Patients with type 2 diabetes (T2D) who received a behavioral intervention experienced greater sustained physical activity and less sedentary time than those treated with standard care, according to study results published in JAMA.
To evaluate the effects of a behavioral intervention strategy on sustained physical activity and sedentary time in patients with T2D, researchers randomly assigned 300 physically inactive and sedentary patients with T2D (average age, 61.6 years; 38.7% women) to receive 3 years of standard care or a behavioral intervention strategy.
Participants were recruited from 3 outpatient diabetes clinics in Rome, Italy. Patients in the intervention group were offered 1 individual theoretical counseling session and 8 individual biweekly theoretical and practical counseling sessions each year. Patients in the standard care group received general physician recommendations. Baseline characteristics were similar between groups.
Compared with the standard care group, the intervention group averaged 3.3 more metabolic equivalent-hours/week of physical activity volume (10.5 vs 13.8, respectively; P <.001). They also averaged 6.4 more minutes/day of moderate- to vigorous-intensity physical activity (12.5 vs 18.9), 0.8 more hours/day of light-intensity physical activity (3.8 vs 4.6), and 0.8 fewer hours/day of sedentary time (11.7 vs 10.9; P <.001 for all).
The researchers reported that between-group differences remained significant throughout the entire follow-up period. However, the difference in moderate- to vigorous-intensity physical activity decreased in year 3 from 6.5 to 3.6 minutes/day.
In total, 41 adverse events occurred in the intervention group and 59 in the standard care group outside of sessions, and 30 adverse events occurred in the intervention group during sessions (mostly musculoskeletal injury/discomfort and mild hypoglycemia).
There were several limitations to this study, including generalizability of results; because of climatic, socioeconomic, and cultural differences, results may be different if the intervention is used in clinical practice.
“Although there was a wide range of responses to the intervention in the current study, a substantial proportion of participants ameliorated their behavior,” the researchers said. “[P]articipants who became and remained physically active throughout the follow-up achieved meaningful improvements in physical activity and sedentary time as well as in physical fitness.”
Balducci S, D’Errico V, Haxhi J, et al. Effect of a behavioral intervention strategy on sustained change in physical activity and sedentary behavior. JAMA. 2019;321(9):880-890.