Increasing physical activity in people with type 2 diabetes. (Pathophysiology/Complications: Original Article)

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Date: Apr. 2003
From: Diabetes Care(Vol. 26, Issue 4)
Publisher: American Diabetes Association
Document Type: Article
Length: 4,501 words

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OBJECTIVE -- To evaluate effect of exercise consultation on physical activity and resultant physiological and biochemical variables at 6 months in people with type 2 diabetes.

RESEARCH DESIGN AND METHODS -- A total of 70 inactive people with type 2 diabetes were given standard exercise information and were randomized to receive an exercise consultation (n = 35) or not (n = 35). Exercise consultation, based on the transtheoretical model, combines motivational theory and cognitive behavioral strategies into an individualized intervention to promote physical activity. Changes from baseline to 6 months were assessed in 1) physical activity (7-day recall, accelerometer, cardiorespiratory fitness, stage, and processes of change), 2) physiological variables (blood pressure and BMI), and 3) biochemical variables ([HbA.sub.1c], lipid profile, and fibrinogen).

RESULTS -- Between-group differences were recorded for the change in minutes of moderate activity (P < 0.001) and activity counts (P < 0.001) per week. Experimental participants recorded an increase in activity counts per week and minutes of moderate activity per week (P < 0.001). The control group recorded no significant changes. More experimental participants increased stage of change ([chi square] = 22.6, P < 0.001). Between-group differences were recorded for the change in total exercise duration and peak gradient (P < 0.005), [HbA.sub.1c] (P = 0.02), systolic BP (P = 0.02), and fibrinogen (P = 0.03).

CONCLUSIONS -- Exercise consultation increased physical activity and improved glycemic control and cardiovascular risk factors in people with type 2 diabetes.

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Traditional exercise guidelines to improve cardiorespiratory fitness recommend a minimum of 20 min of moderate to vigorous exercise three times a week (1). Participation in moderate, accumulated physical activity, which does not necessarily improve cardiorespiratory fitness, has the potential to improve health. Additional physical activity guidelines to improve and maintain health have been developed, and they recommend a minimum of 30 accumulated mm of moderate physical activity 5 days a week (2). Around 60-80% of people with type 2 diabetes do not meet these guidelines, and in comparison to the general population, they report more relapse from physical activity (3). People with type 2 diabetes report receiving less support, education, and encouragement for physical activity compared with any other aspect of diabetes management (4). Information is required to determine how to promote physical activity to this population.

In line with traditional exercise guidelines, the majority of research investigating the effects of physical activity on diabetes management have used structured exercise programs. These programs are effective at increasing physical activity and improving glycemic control and cardiovascular risk factors in people with type 2 diabetes over the short term (up to 3 months). These programs often target motivated, healthy people, are expensive to develop and maintain, and achieve poor long-term adherence. A large prospective study reported that only 25% of people with type 2 diabetes continued supervised exercise after 2 years (5).

Recently, physical activity counseling interventions have emerged as an alternative to structured programs. These interventions generally focus on the new physical activity recommendations and are a promising strategy for attracting...

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Gale Document Number: GALE|A100192803