Exercise and Activity Guidance in Older Adults With Diabetes

• Information and health screening: Interested persons are screened for eligibility and undergo a directed medical history and examination, echocardiogram (if not done within one year), limited ABI test, and maximal treadmill test with oxygen kinetics.
• Measure fitness level at the beginning of the exercise training, at 10 and 20 weeks: DEXA scan, body fat analysis, strength and balance measurements, and blood tests.
• Train for 10 weeks in a supervised small group format. Classes meet three times a week for an hour. Participants are randomly assigned to:

• Flexibility and toning exercises + health education, or 2) Functional circuit training + home activities + tailored physical activity guidance.

• Follow-up phone calls for an additional 10 weeks.

Inclusion criteria

• History of type 2 diabetes on medications
• Age 60 or older
• Able to attend local class 3 times per week for 10 weeks

Exclusion criteria

• Ejection fraction <40%
• Symptomatic obstructive valvular disease (primarily aortic stenosis)
• Atrial fibrillation with poor rate control (particularly during exercise), or high grade AV block
• Substantial dementia (Folstein Mini Mental State Examination <24 out of 30)
• Blood tests suggesting severe renal (Cr>3.0) or hepatic (transaminases>4x normal) disease
• Alcohol intake >3 oz/day
• Hemiplegia or lower limb amputation
• Participating in regular exercise 2 or more hours per week.
• Significant orthopedic or musculoskeletal condition that limits weight bearing
• Acute medical conditions, such as acute flare-up of joint condition or infection
• Normal FBS in those with equivocal diabetes history (< 130)