Introduction
Methods
Participants
Characteristic | Total (n = 92) | Brisk walking (n = 49) | Medical fitness (n = 43) |
---|---|---|---|
Age (years) | 60 ± 9 | 61 ± 9 | 59 ± 9 |
Men/women (n) | 47/45 | 27/22 | 20/23 |
Duration of diabetes (years) | 5 ± 5 | 5 ± 4 | 5 ± 5 |
BW (kg) | 94.3 ± 18.4 | 94.1 ± 18.1 | 94.5 ± 19.0 |
BMI (kg/m2) | 32.3 ± 5.5 | 32.1 ± 5.2 | 32.5 ± 6.0 |
W
max (W) | 156 ± 47 | 155 ± 49 | 157 ± 45 |
Estimated \(\mathop {V{\text{O}}}\limits^ \cdot _{{\text{2peak}}} \) (l/min) | 2.1 ± 0.6 | 2.1 ± 0.6 | 2.1 ± 0.6 |
%Pred. \(\mathop {V{\text{O}}}\limits^ \cdot _{{\text{2peak}}} \)
| 82 ± 11 | 82 ± 10 | 83 ± 11 |
Participants treated with: | |||
Diet only (n) | 11 | 5 | 6 |
Hypoglycaemic agents (n) | |||
Total | 81 | 44 | 37 |
Metformin | 43 | 24 | 19 |
Sulfonylurea | 25 | 13 | 12 |
Thiazolidinedione | 10 | 4 | 6 |
Insulin | 13 | 6 | 7 |
Antihypertensive agents (n) | |||
Total | 59 | 32 | 27 |
ACEI/ARB | 39 | 20 | 19 |
Beta-blocker | 17 | 7 | 10 |
Diuretic | 19 | 10 | 9 |
Calcium-channel blocker | 9 | 5 | 4 |
Other | 3 | 1 | 2 |
Lipid-lowering agents (n) | |||
Total | 54 | 30 | 24 |
Statin | 53 | 29 | 24 |
Fibrate | 1 | 1 | 0 |
Other | 0 | 0 | 0 |
Exercise intervention
Outcome variables
Quality-of-life assessment
Statistical analyses
Results
Characteristics of the study population
Programme adherence, follow-up and adverse events
Events | Brisk walking (n = 49) | Medical fitness (n = 43) |
---|---|---|
Adverse events related to exercise intervention | 15 | 12 |
Shoulder pain/chronic tendinopathy of rotator cuff | 0 | 1 |
(Aggravation of) low back pain | 2 | 2 |
Aggravation of pre-existing osteoarthritis in hip or knee joint | 6 | 4 |
Shin splints/lower leg pain | 1 | 0 |
Chronic tendinopathy of Achilles tendon/plantar fascia | 3 | 1 |
Other/generalised musculoskeletal discomfort | 3 | 3 |
Adverse events not related to exercise intervention | 4 | 6 |
Medical event requiring hospitalisationa
| 3 | 3 |
Other serious medical eventb
| 1 | 3 |
Participants with adverse event resulting in withdrawal | 19 | 17 |
Glycaemic control
Variable | Change from baseline to 12 months | ||||||
---|---|---|---|---|---|---|---|
Mean ± SD |
n
| Mean ± SD |
n
| Difference | 95% CI |
p Value | |
HbA1c (%) | |||||||
Total | 7.13 ± 1.36 | 92 | 6.99 ± 1.26 | 71 | |||
Brisk walking group | 7.18 ± 1.42 | 49 | 7.08 ± 1.37 | 38 | |||
Medical fitness group | 7.08 ± 1.29 | 43 | 6.89 ± 1.13 | 33 | |||
Intragroup comparisons | |||||||
Intragroup comparison total | −0.14 | −0.39, 0.03 | 0.153 | ||||
Intragroup comparison brisk walking | −0.11 | −0.51, 0.15 | 0.464 | ||||
Intragroup comparison medical fitness | −0.18 | −0.45, 0.09 | 0.176 | ||||
Brisk walking vs medical fitness | 0.00 | −0.42, 0.43 | 0.985 | ||||
BMI (kg/m2) | |||||||
Total | 32.3 ± 5.5 | 92 | 31.8 ± 5.4 | 89 | |||
