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Effectiveness of structured exercise program on insulin resistance and quality of life in type 2 diabetes mellitus-a randomized controlled trial
Amaravadi SK, Maiya GA, K V, Shastry BA
PLoS ONE 2024 May;19(5):e0302831
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: Impaired glucose control and insulin resistance are reported to be risk factors for the development of cardiovascular diseases. To find the effects of a structured exercise program on insulin resistance, glycaemic control, functional capacity, and quality of life in patients with Type 2 diabetes mellitus. DESIGN: Randomized, controlled trial. SETTING: Diabetic Foot Clinic, Department of Physiotherapy & Department of General Medicine, Kasturba Hospital in Manipal, Karnataka, India. PARTICIPANTS: 160 participants aged between 30 to 65 years with Type 2 diabetes mellitus. INTERVENTION: A set of structured exercise programs (aerobic, resistance, and combined) along with the standard hospital care was performed 3 to 5 times weekly for 12 weeks. MEASUREMENTS: PRIMARY OUTCOME MEASURES: Fasting Insulin Level, Homa-IR, Six-minute walk test (6MWT), and WHOQOL-BREF questionnaire at baseline and 12th week. SECONDARY OUTCOME MEASURES: Body composition analysis, Fasting Blood Sugar, Postprandial Blood Sugar, Glycated Haemoglobin (HbA1c), and GPAQ questionnaire at baseline and 12th week. RESULTS: Significant differences have been observed in Homeostasis model assessment for insulin resistance (Homa-IR) (F (1, 144) = 89.29, p < 0.001); Fasting insulin (FI) (F (1, 144) = 129.10, p < 0.001); Fasting blood sugar (FBS) (F (1, 144) = 12.193, p < 0.001); Post prandial blood sugar (PPBS) (F (1, 144) = 53.015, p < 0.001); glycated haemoglobin (HbA1c) (F (1, 144) = 80.050, p < 0.001); WHOQOL-Physical health (F (1, 144) = 20.008, p < 0.001), Psychological (F (1, 144) = 77.984, p < 0.001), Social relationship (F (1, 144) = 44.866, p < 0.001); Environmental (F (1, 144) = 69.974, p < 0.001); Six minute walk test (6MWT) (F (1, 144) = 84.135, p < 0.001) in the study group when compared with the control group from baseline to 12th week. CONCLUSIONS: The study reveals that a 12-week structured exercise training program effectively reduces insulin resistance, improves quality of life, enhances functional capacity, and improves glycaemic control in type 2 diabetes mellitus.

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