The concept of exercise prescription is thought to be reserved for "health care professionals". Exercise prescription is the application of fitness principles to persons with a medical condition. Although no exercise professional should diagnose a disease, or try to treat diseases in a medical fashion, if they have a working knowledge of the condition they are working with, and have read most of the medical/sports medical literature to see how other programs have been constructed, then they should be able to prescribe a program for patients with information from the referring physician, and in many instances recommendations from physical therapists on orthopedic limitations for each person, as well. The ability to work with other allied health professionals (physicians, physical therapists, occupational therapists, dietitians) will be important in prescribing exercise in these special population groups. This article highlights current scientific research concerning special populations, give specific medical concerns regarding each group, and when appropriate, detail sample programs that will benefit both the club member, as well as the instructor.

What Constitutes A Special Population?
A special population may be defined in terms of exercise as a group with a special medical condition who may require expertise and supervision to overcome that medical situation. Other special populations may just need to improve their skill levels and knowledge, or increase awareness and social interaction of conditioning by participating in a regular physical activity.

The need for applying exercise to these groups is becoming more important, as more scientific information becomes available as to the efficacy of therapeutic programs. Therefore, the medical conditions in this series will highlight general physiology of each condition, and give information regarding exercise. Keeping in contact with physicians and allied health workers will be an important aspect of working with these groups, and fitness professionals who work with special populations will themselves become a member of the health care team.

Diabetes Mellitus
One of the more prevalent special population groups are diabetic patients. Diabetes is is defined as impaired glucose metabolism, and is one of the most common medical problems in the United States today. It is the third leading cause of death in this country, because of the complications which are undetected by those afflicted manifest themselves into cardiovascular heart disease and stroke, eye disease and blindness, kidney failure, muscle disease, and damage to almost every internal organ. One of the keys to treating diabetes is to prevent its onset, or prevent complications from arising once the disease has been diagnosed.

The use of exercise in diabetes patients has shown improvement in glucose tolerance and overall metabolism, and improvement in overall blood glucose control, cholesterol and strength. Exercise in general (aerobic or strength training) has an insulin like effect on glucose uptake into cells.