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Arthritis and Diabetes

Arthritis and Diabetes Word Cloud


Why is the presence of arthritis in people with diabetes important?

Arthritis may be a barrier to physical activity among adults with diabetes.1

Being physically active, for example, through aerobic exercise or strength training, can benefit people with arthritis or diabetes and especially those with both conditions.1

But people with diabetes, like most adults, face the following common barriers to being more physically active:

  • Lack of time.
  • Competing responsibilities.
  • Lack of motivation.
  • Difficulty finding an enjoyable activity.3

Adults with diabetes who also have arthritis face additional, disease-specific barriers:

  • concerns about aggravating arthritis pain.3
  • rear about causing further joint damage.
  • Uncertainty about which types and amounts of activity are safe for their joints.

Nearly one third of adults with both arthritis and diabetes never or rarely exercise, making physical inactivity a serious risk factor for additional problems in this group. The bar chart in below figure shows that physical inactivity was highest among U.S. adults with both diabetes and arthritis. Physical inactivity was lower among adults with diabetes or arthritis alone and lowest among adults without either condition.

Adults with both arthritis and diabetes were 30% more likely to be physically inactive than those with diabetes only, even after adjustment for age, sex, and body mass index (BMI). This means that simply having diabetes and arthritis together increases your likelihood of physical inactivity, regardless of your age, sex, or BMI.


 

Figure 1. Physical Inactivity Is Most Common Among Adults
Who Have Both Diabetes And Arthritis

Bar chart showing physical inactivity is most common among adults who have both diabetes and arthritis. A more detailed description is found in the paragraph above this figure.

Physical inactivity among adults age ≥18 years, by arthritis and diabetes status—Behavioral Risk Factor Surveillance System, United States, 2005 and 2007.
 

Source:
Bolen J, Hootman J, Helmick CG, Murphy L, Langmaid G, Caspersen CJ. Arthritis as a Potential Barrier to Physical Activity Among Adults with Diabetes — United States, 2005 and 2007. MMWR 2008;57(18):486–489.
html; pdf [1.25MB] page 165.


 

What are the benefits of increased physical activity for people with diabetes and arthritis?

People with diabetes who are inactive and become more active benefit from the following:

  • Improved physical function.
  • Improved glucose tolerance.2

There are many general health benefits for adults through physical activity. The recently released 2008 Physical Activity Guidelines for Americans by the US Department of Health and Human Services describes many of these benefits.4

Compared to less active people, more active men and women have the following:

  • Lower rates of all-cause mortality.
  • Lower occurrence of coronary heart disease, high blood pressure, stroke, and metabolic syndrome.
  • A higher level of cardio-respiratory and muscular fitness.
  • Healthier body mass and composition.
  • A biomarker profile that is more favorable for preventing cardiovascular disease and for enhancing bone health.

In addition, being physically active is associated with the following:

  • Higher levels of functional health.
  • A lower risk of falling.
  • Better cognitive function.

Despite these benefits, 1 in 5 people with diabetes (21%) are physically inactive. Being physically inactive is an even bigger problem for people with diabetes who also have arthritis. Physical inactivity is most common in adults who have both arthritis and diabetes. Almost one third of adults, or one in three, with both conditions are physically inactive. Physical inactivity puts people at greater risk for complications from chronic conditions.

What can people with diabetes and arthritis do to overcome the challenges of both conditions?

Existing resources, such as self management education programs and physical activity programs, are designed to teach people the skills they need to take charge of their conditions and engage in effective, joint-friendly physical activity.
 

Self-management education programs

These programs teach people techniques to manage their chronic diseases, such as diabetes and arthritis, on a day-to-day basis. Specially tailored self-management education interventions, such as the Chronic Disease Self Management Program, and the arthritis-specific Arthritis Foundation Self-Help Program, help adults learn to manage arthritis pain and discuss how to increase physical activity safely.

