Fitness consultations in routine care of patients with type 2 diabetes in general practice: an 18-month non-randomised intervention studyReportar como inadecuado




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BMC Family Practice

, 11:83

First Online: 03 November 2010Received: 17 October 2009Accepted: 03 November 2010

Abstract

BackgroundIncreasing physical activity is a cornerstone in the treatment of type 2 diabetes and in general practice it is a challenge to achieve long-term adherence to this life style change. The aim of this study was to investigate in a non-randomised design whether the introduction of motivational interviewing combined with fitness tests in the type 2 diabetes care programme was followed by a change in cardio-respiratory fitness expressed by VO2max, muscle strength of upper and lower extremities, haemoglobin A1c HbA1c and HDL-cholesterol.

MethodsUncontrolled 18-month intervention study with follow-up and effect assessment every 3 months in a primary care unit in Denmark with six general practitioners GPs. Of 354 eligible patients with type 2 diabetes, 127 35.9% were included. Maximum work capacity was tested on a cycle ergometer and converted to VO2max. Muscle strength was measured with an arm curl test and a chair stand test. The results were used in a subsequent motivational interview conducted by one of the GPs. Patients were encouraged to engage in lifestyle exercise and simple home-based self-managed exercise programmes. Data were analysed with mixed models.

ResultsAt end of study, 102 80.3% participants remained in the intervention. Over 18 months, VO2max increased 2.5% p = 0.032 while increases of 33.2% p < 0.001 and 34.1% p < 0.001 were registered for the arm curl test and chair stand test, respectively. HDL-cholesterol increased 8.6% p < 0.001, but HbA1c remained unchanged p = 0.57 on a low level 6.8%. Patients without cardiovascular disease or pain from function limitation increased their VO2max by 5.2% p < 0.0001 and 7.9% p = 0.0008, respectively.

ConclusionsIn this 18-month study, participants who had repeated fitness consultations, including physical testing and motivational interviewing to improve physical activity, improved VO2max, muscle strength, and lipid profile. Our results indicate that physical testing combined with motivational interviewing is feasible in a primary health care setting. Here, a fitness consultation tailored to the individual patient, his-her comorbidities and conditions in the local area can be incorporated into the diabetes programme to improve patients- muscle strength and cardio-respiratory fitness.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2296-11-83 contains supplementary material, which is available to authorized users.

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Autor: Henning Lohmann - Volkert Siersma - Niels F Olivarius

Fuente: https://link.springer.com/







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