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Mejora en el control de los diabeticos tipo 2 tras una intervencion conjunta: educacion diabetologica y ejercicio fisico (Improvement of control in subjects with type 2 diabetes after a joint intervention: diabetes education and physical activity) [Spanish; with consumer summary]
Copado CA, Palomar VG, Urena AM, Mengual FA, Martinez MS, Serralta JR
Atencion Primaria 2011 Aug;43(8):398-406
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: No; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To study the improvement of metabolic control and cardiovascular risk factors, adherence, self-monitoring, self-care, attitudes and motivation in subjects with type 2 diabetes (DM2) in a specific health care area after group intervention through the community: diabetes education (DE) and physical exercise (PE). DESIGN: A single blind, randomised controlled clinical trial. INTERVENTION: Group 1: DE; group 2: ED and PE; group 3: only PE, and "control" group 4: individual consultations. LOCATION: Urban health centre/municipal sports centre. PARTICIPANTS: 108 DM2, age 40 to 70, glycated haemoglobin (HbA1c) <= 8.5%, blood pressure (BP) < 160/90 and body mass index (BMI) < 45, excluding those with chronic complications and/or acute decompensation. INTERVENTIONS: During 6 months, 8 workshops were held for group education and monitored aerobic physical exercise of moderate intensity (3 hours a week). MAIN MEASUREMENTS: Primary variable pre- and post- intervention: reduction in HbA1c; other variables: examination and analytical data, therapeutic compliance, self-monitoring, self-care, attitudes and motivation (DAS-3SP survey). RESULTS: After intervention, more diabetics had a lower HbA1c following a full intervention: "DE" and "PE", RR 1.93 (0.85 to 4.40) and exercise, RR 1.56 (0.65 to 3.76). With simultaneous DE and PE, the BMI, RR 1.61 (0.85 to 3.03) and LDL cholesterol, RR 1.82 (0.99 to 3.36), of many subjects decreased. Dietary compliance, RR 1.29 (0.32 to 5.22) and exercise, RR 1.93 (0.76 to 4.91) also increased, more patients performing their own checks, RR 3.86 (0.90 to 16.55) and improving motivation/attitudes in "strict control management", RR 1.48 (0.94 to 2.34). With PE, systolic and diastolic BP decreased in more patients RR 1.35 (0.72 to 2.52), 1.87 (0.72 to 4.84) while in the DE group only diastolic values decreased 1.80 (0.69 to 4.67). CONCLUSIONS: Patient conditions improve more with the combination of DE and PE, though the results are not statistically significant, probably due to insufficient sample size.

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