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 .
Lifestyle change and mobility in obese adults with type 2 diabetes.
BACKGROUND Adults with type 2 diabetes mellitus often have limitations in mobility that increase with age . An intensive lifestyle intervention that produces weight loss and improves fitness could slow the loss of mobility in such patients . METHODS We r and omly assigned 5145 overweight or obese adults between the ages of 45 and 74 years with type 2 diabetes to either an intensive lifestyle intervention or a diabetes support- and -education program ; 5016 participants contributed data . We used hidden Markov models to characterize disability states and mixed-effects ordinal logistic regression to estimate the probability of functional decline . The primary outcome was self-reported limitation in mobility , with annual assessment s for 4 years . RESULTS At year 4 , among 2514 adults in the lifestyle-intervention group , 517 ( 20.6 % ) had severe disability and 969 ( 38.5 % ) had good mobility ; the numbers among 2502 participants in the support group were 656 ( 26.2 % ) and 798 ( 31.9 % ) , respectively . The lifestyle-intervention group had a relative reduction of 48 % in the risk of loss of mobility , as compared with the support group ( odds ratio , 0.52 ; 95 % confidence interval , 0.44 to 0.63 ; P<0.001 ) . Both weight loss and improved fitness ( as assessed on treadmill testing ) were significant mediators of this effect ( P<0.001 for both variables ) . Adverse events that were related to the lifestyle intervention included a slightly higher frequency of musculoskeletal symptoms at year 1 . CONCLUSIONS Weight loss and improved fitness slowed the decline in mobility in overweight adults with type 2 diabetes . ( Funded by the Department of Health and Human Services and others ; Clinical Trials.gov number , NCT00017953 . )
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 .