Comparison of two diabetes mellitus exercise programmes with respect to exercise adherence and physiological and psychological effects

The prevalence of type 2 diabetes mellitus (DM) has increased 5-fold over the last 20 years worldwide. Contributed to by an obesity epidemic and sedentary lifestyles, DM is costing the UK Government £5.2 billion a year and this amount is rising gradually. Exercise is a major cornerstone for treatment of DM, however, benefits derived from exercise have been shown to wane 3-10 days after exercise. Therefore, for exercise to be an effective form of treatment, it should be adopted as a lifestyle change. The aim of this study was to show how the aid of psychological intervention, in conjunction with exercise therapy, could be implemented in a cost-effective way into the Primary Care Trust (PCT) infrastructure. Forty newly diagnosed type 2 diabetic patients were assessed by physiological and psychological parameters over a period of 12-weeks. Adherence to the programme was monitored, as well as adherence in a 6-month follow-up. Patients were allocated into two groups, namely exercise only and exercise with psychological intervention. The exercise only group comprised of 1 aerobic training session and I resistance training session while the psychological intervention group involved the same exercise training programme and different psychological intervention strategies. The results confirmed a significant (pc0.001) improvement in physiological parameters (weight, percentage body fat, grip strength, peak flow, flexibility and V02 max) after the 12-week programme in both groups. The psychological intervention group resulted in significant (pc0.05) changes in body fat, grip strength and peak flow in comparison to the exercise only group. In a small adjacent study conducted on 7 of the diabetic patients, average daily blood glucose levels showed a significant (pc0.01) reduction over the 12-week exercise period. Psychological parameters, measuring mood state (anxiety, depression , anger, energy, fatigue and confusion) were all positively (pc0.001) influenced in both groups from the therapy programme. The main findings of the study revealed that psychological intervention had a significant (pc0.001) influence on attendance to the 12-week programme, and this also resulted in a significant better adherence 6-months later, upon follow-up. In contrast, the exercise only group shows a noteworthy decrease (pc0.05) in exercise adherence. In conclusion, the results of the study have demonstrated that psychological intervention is of paramount importance during exercise therapy for type 2 diabetic patients. Moreover, either with or without psychological intervention, exercise therapy is not only beneficial but it is also an important aid to treat type 2 DM