Briefly describe the levels of activity among people living with diabetes in your own setting

Quality Benchmark Proposal
July 16, 2021
Research the role of the Nurse Practitioner.
July 16, 2021

Briefly describe the levels of activity among people living with diabetes in your own setting

Briefly describe the levels of activity among people living with diabetes in your own setting

2,000 words (+/- 10%)

Part A (40%)

Critically review the evidence of the role that physical activity can play in the management of type 2 diabetes.

Part B (60%)

Briefly describe the levels of activity among people living with diabetes in your own setting (you can define this as country, region or your own health care organisation). Then drawing on your learning about behaviour change, structured education and physical activity suggest changes in advice or policy which may enhance patient’s participation in physical activity .


Part A

Critically review the evidence of the role that physical activity can play in the management of type 2 diabetes.

Physical therapy is the key to improving a person’s condition who is suffering from type 2 diabetes. Ensure they always get good balanced diet and physical activity to improve medical conditions such as diabetes. Poor food and exercise lead to obesity and conditions like type 2 diabetes, the result is an entire population in future that is characterized by unhealthy ageing. There are many benefits from exercise like reduce HBA1C, weight loss, improve blood glucose level, increase insulin sensitivity, weight management, improve cardiovascular health, reduce blood pressure, cholesterol level, reduce anxiety and depression, reduce triglycerides, increase HDL cholesterol, improve quality of sleep (not too close to bedtime), improve cognitive function and health, decrease stress hormones, Improved self-confidence and mood.

According to Edward W. Gregg 2003 study, shown the relationship of physical activity(walking) to mortality, all-cause, and cardiovascular disease mortality rates in 2896 adults with Type 2 Diabetes Miletus the study shown walking was lowering the mortality across spectrum of adult with diabetes. One death per year may be preventable for 61 people who reported walking at least 2hr/week. There are many types of exercise for type 2 Diabetes Miletus like aerobic exercise which can help insulin sensitivity and reduce cardiovascular mortality risk, and if it is alternative between moderate and high intensity interval training (HIIT) it possibly will enhance skeletal muscles and help insulin sensitivity. Resistance exercise benefits for type 2 diabetes include improve glycemic control, improve insulin resistance, reduce fat mass, improve blood pressure, improve lean body mass. Benefits of other type of physical activity, flexibility and balance exercises are important for elderly patient with diabetes to reduce hyper glycemia. Stretching also can help to increase the range of motion, although yoga may improve glycemic control. TAI CHI training can improve glycemic control and improve neuropathic symptom. So, the ADA (American Diabetic Association) recommends for type 2 Diabetes physical activity and daily exercise, and do not allow more than 2 days to elapse between exercise sessions to enhance insulin action.  Adults with type 2 diabetes should perform both aerobic and resistance exercise for optimum glycemic control. Structured lifestyle interventions that include at least 150 min/week of physical activity and dietary changes resulting in weight loss of 5%–7% are recommended to prevent or delay the onset of type 2 diabetes in populations at high risk and with pre-diabetes.  Children and adolescents with type 2 diabetes should be encouraged to meet the same physical activity goal set for youth in general.


Part B

Briefly describe the levels of activity among people living with diabetes in your own setting (you can define this as country, region, or your own health care organization). Then drawing on your learning about behavior change, structured education and physical activity suggest changes in advice or policy which may enhance patient’s participation in physical activity.

According to the IDF (International Diabetes Federation) June 2020, the population of Saudi Arabia is slightly more than 34.8 million, adult diabetes prevalence in the Kingdom is currently 18.3%. The IDF also ranked Saudi Arabia as the seventh-highest country for new cases of type 1 diabetes per year. Although there are a variety of factors affecting the development of type 2 diabetes, lifestyle habits typically associated with urbanization are likely the most important ones.

WHO defines physical activity as any body movement produced by skeletal muscles that requires energy consumption. Physical activity refers to all movement including during leisure time, for transport to get to and from places, or as part of a person’s work. Both moderate and vigorous-intensity physical activity improve health, popular ways to be active include walking, cycling and wheeling can be done at any level of skill and for enjoyment by everybody. Regular physical activity is proven to help, prevent and manage noncommunicable diseases such as heart disease, stroke, diabetes, and several types of cancer. It also helps prevent hypertension, maintain healthy body weight and can improve mental health. According to the WHO’s 2016 diabetes country profile, 58.5% of the adult Saudi population were found to be physically inactive (52.1% of men and 67.7% of women). In another study, the prevalence of physical inactivity was found to be 66.6% for the overall Saudi Arabia population (60.1% for men and 72.9% for women). However, it was found that 16.8% of the population engaged in a moderate level of physical activity and 16.6% engaged in a high level of physical activity. The estimated population – attributable fractions (PAF) in Saudi Arabia were calculated using adjusted relative risks and were reported to be 11.4% for coronary heart disease, 14.1% for type 2 diabetes, 19.9% for breast cancer, 20.4% for colon cancer, and 18.4% for all-cause mortality associated with physical inactivity. The estimated gains in life expectancy by eliminating physical inactivity are 1.51 years. And there are barriers to physical activity and behavior solution like:



Barriers Suggested solutions to overcome the barriers
I do not have time to exercise for 30 minutes a day · Think about your day—do you have available time slots? Take advantage of any extra time that you may have and get moving. If you find yourself waiting for the kids to finish practice or watching their game from the sidelines, use that time to take a walk or pace while you watch.

