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Is strength training more effective than aerobic exercise for improving glycaemic control and body composition in people with normal-weight type 2 diabetes? Reply to Pontes‑Silva A, Santos‑de‑Araujo AD, Teixeira BC et al [letter].

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Effectiveness of a Community-Based Structured Physical Activity Program for Adults With Type 2 Diabetes: A Randomized

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Structured exercise, thrice weekly, improved type 2 diabetes control (HbA1c) in a community setting for adherent participants. Adherence is key for exercise interventions to effectively manage diabetes.

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Area of Science:

  • Community health
  • Exercise physiology
  • Diabetes management

Background:

  • Physical activity interventions are effective for type 2 diabetes, but community-based implementation needs exploration.
  • Translating exercise findings into community settings is crucial for broader diabetes management.

Purpose of the Study:

  • To assess the effectiveness of varying weekly structured exercise frequencies on diabetes control.
  • To evaluate community-based exercise programs for individuals with type 2 diabetes.

Main Methods:

  • A randomized controlled trial (IMPACT study) compared once-weekly, thrice-weekly exercise, and usual care (UC) for 6 months.
  • Participants with type 2 diabetes (HbA1c 6.5%-13.0%) attended community fitness centers for exercise.
  • Primary outcome was HbA1c change at 6 months, with intention-to-treat and per-protocol analyses.

Main Results:

  • Intention-to-treat analysis showed no significant HbA1c difference between groups.
  • Per-protocol analysis revealed a significant HbA1c reduction (-0.38%) in the thrice-weekly group compared to UC.
  • Adherence to at least 50% of sessions in the thrice-weekly group correlated with improved HbA1c.

Conclusions:

  • Thrice-weekly exercise improved HbA1c in adherent participants with type 2 diabetes in a community setting.
  • Future interventions should prioritize adherence to structured exercise programs to meet recommended guidelines.
  • Community-based exercise can be a viable strategy for diabetes management when adherence is achieved.