Combined face-to-face and online exercise program reduces medical expenses and medication in the Asian elderly with type 2 diabetes: A randomized controlled trial

To determine the impact of a combined face-to-face (f2f) and online training program on type 2 diabetes mellitus (T2DM) in elderly patients, a single-blinded randomized clinical trial was conducted from April 2021 to April 2023 at a tertiary public hospital in China. Participants aged 60+ were randomly allocated to intervention (n=20) and control (n=20) groups. After a six-month f2f program followed by 18 months of online guidance, intervention participants achieved significantly greater reductions in annual medical expenses (mean difference [SD], -946.39[244.75]; p=0.001), FBG (mean difference [SD], -0.64[0.20]; p=0.003), and 2hPBG (mean difference [SD], -2.68[0.87]; p=0.004) compared to the control group at 24 months. A greater proportion had reduced diabetes medications (RR,7.82; p=0.043). Self-management ability improved in the intervention group (mean difference [SD], 10.11[4.39]; p=0.028). HbA1c remained unchanged in the intervention group but increased in the control group (mean difference [SD], -0.68[0.14]; p<0.001). The combined f2f and online program reduces medical expenses and improves various health outcomes in elderly T2DM patients.