DENVER - Bad news when it comes to diabetics and exercise: Most people with Type 2 diabetes or at risk for it apparently ignore their doctors' advice to be active.

Fewer than 40 percent get exercise, a new study found, and the more in danger the patients are, the less likely they are to be active.

That is despite an earlier study that found nearly three-quarters of diabetics said their doctors had advised them to exercise. The patients who got the strongest warnings to get moving were the least likely to listen, according to research being released today.

"People should exercise more - that story is out," said Elaine Morrato, who led both studies. "What we're saying is, 'Here's a high-risk population that can benefit from exercise, and they're even less likely to exercise.' "

Without exercise, Type 2 diabetics face complications ranging from nerve damage to high blood pressure.

Morrato, an assistant professor at the University of Colorado Denver, said researchers surveyed more than 22,000 patients for the new survey. Results appear in the February's Diabetes Care, published by the American Diabetes Association.

The federal Centers for Disease Control and Prevention estimates more than 20 million Americans have diabetes, about 90 percent of them Type 2, which is linked with obesity.

Larry Deeb, president of medicine and science at the diabetes association, said that by the time patients had Type 2 diabetes or were at risk of getting it, the deck was stacked against them. They may already have problems with mobility as a result of obesity or foot and circulatory disorders that make exercise difficult.

"There's a difference between being unable and being unwilling," he said.

Even for the most disabled, there is hope, fitness expert Charlotte Hayes said, but health professionals must do more.

Hayes, who wrote The I Hate to Exercise Book for People With Diabetes, said telling patients to exercise is different from telling them how.

For those who can walk, a few steps a day helps, she said. For those who can't, there are alternatives.

"We take a small-steps approach," she said.

The diabetes association recommends people get at least 30 minutes of aerobic exercise, such as brisk walking, five times a week. But the group says that for those who cannot, there are benefits from even five minutes a day, along with everyday activities such as gardening or walking to work.

See more on treatment

and prevention at the association's Web site via