Brisk walking group | 32.1 ± 5.2 | 49 | 31.9 ± 5.0 | 48 | |||
Medical fitness group | 32.5 ± 6.0 | 43 | 31.7 ± 5.9 | 41 | |||
Intragroup comparisons | |||||||
Intragroup comparison total | −0.5 | −1.1, 0.1 | 0.108 | ||||
Intragroup comparison brisk walking | −0.2 | −0.6, 0.3 | 0.471 | ||||
Intragroup comparison medical fitness | −0.8 | −2.0, 0.3 | 0.152 | ||||
Brisk walking vs medical fitness | 0.7 | −0.5, 1.9 | 0.237 | ||||
Fasting plasma glucose (mmol/l) | |||||||
Total | 8.44 ± 2.81 | 92 | 8.21 ± 2.37 | 71 | |||
Brisk walking group | 8.64 ± 2.83 | 49 | 8.33 ± 2.64 | 38 | |||
Medical fitness group | 8.21 ± 2.80 | 43 | 8.06 ± 2.05 | 33 | |||
Intragroup comparisons | |||||||
Intragroup comparison total | −0.23 | −0.72, 0.25 | 0.345 | ||||
Intragroup comparison brisk walking | −0.31 | −0.96, 0.34 | 0.344 | ||||
Intragroup comparison medical fitness | −0.15 | −0.91, 0.61 | 0.699 | ||||
Brisk walking vs. medical fitness | −0.16 | −1.14, 0.82 | 0.744 | ||||
HOMAa
| |||||||
Total | 5.55 ± 3.68 | 68 | 5.60 ± 3.38 | 54 | |||
Brisk walking group | 5.86 ± 3.56 | 37 | 5.75 ± 3.20 | 30 | |||
Medical fitness group | 5.19 ± 3.58 | 31 | 5.43 ± 3.64 | 24 | |||
Intragroup comparisons | |||||||
Intragroup comparison total | 0.05 | −0.50, 0.62 | 0.833 | ||||
Intragroup comparison brisk walking | −0.12 | −1.11, 0.85 | 0.794 | ||||
Intragroup comparison medical fitness | 0.24 | −0.19, 0.74 | 0.241 | ||||
Brisk walking vs medical fitness | −0.40 | −1.52, 0.72 | 0.479 | ||||
Resting heart rate (bpm) | |||||||
Total | 73.4 ± 11.8 | 91 | 69.6 ± 13.9 | 77 | |||
Brisk walking group | 72.6 ± 11.8 | 48 | 68.3 ± 15.0 | 41 | |||
Medical fitness group | 74.4 ± 11.8 | 43 | 71.0 ± 12.4 | 36 | |||
Intragroup comparisons | |||||||
Intragroup comparison total | −3.9 | −5.9, −1.8 | 0.000 | ||||
Intragroup comparison brisk walking | −4.3 | −7.4, −1.1 | 0.009 | ||||
Intragroup comparison medical fitness | −3.4 | −5.9, −0.9 | 0.010 | ||||
Brisk walking vs medical fitness | −0.9 | −4.9, 3.2 | 0.678 | ||||
Systolic blood pressure (mmHg) | |||||||
Total | 148.5 ± 18.1 | 91 | 137.5 ± 15.5 | 77 | |||
Brisk walking group | 150.3 ± 18.9 | 48 | 138.9 ± 16.3 | 41 | |||
Medical fitness group | 146.3 ± 17.1 | 43 | 135.9 ± 14.6 | 36 | |||
Intragroup comparisons | |||||||
Intragroup comparison total | −10.9 | −14.0, −7.8 | 0.000 | ||||
Intragroup comparison brisk walking | −11.4 | −15.9, −6.8 | 0.000 | ||||
Intragroup comparison medical fitness | −10.4 | −14.7, 6.2 | 0.000 | ||||
Brisk walking vs medical fitness | −0.9 | −7.1, 5.3) | 0.768 | ||||
Diastolic blood pressure (mmHg) | |||||||
Total | 81.9 ± 10.6 | 91 | 76.6 ± 8.3 | 77 | |||
Brisk walking group | 81.3 ± 10.8 | 48 | 75.9 ± 8.8 | 41 | |||
Medical fitness group | 82.6 ± 10.4 | 43 | 77.4 ± 7.7 | 36 | |||
Intragroup comparisons | |||||||
Intragroup comparison total | −5.3 | −7.1, −3.6 | 0.000 | ||||
