Changing Physical Activity Behavior in Type 2 Diabetes A systematic review and meta-analysis of behavioral interventions

OBJECTIVEdBehavioral interventions targeting “free-living ” physical activity (PA) and exer-cise that produce long-term glycemic control in adults with type 2 diabetes are warranted. However, little is known about how clinical teams should support adults with type 2 diabetes to achieve and sustain a physically active lifestyle. RESEARCHDESIGNANDMETHODSdWe conducted a systematic review of random-ized controlled trials (RCTs) (published up to January 2012) to establish the effect of behavioral interventions (compared with usual care) on free-living PA/exercise, HbA1c, and BMI in adults with type 2 diabetes. Study characteristics, methodological quality, practical strategies for in-creasing PA/exercise (taxonomy of behavior change techniques), and treatment fidelity strategies were captured using a data extraction form. RESULTSdSeventeen RCTs fulfilled the review criteria. Behavioural interventions showed statistically significant increases in objective (standardized mean difference [SMD] 0.45, 95 % CI 0.21–0.68) and self-reported PA/exercise (SMD 0.79, 95 % CI 0.59–0.98) including clinically significant improvements in HbA1c (weighted mean difference [WMD] –0.32%, 95 % CI –0.44% to –0.21%) and BMI (WMD –1.05 kg/m2, 95 % CI –1.31 to –0.80). Few studies provided detail