Patients should move away from using hospitals and medications and get some exercise prescribed instead

Patients should move away from using hospitals and medications and get some exercise prescribed instead
Mathias Ried-Larsen

How little movement is required to reduce the risk of type 2 diabetes, and can an exercise programme really be used as a treatment and/or cure for type 2 diabetes? These are the two main questions Mathias Ried-Larsen asks himself in his research, and he already has part of the answer: A review of 17 domestic and foreign research projects, which he conducted, has concluded that if one interrupts lengthy sedentary periods with just a little movement, it appears to have health-promoting effects on many inactive and/or overweight persons. 

“Our message to those who don’t get much exercise is that they should not give up, because it’s not impossible. It’s not a question of how much time you spend sitting that is important, but how you sit. If you just get on your feet and move around a little”, says Mathias Ried-Larsen, who hopes that moving around a little may make you want to get more exercise. “If movement is medicine, which still has yet to be demonstrated, a little physical activity and interrupting sedentary activities could be a gateway drug”, he says. 

“Although this is good news, it may require a larger effort to move patients away from – and keep them away from – hospitals and excessive use of medications. Therefore, I seek to empower patients to sustain a physically active lifestyle. This requires continuously developing and testing feasible lifestyle-based treatment strategies which are at least as efficient and safe as standard care. To ensure effectiveness, these strategies should be developed and tested in the environment where they are used. One important aspect of my research includes communicating research results to the public, in acknowledgment that practice can be reformed by both those who perform and those who require treatment. I aim to have my research acknowledged and understood by clinicians as well as by patients and policymakers”, says Mathias Ried-Larsen. 

Lifestyle interventions

Mathias Ried-Larsen works with lifestyle intervention at Copenhagen University Hospital, Rigshospitalet, for the project U-TURN. Lifestyle intervention is recognized as first-line treatment in type 2 diabetes as a supplement to pharmacological treatment. However, type 2 diabetes is regarded as an irreversible condition requiring increasing use of medication over a lifetime, with the accompanying side effects and multimorbidity. There is an increasing body of evidence suggesting that type 2 diabetes conditions can be reversed using gastric bypass, for example. Although lifestyle intervention is efficient in regulating blood sugar, no studies have shown that it can replace pharmaceutical treatment for type 2 diabetes or cure the disease. “If it can be shown that lifestyle intervention is equivalent to pharmaceutical treatment or can reduce or eliminate the need for medication, this study will provide patients and physicians with a real alternative to standard disease management”, Ried-Larsen says. 

Relationship between work and private life

There is a strong relationship between Mathias’s work and his private life. He had a career in gymnastics for over 20 years, both as a gymnast and as a coach, but he had to stop after he had some injuries. Now he rides mountain bike a few times a week, plays beach volleyball, runs and does ‘whatever comes along’. He and his wife Anja take active vacations together, going hiking, doing water sports, for example. And he is about to initiate three-year old Alberte and five-year old Karla into the joys of the outdoor life—the pleasure of lying in a tent and having everything you need, but in a backpack. 

Even if he is taking his own medicine—or rather attempting to share his own joy in physical activity—he does not do as he says. He could never, never imagine living a life where he only got up a few times an hour and moved around a little. But he is enthusiastic about telling patients that indeed so little can change so much …

Danish Diabetes Academy Post Doc Mathias Ried-Larsen