Diabetes exercise project

Background: Exercise can play a major role in improving diabetic control and prevention of complications. In order to encourage overweight people with poorly controlled diabetes to take more exercise a group exercise programme was set up. Objectives: To evaluate the effectiveness of the diabetes exercise project 20 months after professional contact and funding had ceased. The project ran from October 1994 to March 1996 and the evaluation was carried out in November 1997. Method: Evaluation was carried out through a postal questionnaire, focus group discussions and clinical data collection on a sample of those referred on to the project. The project set out to find: (1) the number of the original group who took up the exercise programme and were still exercising on a regular basis; (2)the clinical outcomes in terms of changes in body mass index (BMI), glycosylated haemoglobin (HbA1) and diabetes medication from the start of the exercise project to the evaluation; (3) the self-reported benefits to those with diabetes on the exercise programme, including any self-reported effect regular exercise has had on their diabetes control at the time of the evaluation; (4) the factors associated with their ability to carry on exercising. Results: Clinical outcomes showed no significant changes in those who continued to exercise and those who stopped. However, there was a statistically significant increase (P = 0.01) in the proportion of those with non-insulin dependent diabetes (NIDDM) who were treated with insulin, from 30% to 53%. Of the 42 who had replied to the questionnaire, 71% continued to exercise for more than 6 months and, of these, 52% continued to exercise for over 20 months. Self-reported benefits of exercise included 'increased energy levels', a greater ability to concentrate and enjoy exercise, increased motivation and more positive mood and feelings. Improvement in diabetic control was reported by 25 (60%). Further benefits reported included a stabilizing of their diabetes, loss of weight and a more positive attitude towards their health. Conclusions: It is possible to motivate overweight, poorly controlled people with diabetes to exercise on a regular basis. To do so successfully, consideration needs to be given to having the right personnel involved in the exercise programmes, support from the health professionals and suitable facilities and instruction. Injury and lack of time were given as the main barriers to exercise.