Outcomes of an Education and Exercise Program for Adults with Type 2 Diabetes,and Comorbidities that Limit their Mobility: A Preliminary Project Report |
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| Authors: | Gina Pariser Mary Ann DeMeuro Patricia Gillette Winters Stephen |
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| Institution: | 1.Physical Therapy Program, Bellarmine University, Louisville, KY;2.Division of Endocrinology & Metabolism, University of Louisville Medical School, Louisville, KY |
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| Abstract: | Purpose: Some adults with type 2 diabetes mellitus (T2DM) have comorbidities and mobility impairments that limit their exercise capacity. In consideration of this, we developed and piloted a program called Active Steps for Diabetes for people with T2DM, comorbidities, and mobility impairments. The purpose of this paper was to report outcomes for the pilot program. Methods: Active Steps for Diabetes, an 8-week program, included instruction on diabetes self-care andgroup and home exercise programs. Twenty-two females (62.7 ± 6.1yrs) with T2DM and self-reported mobility impairments completed the program. Six participants used a walking aid. Outcome measures included two risk factors for coronary artery disease daily physical activity and body mass index (BMI)], cardiovascular fitness (6-minute walk distance), and knowledge of diabetes-specific exercise guidelines. A two-way repeated measures ANOVA was used to compare outcomes before and after the program and between participants who did and did not use a walking aid. Results: Active Steps for Diabetes was effective in increasing daily physical activity in both groups of subjects (walking aid group: 2.6 days/week 95% confidence interval (CI) = 2.1 to 3.3]; no walking aid group: 1.9 days/week 95% CI=1.2 to 2.5]). This was accompanied by increases in 6-minute walk distances (walking aid group: 54.0 m 95% CI = 36.4 to 71.6]; no walking aid group: 62.6 m 95% CI=55.7 to 69.4]). Changes in BMI were not significant (walking aid group: −0.4 95% CI = −1.2 to 0.4]; no walking aid group: −.2495% CI = −.91 to .44]). Increases in knowledge of diabetes-specific exercise guidelines were observed in both groups (walking aid group: 18.8% 95% CI = 11.3 to 26.4]; no walking aid group: 19.3% 95% CI = 16.1 to 22.5]). Discussion:: Physical inactivity and low cardiovascular fitness are predictors of CAD morbidity and mortality in adults with T2DM. This pilot program suggests that a model for diabetes education, incorporating exercise programs developed by a physical therapist, may increase physical activity, improve endurance, and thereby potentially reduce CAD risk in people with T2DM and mobility impairments from comorbidities.Key Words: type 2 diabetes, physical activity |
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