Does home-based exercise improve body mass index in patients with type 2 diabetes? Results of a feasibility trial

Ochsner Clinic Foundation, Center for Health Research, New Orleans, LA 70121, United States.
Diabetes research and clinical practice (Impact Factor: 2.54). 02/2008; 79(2):230-6. DOI: 10.1016/j.diabres.2007.08.028
Source: PubMed


This feasibility trial evaluated the use, safety, and short-term benefits of a home-based exercise intervention designed to increase physical activity among adults with diabetes.
Participants with type 2 diabetes in a group practice were recruited and randomly assigned to the home-based exercise intervention or usual care. Participants were given diabetes self-management education, instructed to exercise 30 min 5 days/week, and were followed for 3 months. The intervention contained three exercise routines (aerobic and resistance exercises). Outcomes included changes from baseline at 3 months between groups in body mass index (BMI), quality of life, A1C, and blood pressure.
Seventy-six sedentary adults completed the study: 49% intervention group, 68% women, 47% black, mean age 56.6+/-9.6 years. Using intention to treat analysis, a trend towards improvement between groups for BMI (mean change -0.4 versus 0.1, respectively; P=0.06) was identified. Thirty-eight percent of the intervention group adhered to 80% of the exercise recommendation and significantly improved BMI (-1.07; P<0.05). No other differences were detected between groups.
Home-based exercise interventions have potential to reduce BMI in patients with diabetes. The results provide variance estimates necessary to power a larger study of longer duration.

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    • "These lifestyle interventions, which generally included both physical activity and nutritional interventions, have been highly successful in preventing the onset of type 2 diabetes. Studies that failed to show improved glycemic control typically reported poor exercise compliance (11) or low-intensity exercise (12). However, most physical activity intervention studies focused on English speakers. "
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    ABSTRACT: To determine the association of regular exercise, BMI, and fasting glucose with the risk of type 2 diabetes and to predict the risk. Korean subjects (n = 7,233; 40-79 years old) who were not diagnosed with diabetes at baseline were enrolled through the National Health Insurance Corporation. All participants underwent biennial examinations, and 1,947 of 7,233 subjects also underwent a 6-month program of moderate-intensity exercise (300 min/week) without dietary advice. During follow-up (mean = 2 years), there were 303 incidents of type 2 diabetes in the nonexercise program group (n = 5,286) and 83 in the exercise program group (n = 1,947). After adjusting for confounders, the risk of type 2 diabetes was positively associated with BMI and inversely with regular exercise, especially among overweight/obese subjects. After further adjustment for BMI, the odds ratios for risk of diabetes associated without and with regular exercise were 1.00 and 0.77, respectively. Among subjects with normal fasting glucose, exercise reduced the diabetes risk; however, among those with impaired fasting glucose (IFG), the protective effect of exercise was found only among overweight/obese subjects. The overweight/obese subjects in the exercise program group exhibited improved fasting glucose compared with the nonexercise program group and showed 1.5 kg of weight loss and a 3-cm decrease in waist circumference. Among overweight/obese subjects with unchanged fasting glucose, weight loss was greater in the exercise program group. Regular exercise reduces the risk of type 2 diabetes in overweight/obese individuals. Particularly, regular exercise and weight or waist circumference control are critical factors for preventing diabetes in overweight/obese individuals with IFG.
    Full-text · Article · Jun 2012 · Diabetes care
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    • "Marrero et al. (1988) found that adolescents with type 1 diabetes significantly increased their VO 2 levels and decreased their HbA1c levels through a twelve-week programme (weekly 45 minutes cycling sessions ). In addition, some studies have found that long-term aerobic exercise is beneficial for glycaemic control (Chao et al. 2007; Krousel-Wood et al. 2008). However, in designing our protocol, we took into account the demanding schoolwork of children and adolescents with type 1 DM. "
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    ABSTRACT: To explore the effects of exercise programme on glycosylated haemoglobin and peak oxygen uptake in children and adolescents with type 1 diabetes mellitus. Regular exercise has been shown to be effective in blood glucose control, which includes improving glucose tolerance and insulin sensitivity, decreasing glycosylated haemoglobin levels and improving cardiorespiratory fitness. Quasi-experimental design with a twelve-week home-based aerobic exercise programme. Twenty-eight participants completed the study: 12 in the home-based exercise group, 11 in the non-exercise control group and five in the self-directed exercise group. A mixed model was used to capture longitudinal change in glycosylated haemoglobin levels. The home-based aerobic exercise group showed no significant effect on glycemic control and peak oxygen uptake in this study across assessment times. However, a group difference in glycosylated haemoglobin levels at the nine-month follow-up was significant (general linear model: F = 4.06, p = 0.03). A Bonferroni test indicated that glycosylated haemoglobin levels in the home-based exercise group were higher than in the self-directed exercise group (p < 0.05) and higher in the control group than in the self-directed exercise group (p < 0.05) at the nine-month follow-up. Home-based aerobic exercise showed no significant effect on peak oxygen uptake in this study. A three-month home-based aerobic exercise programme has no significant effect on glycosylated haemoglobin and peak oxygen uptake levels in children with type 1 diabetes mellitus. Our exercise programme has designed that children can practice exercise at home and is a viable component of self-care intervention to improve patient's self-care skill and diabetes care control. However, how to encourage patients to adhere the exercise programme is a challenge for health care providers.
    Full-text · Article · Mar 2011 · Journal of Clinical Nursing
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    • "Among patients with diabetes, the benefits of regular physical activity have been well documented [24]. It was shown that restrictions on dietary freedom have a major negative impact on QoL [25]. "
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    ABSTRACT: The quality of life in patients with diabetes is reduced and emotional coping with the disease has great impact on patient well-being. The aim of this study was to assess the psychological well-being and treatment satisfaction in patients with type 2 diabetes mellitus in primary care. Patients (n = 112) with type 2 diabetes mellitus diagnosis for at least six months were enrolled. The Well-Being Questionnaire-22 and the Diabetes Treatment Satisfaction Questionnaire were used. Physical examination and laboratory investigations were performed. The rates of the achieved targets were 32.1% for hemoglobin A1c, 62.5% for cholesterol and 20.5% for blood pressure. The mean scores for the general well-being, depression, anxiety, positive well-being and energy were 44.40 +/- 13.23 (range = 16-62), 12.65 +/- 3.80 (range = 5-18), 10.57 +/- 4.47 (range = 1-18), 12.00 +/- 4.01 (range = 2-18), and 9.16 +/- 2.47 (range = 2-12), respectively. The mean scores for the treatment satisfaction, perception for hyperglycemia and perception for hypoglycemia were 22.37 +/- 9.53 (range = 0.00-36.00), 1.71 +/- 1.59 (range = 0-6), and 0.51 +/- 0.98 (range = 0-6), respectively. There were significant associations between the depression score and the educational status, compliance to diet and physical exercise, and diabetic complications; between the anxiety score and the educational status, glycemic control, compliance to diet and physical exercise; between the energy score and the educational status, compliance to physical exercise, and diabetic complications; between the positive well-being score and the educational status, compliance to diet and physical exercise, complications and type of treatment; between the general well-being score and the educational status, compliance for diet and physical exercise, and complications. Treatment satisfaction was significantly associated to the educational status, glycemic control and compliance to diet and physical exercise. A significant correlation was found between the treatment satisfaction and the well-being. Individualized care of patients with diabetes should consider improving the quality of life. Psychosocial support should be provided to the patients with type 2 diabetes and the negative effects of psychopathological conditions on the metabolic control should be lessened.
    Full-text · Article · Jul 2010 · Health and Quality of Life Outcomes
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