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Technology-based and supervised exercise interventions for individuals with type 2 diabetes: Randomized controlled

Eren Timurtas1, Mehmet Inceer2, Nancy Mayo2

  • 1Marmara University Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Istanbul, Turkey.

Primary Care Diabetes
|December 20, 2021
PubMed
Summary

Technology-assisted exercise programs, including mobile apps and smartwatches, effectively improved glycemic control in type 2 diabetes patients, comparable to supervised training. These digital tools offer accessible options for diabetes self-management.

Keywords:
ExerciseGlycemic controlHbA1cMobile healthRehabilitationTechnologyType 2 diabetesWearable smartwatch

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Area of Science:

  • Exercise Physiology
  • Digital Health Interventions
  • Diabetes Management

Background:

  • Type 2 Diabetes (T2D) management requires effective strategies for glycemic control.
  • Supervised exercise training is beneficial but not universally accessible.
  • Technological solutions offer potential for scalable diabetes self-management.

Purpose of the Study:

  • To compare the effectiveness of a 12-week mobile app and wearable smartwatch program versus supervised exercise training on glycemic control in individuals with T2D.
  • To evaluate secondary outcomes including the Six Minute Walk Test and explanatory outcomes such as exercise behavior and physical capacity.

Main Methods:

  • A stratified, randomized, assessor-blind, controlled, pragmatic trial with three parallel groups: supervised exercise, mobile app, and wearable smartwatch.
  • Individually tailored exercise regimens incorporating aerobic, resistance, calisthenic, flexibility, balance, and coordination exercises.
  • Primary outcome: change in glycated hemoglobin (HbA1c); secondary outcome: Six Minute Walk Test; explanatory outcomes: exercise behavior, muscle function, physical capacity. Analyzed using linear/logistic regressions and generalized estimating equations.

Main Results:

  • No significant difference in HbA1c change was observed between the combined technology groups and the supervised group, or between the mobile app and smartwatch groups.
  • Similar proportions of participants achieved a clinically meaningful reduction in HbA1c (≥0.5%) across supervised (46%) and technology groups (43%).
  • No significant differences were found in secondary or explanatory outcomes across the groups.

Conclusions:

  • All exercise delivery methods, including mobile app and smartwatch interventions, led to improvements in outcomes for individuals with T2D.
  • Technological exercise programs are crucial for enhancing self-management of diabetes, particularly when supervised programs are inaccessible.
  • Digital health tools provide viable and effective alternatives for improving glycemic control and overall health in T2D populations.