Intragroup comparison brisk walking | −5.4 | −7.8, 2.9 | 0.000 | ||||
Intragroup comparison medical fitness | −5.2 | −7.8, −2.7 | 0.000 | ||||
Brisk walking vs medical fitness | −0.1 | −3.6, 3.4 | 0.949 | ||||
Total cholesterol level (mmol/l) | |||||||
Total | 4.70 ± 0.86 | 88 | 4.53 ± 0.94 | 65 | |||
Brisk walking group | 4.83 ± 0.89 | 47 | 4.61 ± 0.92 | 35 | |||
Medical fitness group | 4.54 ± 0.12 | 41 | 4.44 ± 0.96 | 30 | |||
Intragroup comparisons | |||||||
Intragroup comparison total | −0.16 | −0.32, −0.01 | 0.035 | ||||
Intragroup comparison brisk walking | −0.22 | −0.45, 0.01 | 0.064 | ||||
Intragroup comparison medical fitness | −0.10 | −0.30, 0.10 | 0.307 | ||||
Brisk walking vs medical fitness | −0.12 | −0.42, 0.19 | 0.453 | ||||
LDL-cholesterol level (mmol/l) | |||||||
Total | 2.83 ± 0.76 | 88 | 2.70 ± 0.79 | 64 | |||
Brisk walking group | 2.90 ± 0.82 | 47 | 2.72 ± 0.85 | 35 | |||
Medical fitness group | 2.74 ± 0.69 | 41 | 2.68 ± 0.72 | 29 | |||
Intragroup comparisons | |||||||
Intragroup comparison total | −0.12 | −0.26, 0.01 | 0.070 | ||||
Intragroup comparison brisk walking | −0.18 | −0.38, 0.02 | 0.080 | ||||
Intragroup comparison medical fitness | −0.06 | –0.25, 0.12 | 0.493 | ||||
Brisk walking vs medical fitness | −0.11 | −0.38, 0.16 | 0.401 | ||||
HDL-cholesterol level (mmol/l) | |||||||
Total | 1.09 ± 0.28 | 88 | 1.10 ± 0.29 | 65 | |||
Brisk walking group | 1.10 ± 0.23 | 47 | 1.09 ± 0.26 | 35 | |||
Medical fitness group | 1.07 ± 0.33 | 41 | 1.11 ± 0.32 | 30 | |||
Intragroup comparisons | |||||||
Intragroup comparison total | −0.01 | –0.02, 0.04 | 0.570 | ||||
Intragroup comparison brisk walking | −0.01 | −0.06, 0.04 | 0.629 | ||||
Intragroup comparison medical fitness | 0.03 | −0.01, 0.08 | 0.129 | ||||
Brisk walking vs medical fitness | −0.05 | −0.12, 0.02 | 0.172 | ||||
Triacylglycerol level (mmol/l) | |||||||
Total | 1.88 ± 0.99 | 88 | 1.79 ± 0.91 | 64 | |||
Brisk walking group | 2.00 ± 1.08 | 47 | 1.94 ± 0.98 | 35 | |||
Medical fitness group | 1.74 ± 0.88 | 41 | 1.61 ± 0.79 | 29 | |||
Intragroup comparisons | |||||||
Intragroup comparison total | −0.09 | −0.25, 0.06 | 0.239 | ||||
Intragroup comparison brisk walking | −0.06 | −0.33, 0.17 | 0.646 | ||||
Intragroup comparison medical fitness | −0.13 | −0.27, 0.06 | 0.120 | ||||
Brisk walking vs medical fitness | −0.02 | −0.29, 0.33 | 0.892 | ||||
RAND-36 (score 0–100 scale) | |||||||
Total | 71 ± 15 | 89 | 70 ± 15 | 58 | |||
Brisk walking group | 69 ± 15 | 46 | 68 ± 15 | 31 | |||
Medical fitness group | 73 ± 15 | 43 | 71 ± 14 | 27 | |||
Intragroup comparisons | |||||||
Intragroup comparison total | −0.6 | −2.4, 1.2 | 0.503 | ||||
Intragroup comparison brisk walking | 0.1 | –2.7, 2.8 | 0.969 | ||||
Intragroup comparison medical fitness | −1.4 | −3.8, 1.1 | 0.261 | ||||
Brisk walking vs medical fitness | 1.4 | −2.2, 5.0 | 0.438 |