In an attempt to weed out flukes & look for trends, a meta-analysis was published last week in JAMA, concluding that structured exercise was more effective at lowering HgbA1c than exercise advice, after culling 47 RCTs from 4,191 articles, by excluding those of shorter than 12 weeks' duration. Specifically, physical activity of greater than 150 minutes/week was twice as effective at lowering HgbA1c compared to exercise programs of less than or equal to 150 minutes/week.
Lest you feel bad about only leading the horse to water but not making him/her drink, physical activity advice plus dietary advice was associated w/better sugar control compared to those who did not receive any encouragement. So don't give up hope. Just like continuing to encourage tobacco cessation at each outpatient visit in those who smoke, it's imperative that we encourage our patients w/diabetes to exercise & eat wisely. Hopefully, we can then congratulate them when they actually take it upon themselves to become physically active more than 30 minutes/day, 5 days/week.