Make Your Diabetic Patients Walk
Long-term impact of different amounts of physical activity on type 2 diabetes
- Chiara Di Loreto, MD,
- Carmine Fanelli, MD,
- Paola Lucidi, MD,
- Giuseppe Murdolo, MD,
- Arianna De Cicco, MD,
- Natascia Parlanti, MD,
- Anna Ranchelli, MD,
- Cristina Fatone, MD,
- Chiara Taglioni, MD,
- Fausto Santeusanio, MD and
- Pierpaolo De Feo, MD
- Department of Internal Medicine, Section of Internal Medicine, Endocrine and Metabolic Sciences, University of Perugia, Perugia, Italy
- Address correspondence and reprint requests to Prof. Pierpaolo De Feo, DIMI, Via E. Dal Pozzo, 06126 Perugia, Italy. E-mail: defeo{at}dimisem.med.unipg.it
Abstract
OBJECTIVE—To establish the impact of different amounts of increased energy expenditure on type 2 diabetes care.
RESEARCH DESIGN AND METHODS—Post hoc analysis of long-term effects of different amounts of increased energy expenditure (metabolic equivalents [METS] per hour per week) through voluntary aerobic physical activity was performed in 179 type 2 diabetic subjects (age 62 ± 1 years [mean ± SE]) randomized to a physical activity counseling intervention. Subjects were followed for 2 years and divided into six groups based on their increments in METs per hour per week: group 0 (no activity, n = 28), group 1–10 (6.8 ± 0.3, n = 27), group 11–20 (17.1 ± 0.4, n = 31), group 21–30 (27.0 ± 0.5, n = 27), group 31–40 (37.5 ± 0.5, n = 32), and group >40 (58.3 ± 1.8, n = 34).
RESULTS—At baseline, the six groups did not differ for energy expenditure, age, sex, diabetes duration, and all parameters measured. After 2 years, in group 0 and in group 1–10, no parameter changed; in groups 11–20, 21–30, 31–40, and >40, HbA1c, blood pressure, total serum cholesterol, triglycerides, and estimated percent of 10-year coronary heart disease risk improved (P < 0.05). In group 21–30, 31–40, and >40, body weight, waist circumference, heart rate, fasting plasma glucose, serum LDL and HDL cholesterol also improved (P < 0.05). METs per hour per week correlated positively with changes of HDL cholesterol and negatively with those of other parameters (P < 0.001). After 2 years, per capita yearly costs of medications increased (P = 0.008) by $393 in group 0, did not significantly change in group 1–10 ($206, P = 0.09), and decreased in group 11–20 (−$196, P = 0.01), group 21–30 (−$593, P = 0.009), group 31–40 (−$660, P = 0.003), and group >40 (−$579, P = 0.001).
CONCLUSIONS—Energy expenditure >10 METs · h−1 · week−1 obtained through aerobic leisure time physical activity is sufficient to achieve health and financial advantages, but full benefits are achieved with energy expenditure >20 METs · h−1 · week−1.
- CHD, coronary heart disease
- FPG, fasting plasma glucose
- MET, metabolic equivalent
- NHS, National Health Service
Footnotes
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A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
See accompanying editorial, p. 1524.
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- Accepted January 15, 2005.
- Received November 29, 2004.
- DIABETES CARE
