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Make Your Diabetic Patients Walk: Long-term impact of different amounts of physical activity on type 2 diabetes
- Di Loreto, Chiara, Fanelli, Carmine, Lucidi, Paola, Murdolo, Giuseppe, De Cicco, Arianna, Parlanti, Natascia, Ranchelli, Anna, Fatone, Cristina, Taglioni, Chiara, Santeusanio, Fausto, De Feo, Pierpaolo
- Diabetes care 2005 v.28 no.6 pp. 1295-1302
- blood glucose, blood pressure, blood serum, body weight, cholesterol, coronary disease, correlation, counseling, energy expenditure, fasting, heart rate, high density lipoprotein cholesterol, long term effects, low density lipoprotein, noninsulin-dependent diabetes mellitus, patients, physical activity, risk, triacylglycerols, waist circumference
- 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, HbA[subscript 1c], 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.