Intensive exercise intervention for DM2

January 01, 0001

Intensive exercise intervention for DM2

This study by Italian investigators aimed to assess the efficacy of an intensive exercise intervention strategy in promoting physical activity (PA) and improving hemoglobin A1c(HbA1c) level and other modifiable cardiovascular risk factors in patients with type 2 diabetes mellitus (T2DM). Of 691 eligible sedentary patients with T2DM and the metabolic syndrome, 606 were enrolled in 22 outpatient diabetes clinics across Italy and randomized by center, age, and diabetes treatment to twice-a-week supervised aerobic and resistance training plus structured exercise counseling (exercise group) vs counseling alone (control group) for 12 months.

They found: "The mean volume of PA (metabolic equivalent hours per week) was significantly higher in the exercise (total PA, 20.0 and nonsupervised, 12.4) vs control (10.0) group. Compared with the control group, supervised exercise produced significant improvements (mean difference) in physical fitness; HbA1c level (-0.30%); systolic (-4.2 mm Hg) and diastolic (-1.7 mm Hg) blood pressure; high-density lipoprotein (3.7 mg/dL) and low- density lipoprotein (-9.6 mg/dL) cholesterol level; waist circumference (-3.6 cm); body mass index; insulin resistance; inflammation; and risk scores. These parameters improved only marginally in controls."

The authors concluded: "This exercise intervention strategy was effective in promoting PA and improving HbA1c and cardiovascular risk profile. Conversely, counseling alone, though successful in achieving the currently recommended amount of activity, was of limited efficacy on cardiovascular risk factors, suggesting the need for a larger volume of PA in these high-risk subjects."

Further evaluation of patient-oriented outcomes and cost- effectiveness are needed.

For the full abstract, click here.

Arch Intern Med 170(20):1794-1803, 8 November 2010 © 2010 to the American Medical Association
Effect of an Intensive Exercise Intervention Strategy on Modifiable Cardiovascular Risk Factors in Subjects With Type 2 Diabetes Mellitus-A Randomized Controlled Trial: The Italian Diabetes and Exercise Study (IDES). Stefano Balducci, Silvano Zanuso, Antonio Nicolucci, et al. Correspondence to Dr. Pugliese: [email protected]

Category: T. Endocrine/Metabolic/Nutritional. Keywords: exercise, physical activity, supervised, counseling, diabetes mellitus type 2, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 23 November 2009

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.