Are Health Care Professionals Advising Patients With Diabetes or At Risk for Developing Diabetes to Exercise More?

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Abstract
OBJECTIVE—With increased focus on the obesity and diabetes epidemics, and the clear benefit of exercise in disease prevention and management, this study determined the lifetime prevalence of health professional advice to exercise among individuals with or at risk for diabetes. RESEARCH DESIGN AND METHODS—The Medical Expenditure Panel Survey is a nationally representative survey of the U.S. population. In the 2002 survey, 26,878 adults responded when asked about ever receiving health professional advice to exercise more. Information on sociodemographic characteristics and health conditions were self-reported. Type 2 diabetes risk factors were age ≥45 years, non-Caucasian ethnicity, physical inactivity, BMI ≥25 kg/m2, hypertension, and cardiovascular disease. RESULTS—A total of 73% of adults with diabetes were told by a health professional to exercise more versus 31% of adults without diabetes. The proportion receiving advice increased as the number of diabetes risk factors increased until reaching similar rates as people with diabetes. After adjustment for sociodemographic and clinical factors, the strongest correlates of receiving advice were BMI and cardiovascular risk factors. Among respondents with diabetes, the likelihood of receiving advice did not vary by age, sex, education, or income level but was less likely in Hispanics. CONCLUSIONS—Health professionals advised most patients with or at highest risk for diabetes to exercise, suggesting recognition of its importance for disease management. As risk factors declined, fewer patients were advised to exercise, suggesting missed opportunities for disease prevention. However, exercise has not increased proportional to exercise advice. The challenge remains converting patient awareness into behavior change.