Implementation of resources to support patient physical activity through diabetes centres in Nova Scotia: the effectiveness of enhanced support for exercise participation.

OBJECTIVE: The purpose of this study was to determine the effectiveness of enhancing support for physical activity counselling and exercise participation at diabetes centres in Nova Scotia on physical activity and exercise behaviours and clinical outcomes in patients with type 2 diabetes mellitus.

METHODS: In all, 180 patients at 8 diabetes centres participated in this observational study. A range of enhanced supports for exercise were offered at these centres. A kinesiologist was added to the diabetes care team to primarily provide extra physical activity counselling and exercise classes. Patient physical activity and exercise levels, efficacy perceptions and mean glycated hemoglobin (A1C) were evaluated at baseline and 6 months. We compared changes in these variables for patients who participated in the enhanced supports versus patients who did not.

RESULTS: Participants who attended exercise classes (n=46), increased moderate physical activity by 27% and doubled resistance exercise participation (1.0±1.8 to 2.0±2.1 days per week) whereas those who did not attend exercise classes (n=49) reduced moderate physical activity by 26% and did not change resistance exercise participation (interactions, p=0.04 and p=0.07, respectively). Patients who received resistance band instruction (n=15) from a kinesiologist had reductions in A1C (from 7.5±1.4 to 7.1±1.2; p=0.04), whereas other subgroups did not have significant changes in A1C.

CONCLUSIONS: Offering enhanced support for exercise at diabetes centres produced improvements in physical activity and exercise in type 2 diabetes patients. Resistance band instruction from a kinesiologist combined with participating in a walking and resistance training program improved glycemic control, which underscores the importance of including exercise professionals in diabetes management.