What is the ideal exercise and physical activity for an individual above 60 years old with diabetes (Diabetes Mellitus) and hypertension (High Blood Pressure)?

From the Guidelines

For individuals over 60 with diabetes and hypertension, the ideal exercise regimen should include a combination of moderate aerobic activity for 150 minutes per week and resistance training 2-3 times weekly, as recommended by the most recent guidelines 1. This approach is supported by the latest standards of care in diabetes, which emphasize the importance of physical activity in managing diabetes and related comorbidities, such as hypertension 1. Key components of the exercise regimen should include:

• Moderate aerobic activity, such as walking, swimming, or cycling, for at least 150 minutes per week, which can be broken down into 30 minutes, 5 days a week 1
• Resistance training 2-3 times weekly, targeting major muscle groups using light weights or resistance bands with 10-15 repetitions per set 1
• Balance exercises, such as tai chi or simple standing poses, 2-3 times weekly to prevent falls, which is particularly important for older adults with diabetes 1
• Flexibility training and balance training 2-3 times/week, which may include yoga and tai chi, to increase flexibility, muscular strength, and balance 1 It is essential to monitor blood glucose levels before and after exercise, avoiding activity if levels are below 100 mg/dL or above 250 mg/dL, and to control blood pressure reasonably before exercising 1. Additionally, activities should be stopped if experiencing chest pain, dizziness, or unusual shortness of breath, and patients should be advised to interrupt prolonged sitting at least every 30 minutes for blood glucose benefits 1. By following this exercise regimen, older adults with diabetes and hypertension can improve insulin sensitivity, lower blood pressure, strengthen muscles, and enhance overall cardiovascular health while minimizing risks associated with these chronic conditions.

From the Research

Ideal Exercise and Physical Activity for Individuals Above 60 Years Old with Diabetes and Hypertension

The ideal exercise and physical activity for individuals above 60 years old with diabetes and hypertension include:

• Aerobic training, resistance training, and combined training programmes to reduce HbA1c levels and improve cardiorespiratory fitness and cardiovascular risk factors 2
• At least 90 minutes per week of vigorous aerobic exercise or 150 minutes per week of moderate-intensity aerobic physical activity to improve health outcomes 2
• Low-intensity walking as a mild and effective type of exercise to add to hypertension management, with a target exercise dose of 500-1000 METs·min/week 3
• Regular physical activity to reduce the risk of chronic diseases, including coronary heart disease, hypertension, diabetes, osteoporosis, and depression 4
• Aerobic exercise to reduce arterial stiffness in older adults with type 2 diabetes, hypertension, and hypercholesterolemia 5
• Brisk walking as an attractive alternative to individualised medical fitness programmes for patients with type 2 diabetes, with similar clinical benefits and adherence rates 6

Key Considerations

• Exercise interventions should be tailored to the individual's needs and abilities, taking into account any comorbidities or health complications 2, 3, 4
• A combination of aerobic and resistance training may be more effective than either type of exercise alone in improving health outcomes 2, 6
• Regular physical activity can help to reduce the risk of chronic diseases and improve overall health and well-being, even in older adults 4, 5
• Adherence to exercise programmes can be a challenge, and strategies to promote motivation and reduce dropout rates should be implemented 6