OBJECTIVE: The aim of our study is to identify the role of structured exercise in the prevention of development of distal symmetric polyneuropathy (DSPN) in people with diabetes (PWD) residing in a low-middle income country (LMIC). MATERIALS AND METHODS: This is an open-label, randomized, controlled trial. Subjects were randomized to standard diabetes control alone or plus a structured exercise regimen for two years. The primary outcome was the development of DSPN at the end of this period. RESULTS: Forty-eight patients (66.7% male) were included in the analysis (25 in intervention arm and twenty-three in control arm). The average age was 50.7 +/- 8.5 years. Subjects in control arm received standard diabetes control with home exercise instructions while subjects in intervention arm received standard diabetes control with structured exercise for two years. The intervention group was advised to perform at least 30 to 60 minutes of moderate structured exercise with resistance training per week under supervision of a certified physiotherapist. The compliance rate after two years was 66.6%. Out of these patients, 21 (65.6%) were in the intervention group and 11 (34.3%) patients were in the control group. At the end of year 2, there was evidence of development of DSPN in both groups (28% in intervention arm versus 26% in control arm); however, the difference was not statistically significant. CONCLUSIONS: This study did not show a benefit of structured exercise for neuropathy prevention in PWD residing in a LMIC. This could be related to suboptimal compliance of subjects with a structured exercise program.

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