Middle aged and older people with type 2 diabetes may be able to meet activity guidelines by playing games on the Wii Fit Plus system, according to a small Swiss study.

"Motivation to exercise is a major unsolved issue in patients with diabetes, especially type 2," said senior author Dr. Arno Schmidt-Trucksass of the University of Basel. "Alternatives are urgently needed and enjoyable exercise while playing a game might be one."

The American Diabetes Association recommends that adults aim for at least 30 minutes a day, five days a week, of moderate to vigorous aerobic activities like brisk walking, tennis or hiking. The ADA also recommends some type of strength training twice per week.

The researchers included 12 overweight or obese people with type 2 diabetes in their 50s and 60s. Ten of the participants were men.

The participants started with a test of maximum and average oxygen consumption during peak exertion on a treadmill. Two or three days later, researchers took the same oxygen consumption measures while the participants played three 10-minute bouts of Wii Fit games, including a boxing game, an obstacle course and a cycling game.

Playing the Wii Fit games brought heart rate and resting energy expenditure into the range of moderate aerobic activity, the researchers found. The participants reached more than 40 percent of the maximum oxygen consumption they had achieved in the all-out treadmill test, according to the results in the Clinical Journal of Sports Medicine.

"It could be even more but to start with an intensity just above 40 percent of maximal oxygen uptake is enough in order not to discourage people," Schmidt-Trucksass told Reuters Health by email. "Further, it should be pointed out, that they chose the exercise intensity by themselves."

The 12 participants individually adjusted the intensity of play according to their own fitness level, he explained.

But the exercise intensity of the games may be too low for younger people, he said.

"These results suggest that exergames may offer an alternative way to meet guidelines," said Deborah Thompson of Baylor College of Medicine in Houston, Texas.

"We need to keep in mind that to receive benefits, a specific exercise needs to be performed routinely and consistently, most days of the week," said Thompson, who was not involved in the study. "For people to do this regularly it needs to be fun, available and affordable."

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Games like this may suit some older people who have teens or young adults in the home and already have access to the gaming system, but they may not suit everyone, she said.

Regardless, older people with diabetes who want to change their exercise routine should check with their doctors first, she said.

"Particularly if they are not working out now, they need guidance on some of the signs that maybe they're overexerting or getting hypoglycemic," Thompson said. "There are lots of things that a physician can talk with them about."