Background and aim:
The benefits of physical activity (PA) in improving glycemic control and
physical fitness in patients with type 2 diabetes are well documented.
However, data about effects of "real-life" PA programs in non-specialized
centers and especially about their long-term effects are lacking and
represent a relevant public health challenge.
We aimed to evaluate the effect of a nation-wide PA program (DIAfit) on PA,
well-being, body weight and metabolic parameters in patients with type 2
diabetes one year after the end of the program. We also asked about a
feedback regarding the program and about barriers to perform PA more
long-term.
Methods:
185 Patients with type 2 diabetes participated in a newly approved national
PA (DIAfit program) in 11 centers. All patients agreed to participate in the
study and were randomly assigned to one or two PA groups (1-2 versus 3
weekly sessions; in total 36 sessions for both groups) including 6-8
interactive group workshop. A first evaluation was done at the end of the
program.
The current study focuses on the second evaluation one year after the end of
the program. The first 123 patients who had finished the program one year
before were contacted and invited to participate. They received a
questionnaire and their physician was contacted to obtain further laboratory
information. The primary outcome measure was self-reported PA using the
short form of the International Physical Activity Questionnaire (IPAQ). Wellbeing
using the WHO-Five Well-being Index (WHO-5) questionnaire, weight,
the lipid profile and HbA1c were predefined secondary outcomes.
Results:
71 of 123 the invited participants completed and returned the questionnaire
(57.7%). Patients with follow-up data were slightly older, had a higher BMI,
Patients with follow-up data had significantly lower levels of moderate PA
and lower total well-being scores compared to patients with no follow-up
data (all p≤0.03).
Compared to baseline, moderate PA increased significantly and almost
doubled (p=0036) walking and the total IPAQ score had a tendency to
increase (both p=0.07) and vigorous PA did not change (p=0.350) one year
after the end of the program. Well-being increased significantly by around
10% (p=0.032). Weight, lipid parameters and HbA1c did not change except
for an increase in HDL-Cholesterol (p=0.01).
The most important barriers for PA were health problems and a reduced
physical condition (together 44%) and lack of motivation (19%). One year
after the program, 90% of the patients gave the program a score of at least
8 out of 10.
Conclusion
A PA program in unselected patients with type 2 diabetes can improve PA
and well-being one year after its end. There exist many barriers for PA in
this population and PA group programs are well appreciated.