· Do as much as you can.

· Every step counts.

· If you are just starting out, start with 5-10 minutes a day and add more, little by little.

· Work up to three times a day.

· You can also try for 15-minute sessions twice a day.

· Make physical activity part of your daily routine. For example, walk or bike to work or to the store, exercise while you watch TV, take the stairs instead of the elevator or do something active with your family to spend time together.

I am too tired after work. · Find a time when your energy is highest.

· You could plan to do something active before work or during the day. For example, you could try walking for 30 minutes during your lunch break a few days each week or hitting the gym early in the morning.

· Remember that increasing the amount of physical activity you do will actually increase your energy.

 Do not have the right clothes. Wear anything that is comfortable as long as you have shoes that fit well and socks that do not irritate your skin.
I do not want to have sore muscles. · Exercise should not hurt if you go slowly at first.

· Choose something you can do without getting sore.

· Make sure you warm up and cool down.

I am afraid my blood sugar level will drop too low. · Always be prepared.

· Make sure you have got mobile phone if you are exercising alone and fast-acting carbohydrate to treat a low if one should occur.

· Wearing a diabetes ID, card or bracelet is another important safety precaution.

Walking hurts my knees. Try chair exercise, biking, swimming.
 It is too hot outside. · walk inside at a school gym or a shopping center.

· Think of some other activities that are always available regardless of the weather like using a stationary bike, indoor aerobics classes, yoga videos at home, indoor swimming or stair climbing.

It is not safe to walk in my neighborhood Think of activities you can do in the safety of your home
I am afraid I will make my condition worse. Remember that exercise helps lower A1C and has many other health benefits
I cannot afford to join a fitness center or buy equipment. Do something that does not require fancy equipment, such as chair exercises, walking or using water bottles for weights, Jumping rope and resistance band exercises are activities that only require one piece of inexpensive equipment.
Exercise is boring. · Find something you enjoy doing.

· Mix it up.

· Try different activities on different days, and make sure you pick an activity that you enjoy.

I do not really know how to do exercise. · Find a personal trainer.

· Choose activities that require few skills like climbing stairs, walking, or jogging.

· Search YouTube for exercise videos.

I do not have the motivation to exercise. · Invite a family member or friend to exercise with you on a regular basis.

· You can also join an exercise group or class in your community.

· Remember all of the benefits that come with being physically active.

· Make a plan so you decide when you will do each type of activity.

· Be sure to set realistic goals and make a plan so you know what you are working toward.



Youth and adults with type 1 diabetes can benefit from being physically active, and activity should be recommended to all. Blood glucose responses to physical activity in all people with type 1 diabetes are highly variable based on activity type/timing and require different adjustments. Additional carbohydrate intake and/or insulin reductions are typically required to maintain glycemic balance during and after physical activity. Frequent blood glucose checks are required to implement carbohydrate intake and insulin dose adjustment strategies. Insulin users can exercise using either basal-bolus injection regimens or insulin pumps, but there are advantages and disadvantages to both insulin delivery methods. Continuous glucose monitoring during physical activity can be used to detect hypoglycemia when used as an adjunct rather than in place of capillary glucose tests. 






· Physical Activity in the prevention of type 2 diabetes (

· Goldfield, N. I., Crittenden, R., Fox, D., McDonough, J., Nichols, L., & Rosenthal, E. L. (2020). COVID-19 Crisis Creates Opportunities for Community-Centered Population Health: Community Health Workers: at the Center. The Journal of ambulatory care management43(3), 184-190.

· Kusumawardani, D. A., Nurika, G., & Luthfiyana, N. U. (2020). The Mental Health of Medical Workers During the Covid-19 Pandemic: How Do We Manage It? JURNAL KESEHATAN LINGKUNGAN12(1si), 21-28.

· Mayfield- Johnson, S., Smith, D. O., Crosby, S. A., Haywood, C. G., Castillo, J., Bryant-Williams, D., … & Wennerstrom, A. (2020). Insights on COVID-19 from community health worker state leaders. The Journal of ambulatory care management43(4), 268-277.

· David E. Laaksonen12, Jaana Lindström3, Timo A. Lakka245, Johan G. Eriksson3, Leo Niskanen1, Katja Wikström3, Sirkka Aunola67, Sirkka Keinänen-Kiukaanniemi89, Mauri Laakso8, Timo T. Valle3, Pirjo Ilanne-Parikka1011, Anne Louheranta12, Helena Hämäläinen7, Merja Rastas37, Virpi Salminen13, Zygimantas Cepaitis3, Martti Hakumäki212, Hannu Kaikkonen89, Pirjo Härkönen89, Jouko Sundvall14, Jaakko Tuomilehto315, Matti Uusitupa12 and for the Finnish Diabetes Prevention Study Group.

· Gregg EW, Cauley JA, Stone K, Thompson TJ, Bauer DC, Cummings SR, Ensrud KE; Study of Osteoporotic Fractures Research Group.


· Diabetes in Saudi Arabia: Prevalence, Prevention, and Progress – Saudi GazetteMember.

· Sheri R. Colberg1⇑, Ronald J. Sigal2, Jane E. Yardley3, Michael C. Riddell4, David W. Dunstan5, Paddy C. Dempsey5, Edward S. Horton6, Kristin Castorino7 and Deborah F. Tate8.