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Physical Activity and Diabetes: Opportunities for Prevention Through Policy

AD Deshpande, PhD, MPH, is Research Assistant Professor, Division of Health Behavior Research, Washington University School of Medicine, 4444 Forest Park Ave, Box 8504, St Louis, MO 63108 (USA)
EA Dodson, PhD, MPH, is Program Manager, Prevention Research Center in St Louis, George Warren Brown School of Social Work, Washington University, St Louis, Missouri
I Gorman, PT, MSPH, is Assistant Professor, School of Physical Therapy, Rueckert-Hartman College for Health Professions, Regis University, Denver, Colorado
RC Brownson, PhD, is Professor of Epidemiology, Prevention Research Center in St Louis, George Warren Brown School of Social Work, Washington University, and Department of Surgery and Siteman Cancer Center, Washington University School of Medicine

Address all correspondence to Dr Deshpande at: adeshpan{at}dom.wustl.edu

Over the past decade, the prevalence of type 2 diabetes mellitus has reached epidemic levels in the United States and other developed countries. With a concomitant rise in obesity levels in the United States and advances in the treatment of diabetes and its complications, the prevalence of diabetes is expected to continue to rise through the year 2050. Despite strong evidence that regular physical activity can prevent or delay the onset of diabetes, too many Americans are not meeting the recommended levels of regular physical activity. Although most physical activity interventions to date have been focused on characteristics of the individual, more-recent studies have considered how changing characteristics of the social and physical environment in which people live may ultimately have a greater impact on increasing population levels of physical activity. Policy interventions are a way to make sustainable changes in the physical environment of a community and thus provide support for other intrapersonal and interpersonal behavioral change interventions. Policy changes also can affect the social norms that shape behavior. The purposes of this perspective article are: (1) to describe the rationale for population approaches to primary prevention of type 2 diabetes, (2) to discuss how policy interventions can increase physical activity levels within populations, and (3) to provide recommendations for the role of physical therapists in interventions that can increase the level of physical activity in communities. Public health approaches to curb the diabetes epidemic are urgently needed. Policy interventions to increase population levels of physical activity show promise for diabetes prevention. Physical therapists are uniquely suited to influence primary prevention efforts for diabetes.

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