Programmed changes in the habits of people with type 2 diabetes to increase their physical activity and reduce their sedentary lifestyle are possible and effective.
This is the relevant positive outcome from the adoption of a strategy that implements the recommendations of the most accredited national and international guidelines in the fight against diabetes.
The new evidence is the result of the work of a group of Italian experts and researchers in IDES_2 Study dedicated to the relationship between diabetes and physical exercise.

The results of the study, which lasted 3 years and involved 300 subjects of average age around 60 years and followed in some diabetes outpatients facilities in Rome, were published in the prestigious Journal of the American Medical Association (JAMA).

In order to be introduced into the trial protocol, selected patients had to have a sedentary lifestyle or substantial inactivity. Once recruited in the study, they were divided into two groups of comparison: in the first group, the standard care recommended by the existing guidelines was followed.
In the second group of interventions, instead, in addition to the above criteria, a behavioural intervention program was added, which included an initial counselling session, followed by 8 bi-weekly sessions on an annual basis in which the theoretical part was associated with specific lessons for the practice of exercises and physical activity with varying degrees of intensity.

Well, the statistical analysis of the results of the study, coordinated by Dr. Nicolucci of CORESEARCH, was able to demonstrate the clear advantage of the educational and motivational program in terms of increased dedication to physical activity and reduction of sedentary time by people with diabetes.
The benefits were maintained 3 years after the start of the study, as proof of the persistence over time of the positive effects of the intervention to reduce sedentary lifestyle.

On the otherhand, as observed in secondary evaluations of the samestudy, this improvement in attitudes is reflected in benefits on the glycemic profile, on the global cardiovascular risk, on cardiorespiratory fitness and on muscle strength, all aspects of fundamental clinical importance for the adequate fight against the damage resulting from the progression of diabetic disease.

The authors of the study naturally wish for further experimental evaluations to be carried out on the subject in order to reach criteria that can be generalized and systematically adopted in the various clinical settings, also in consideration of those environmental contexts, such as urban centers, in which walking, outdoor living and aspects related to the sphere of personal safety are hindered.


Effect of a Behavioral Intervention Strategy on Sustained Change in Physical Activity and Sedentary Behavior in Patients With Type 2 Diabetes
The IDES_2 Randomized Clinical Trial

Stefano Balducci, MD; Valeria D’Errico, MD; JonidaHaxhi, MD, PhD; Massimo Sacchetti, PhD; Giorgio Orlando, PhD; Patrizia Cardelli, PhD; Martina Vitale, MD; Lucilla Bollanti, MD; Francesco Conti, MD, PhD; Silvano Zanuso, PhD; Giuseppe Lucisano, StatD; Antonio Nicolucci, MD, PhD; Giuseppe Pugliese,MD, PhD; for the ItalianDiabetes and ExerciseStudy 2 (IDES_2) Investigators

JAMA March 5, 2019 Volume 321, Number 9, 880-890