Initiating Exercise Programs for Patients with Non-insulin-dependent Diabetes

Considerable attention has been focused on the importance of physical activity in improving the diabetic state in obese, non-insulin-dependent diabetic patients. Because this patient population tends to be sedentary, this challenge requires an active effort involving the patient and health-care providers. The latter may be a team including physician, dietitian, nurse practitioner, and physical therapist. Programs must be individualized. The patient must be a full partner in developing plans and goals. Plans should represent the patient's interests, should blend into the daily schedule, and should avoid boredom. Programs are adapted to the patient's physical condition and are graduated in duration and intensity. Motivation is stimulated through education and is reinforced both by self-monitoring techniques and monitoring by providers. Such programs add a new dimension to both physical and psychological well-being.