  • Chronic Disease Self-Management Program (CDSMP) is an effective self-management education program for people with chronic health problems. The program specifically addresses arthritis, diabetes, lung and heart disease, but the skills taught are useful for managing a variety of chronic disease. This program was developed at Stanford University. CDSMP workshops are held in community settings and meet 2 1/2 hours per week for 6 weeks. Workshops are facilitated by two trained leaders, one or both of whom are non-health professionals with a chronic disease themselves. This program covers topics such as the following:

    • Techniques to deal with problems associated with chronic disease.
    • Appropriate exercise.
    • Appropriate use of medications.
    • Communicating effectively with family, friends, and health professionals.
    • Nutrition.
    • How to evaluate new treatments.

    Participants who took CDSMP demonstrated significant improvements in the following:
     

    • Exercise.
    • Communication with physicians.
    • Self-reported general health.
    • Health distress.
    • Fatigue.
    • Disability.
    • Social/role activities limitations.

    Locate your state arthritis program. More information about CDSMP is available.

     

  • Arthritis Foundation Self-Help Program (AFSHP) is an effective self-management education intervention for people with arthritis. Developed by Dr. Kate Lorig of Stanford University, the course helps people learn and practice the different techniques needed to build an individualized self-management program and gain the confidence to carry it out. The 6-week course consists of weekly 2-hour sessions guided by 2 trained instructors who follow a detailed protocol. There is a robust science base that demonstrates the positive impacts of participation in the Arthritis Foundation Self-Help Program: participants report a 20% decrease in pain, and a 40% decrease in physician visits, even 4 years after course participation. To find out about availability in your area you can check with the Arthritis Foundation or view this map to locate your state arthritis program.

Physical activity programs

Several exercise programs, including EnhanceFitness®, the Arthritis Foundation Exercise Program, and the Arthritis Foundation Aquatics Program, are available in many communities and are appropriate for adults with arthritis and adults with arthritis plus other chronic conditions (e.g., heart disease and diabetes).

In addition, people with diabetes and arthritis can engage in joint-friendly physical activity on their own or with friends. Some of the joint-friendly physical activities that are appropriate for adults with diabetes and arthritis are as follows:

  • Walking.
  • Swimming.
  • Riding a bike.

For more information on joint-friendly exercise programs, visit CDC’s Arthritis Web site. A physical activity fact sheet and information detailing the importance of physical activity for people with arthritis are available.

References:

1. Bolen J, Hootman J, Helmick CG, Murphy L, Langmaid G, Caspersen CJ. Arthritis as a Potential Barrier to Physical Activity Among Adults with Diabetes — United States, 2005 and 2007. MMWR 2008;57(18):486–489. html; pdf [1.25MB] page 165.

2. CDC. National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2005. Atlanta, GA: U.S. Department of Health and Human Services, CDC; 2005. Available at http://www.cdc.gov/diabetes/pubs/factsheet05.htm.

3. J Bolen, J Hootman, CG Helmick, L Murphy, G Langmaid, CJ Caspersen. Arthritis as a Potential Barrier to Physical Activity Among Adults with Diabetes --- United States, 2005 and 2007. MMWR 2008;57:486–9. html pdf [1.3Mb]

4. U.S. Department of Health and Human Services. 2008 physical activity guidelines for Americans. Hyattsville, MD: U.S. Department of Health and Human Services; 2008. Available at http://www.health.gov/paguidelines.

Further Information

CDC published research on arthritis and comorbidities.

Bolen J, Hootman J, Helmick CG, Murphy L, Langmaid G, Caspersen CJ. Arthritis as a Potential Barrier to Physical Activity Among Adults with Diabetes — United States, 2005 and 2007. MMWR 2008;57(18):486–489. html; pdf [1.25MB] page 165.

CDC. National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2005. Atlanta, GA: U.S. Department of Health and Human Services, CDC; 2005. Available at http://www.cdc.gov/diabetes/pubs/factsheet05.htm.

U.S. Department of Health and Human Services. 2008 physical activity guidelines for Americans. Hyattsville, MD: U.S. Department of Health and Human Services; 2008. Available at http://www.health.gov/paguidelines.

CDC Heart Disease Web site

CDC Diabetes program Web site

CDC Diabetes—Be Active

The Diabetes-Arthritis Connection - Arthritis Today from the Arthritis Foundation

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