps for Diabetes for people with T2DM, comorbidities, and mobility impairments. The purpose of this paper was to report outcomes for the pilot program., Methods: Active Steps for Diabetes, an 8-week program, included instruction on diabetes self-care andgroup and home exercise programs. Twenty-two females (62.7 +/- 6.1yrs) with T2DM and self-reported mobility impairments completed the program. Six participants used a walking aid. Outcome measures included two risk factors for coronary artery disease [daily physical activity and body mass index (BMI)], cardiovascular fitness (6-minute walk distance), and knowledge of diabetes-specific exercise guidelines. A two-way repeated measures ANOVA was used to compare outcomes before and after the program and between participants who did and did not use a walking aid., Results: Active Steps for Diabetes was effective in increasing daily physical activity in both groups of subjects (walking aid group: 2.6 days/week [95% confidence interval (CI) = 2.1 to 3.3]; no walking aid group: 1.9 days/week [95% CI=1.2 to 2.5]). This was accompanied by increases in 6-minute walk distances (walking aid group: 54.0 m [95% CI = 36.4 to 71.6]; no walking aid group: 62.6 m [95% CI=55.7 to 69.4]). Changes in BMI were not significant (walking aid group: -0.4 [95% CI = -1.2 to 0.4]; no walking aid group: -.24[95% CI = -.91 to .44]). Increases in knowledge of diabetes-specific exercise guidelines were observed in both groups (walking aid group: 18.8% [95% CI = 11.3 to 26.4]; no walking aid group: 19.3% [95% CI = 16.1 to 22.5])., Discussion: : Physical inactivity and low cardiovascular fitness are predictors of CAD morbidity and mortality in adults with T2DM. This pilot program suggests that a model for diabetes education, incorporating exercise programs developed by a physical therapist, may increase physical activity, improve endurance, and thereby potentially reduce CAD risk in people with T2DM and mobility impairments from comorbidities.