Department of Clinical and Molecular Medicine, ''La Sapienza'' University, Rome, Italy.
Diabetes Unit, Sant'Andrea Hospital, Rome, Italy.
Diabetes Care. 2017 Nov;40(11):1444-1452. doi: 10.2337/dc17-0594. Epub 2017 Aug 18.
Adherence to physical activity (PA) recommendations is hampered by the lack of effective strategies to promote behavior change. The Italian Diabetes and Exercise Study 2 (IDES_2) is a randomized controlled trial evaluating a novel behavioral intervention strategy for increasing PA and decreasing sedentary time (SED-time) in patients with type 2 diabetes.
The study randomized 300 physically inactive and sedentary patients with type 2 diabetes 1:1 to receive theoretical and practical counseling once yearly for 3 years (intervention group [INT]) or standard care (control group [CON]). Here, we report the 4-month effects on objectively (accelerometer) measured daily light-intensity PA (LPA), moderate-to-vigorous-intensity PA (MVPA), and SED-time, and cardiovascular risk factors.
LPA and MVPA both increased, and SED-time decreased in both groups, although changes were significantly more marked in INT participants (approximately twofold for LPA and SED-time and approximately sixfold for MVPA). A significant reduction in HbA was observed only in INT subjects. An increase in LPA >0.92 h · day and in MVPA >7.33 min · day and a decrease in SED-time >1.05 h · day were associated with an average decrease in HbA of ∼1% and also with significant improvements in fasting glucose, body weight, waist circumference, and hs-CRP. Changes in PA and SED-time were independent predictors of improvements in HbA.
This behavioral intervention is effective in the short term for increasing LPA and MVPA and reducing SED-time. Significant improvements in cardiometabolic risk profiles were observed in subjects experiencing the most pronounced changes in PA and SED-time, even if below the recommended level.
由于缺乏促进行为改变的有效策略，身体活动（PA）建议的依从性受到阻碍。意大利糖尿病和运动研究 2 期（IDES_2）是一项随机对照试验，评估了一种新的行为干预策略，以增加 2 型糖尿病患者的 PA 并减少久坐时间（SED-time）。
该研究将 300 名身体不活跃且久坐的 2 型糖尿病患者以 1:1 的比例随机分为两组，分别接受每年一次的理论和实践咨询，持续 3 年（干预组 [INT]）或标准护理（对照组 [CON]）。此处，我们报告了 4 个月内对客观（加速度计）测量的日常低强度 PA（LPA）、中高强度 PA（MVPA）和 SED-time 以及心血管危险因素的影响。
两组的 LPA 和 MVPA 均增加，SED-time 减少，尽管 INT 参与者的变化更为显著（LPA 和 SED-time 增加约两倍，MVPA 增加约六倍）。仅在 INT 受试者中观察到 HbA 显著降低。LPA 增加>0.92 h·天，MVPA 增加>7.33 min·天，SED-time 减少>1.05 h·天与 HbA 平均降低约 1%以及空腹血糖、体重、腰围和 hs-CRP 的显著改善相关。PA 和 SED-time 的变化是 HbA 改善的独立预测因素。
这种行为干预在短期内有效增加 LPA 和 MVPA 并减少 SED-time。在 PA 和 SED-time 变化最明显的受试者中观察到心血管代谢风险特征的显著改善，即使低于推荐水平。
