Di Loreto Chiara, Fanelli Carmine, Lucidi Paola, Murdolo Giuseppe, De Cicco Arianna, Parlanti Natascia, Santeusanio Fausto, Brunetti Paolo, De Feo Pierpaolo
Department of Internal Medicine, Section Internal Medicine, Endocrine and Metabolic Sciences, University of Perugia, Italy.
Diabetes Care. 2003 Feb;26(2):404-8. doi: 10.2337/diacare.26.2.404.
There is enough evidence that physical activity is an effective therapeutic tool in the management of type 2 diabetes. The present study was designed to validate a counseling strategy that could be used by physicians in their daily outpatient practice to promote the adoption and maintenance of physical activity by type 2 diabetic subjects.
The long-term (2-year) efficacy of the behavioral approach (n = 182) was compared with usual care treatment (n = 158) in two matched, randomized groups of patients with type 2 diabetes who had been referred to our Outpatient Diabetes Center. The outcome of the intervention was consistent patient achievement of an energy expenditure of >10 metabolic equivalents (METs)-h/week through voluntary physical activity.
After 2 years, 69% of the patients in the intervention group (27.1 +/- 2.0 METs x h/week) and 18% of the control group (4.1 +/- 0.8 METs x h/week) achieved the target (P < 0.001) with significant (P < 0.001) improvements in BMI (intervention group 28.9 +/- 0.2 versus control group 30.4 +/- 0.3 kg/m(2)) and HbA(1c) (intervention group 7.0 +/- 0.1 versus control group 7.6 +/- 0.1%).
This randomized, controlled study shows that physicians can motivate most patients with type 2 diabetes to exercise long-term and emphasizes the value of individual behavioral approaches in daily practice.
有充分证据表明,体育活动是管理2型糖尿病的一种有效治疗手段。本研究旨在验证一种咨询策略,供医生在日常门诊实践中使用,以促进2型糖尿病患者采用并维持体育活动。
在两个匹配的随机分组中,将行为疗法组(n = 182)与常规护理治疗组(n = 158)的长期(2年)疗效进行比较,两组均为转诊至我们门诊糖尿病中心的2型糖尿病患者。干预的结果是患者通过自愿体育活动持续达到每周能量消耗>10代谢当量(METs)-小时。
2年后,干预组69%的患者(27.1±2.0 METs×小时/周)和对照组18%的患者(4.1±0.8 METs×小时/周)达到目标(P<0.001),体重指数(BMI)(干预组28.9±0.2与对照组30.4±0.3 kg/m²)和糖化血红蛋白(HbA1c)(干预组7.0±0.1与对照组7.6±0.1%)有显著改善(P<0.001)。
这项随机对照研究表明,医生可以激励大多数2型糖尿病患者长期锻炼,并强调了日常实践中个体行为疗法的价值。