Diabetes and Exercise: The Effects on A1C Levels and BMI
Health Guide November 29, 2006
As winter sets in and as the season of gluttony arrives, three studies in November issues of scientific journals appropriately focus on the benefits of exercise. It’s none too soon for me since I haven’t hit the trail for two weeks.
I’ve been literally laid low with a respiratory infection. I know that some people say that they keep on exercising when they are sick.
But one of my doctors, David Tanner, was out sick at the same time as I have been down with a bug. He is professionally a doctor of osteopathic medicine (D.O.) and personally an athlete. So I asked him yesterday if he had kept up his exercise program.
Like me, he tried when the infection first set in. But both of us took a break from exercise when we didn’t have the strength for it. Now, we are both better and have started to work out again. He’s a lot younger, in better shape than me, and doesn’t have diabetes.
These differences all make exercise more difficult for me than for him. And more important.
The three new studies gave me the motivation to start up my exercise program again.
A meta-analysis compared different types of exercise on A1C levels. A meta-analysis combines the results of several studies that address a set of related research hypotheses. This one analyzed 27 studies including one thousand people.
Two scientists from New Zealand reported in Diabetes Care that exercise – whether aerobic, resistance (such as weight lifting), or a combination of the two – produced better A1C levels. The improvement, they write, is similar to what we can achieve with diet and drugs.
How much improvement? It’s a “small amount,” they say, 0.8 percent for any type of exercise lasting at least 12 weeks.
But anyone with diabetes knows that a 0.8 percent change in A1C is a lot. If your A1C goes from 7.8 percent to 7.0 percent, for example, you have a reason to rejoice.
The two other studies both come from Edward Weiss of Saint Louis University in St. Louis, Missouri, and his associates. The article in the Journal of Applied Physiology concludes that exercise and diet are equally effective ways to lose weight. They studied people between 50 and 60 with a body mass index between 23 and 30. This places them at the high end of normal weight or overweight – but not obese.
“Exercise-induced weight loss provides the additional benefit of improving physical performance capacity,” Dr. Weiss says. “If push comes to shove and somebody wants to know if they should diet or exercise to lose weight, I would suggest exercise – provided they are willing to put in the extra time and effort and not offset the gains they make by eating more.”
He adds that when we lose weight, our muscles don’t have to work as hard at everyday movements, such as rising from a chair or walking up steps. This is certainly something that I have noticed as I have lost weight.
Dr. Weiss’s other study also published this month is in the American Journal of Clinical Nutrition. They asked, which works better in fighting the risk factors of diabetes – exercise or diet?
Dr. Weiss says that they thought when they began the study that exercise would be more beneficial. But the study shows that it’s a toss up.
“The next step is to determine what happens when you exercise and diet to lose weight,” Dr. Weiss says. “We don’t know if the combination is going to provide greater benefits.”
I don’t know either. But that’s not keeping me from both watching my calories and counting my steps.
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