A minority of published evidence -based PA interventions for adults with T2D were both effective and pragmatic for clinical implementation .
Although regular physical activity ( PA ) is a cornerstone of treatment for type 2 diabetes ( T2D ) , most adults with T2D are sedentary .
R and omized controlled trials ( RCTs ) have proven the effectiveness of PA behavioral interventions for adults with T2D but have rarely been conducted in healthcare setting s. We sought to identify PA interventions that are effective and practical to implement in clinical practice setting s. Our first aim was to use the valid Pragmatic-Explanatory Continuum Indicator Summary 2 ( PRECIS-2 ) tool to assess the potential for future implementation of PA interventions in clinical practice setting s. Our second aim was to identify interventions that effectively increased PA and glycemic control among the interventions in the top tertile of PRECIS-2 scores .
Intensified multifactorial intervention in patients with type 2 diabetes mellitus and microalbuminuria: the Steno type 2 randomised study
BACKGROUND In type 2 diabetes mellitus the aetiology of long-term complications is multifactorial . We carried out a r and omised trial of stepwise intensive treatment or st and ard treatment of risk factors in patients with microalbuminuria . METHODS In this open , parallel trial patients were allocated st and ard treatment ( n=80 ) or intensive treatment ( n=80 ) .  St and ard treatment followed Danish guidelines . Intensive treatment was a stepwise implementation of behaviour modification , pharmacological therapy targeting hyperglycaemia , hypertension , dyslipidaemia , and microalbuminuria . The primary endpoint was the development of nephropathy ( median albumin excretion rate > 300 mg per 24 h in at least one of the two-yearly examinations ) . Secondary endpoints were the incidence or progression of diabetic retinopathy and neuropathy . FINDINGS The mean age was 55.1 years ( SD 7.2 ) and patients were followed up for 3.8 years ( 0.3 ) . Patients in the intensive group had significantly lower rates of progression to nephropathy ( odds ratio 0.27 [ 95 % CI 0 - 10 - 0.75 ] ) , progression of retinopathy ( 0.45 [ 0.21 - 0.95 ] ) , and progression of autonomic neuropathy ( 0.32 [ 0.12 - 0.78 ] ) than those in the st and ard group . INTERPRETATION Intensified multifactorial intervention in patients with type 2 diabetes and microalbuminuria slows progression to nephropathy , and progression of retinopathy and autonomic neuropathy . However , further studies are needed to establish the effect of intensified multifactorial treatment on macrovascular complications and mortality
A minority of published evidence -based PA interventions for adults with T2D were both effective and pragmatic for clinical implementation .
Although regular physical activity ( PA ) is a cornerstone of treatment for type 2 diabetes ( T2D ) , most adults with T2D are sedentary .
R and omized controlled trials ( RCTs ) have proven the effectiveness of PA behavioral interventions for adults with T2D but have rarely been conducted in healthcare setting s. We sought to identify PA interventions that are effective and practical to implement in clinical practice setting s. Our first aim was to use the valid Pragmatic-Explanatory Continuum Indicator Summary 2 ( PRECIS-2 ) tool to assess the potential for future implementation of PA interventions in clinical practice setting s. Our second aim was to identify interventions that effectively increased PA and glycemic control among the interventions in the top tertile of PRECIS-2 scores .