IMPACT OF SMART SENSING–BASED AEROBIC EXERCISE ON FUNCTIONAL CAPACITY IN ADULTS WITH TYPE 2 DIABETES MELLITUS: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Many patients with Type 2 Diabetes Mellitus (T2DM) in Pakistan and similar countries experience decline in their physical health, and have limited access to exercise programs. One potential way to provide exercise programs to these patients is through the use of real-time exercise programs and technology.

Objective: To determine the impact of a real-time exercise program, made available through an app, on the physical functionality and glycemic control of patients with T2DM.

Methods: This study was a randomized control group study. There was a total of 62 patients between the ages of 30-65 with a diagnosis of T2DM. The control group (n=31) received standard care. The exercise group (n=31) completed 20-25 exercise sessions, each 30-45 minutes long, over the 12 week period. Participants of the exercise group walked and jogged at a real time monitoring and logging system. At the end of the 12 weeks, all participants took a 6 minute walk test to evaluate VO2 max. Blood was also drawn to assess HbA1c levels, and Fasting Blood Glucose levels. The primary outcome of the study was to evaluate the difference in the control and exercise groups in glycemic control and physical activity and exercise logging.

Results: Among the 58 participants in the Intervention group and 62 participants in the Control group with complete data, large improvements in all outcomes were observed for the Intervention group as follows: HbA1c (Intervention: 7.38%; Control: 8.12%; difference between means: −0.59%; p < 0.001; Cohen’s d: −3.18); Fasting Blood Glucose (Control: 157.08 mg/dL; Intervention: reduction by 13.59 mg/dL from Control; p < 0.001; Cohen’s d: −3.38); 6-Minute Walk Test (Control: 269.10 m; Intervention: 309.90 m; difference between means: 40.90 m; p < 0.001; Cohen’s d: 4.14); Estimated VO₂ Max (Control: 12.76 ml/kg/min; Intervention: 13.18 ml/kg/min; difference between means: 0.42 ml/kg/min; p < 0.001; Cohen’s d: 1.56), Walking distance (Control: 719.21 m; Intervention: 831.10 m; difference between means: 111.89 m; p < 0.001; Cohen’s d: 3.42), and other outcomes. The Intervention group also demonstrated greater Running Distance and Duration and other outcomes. Overall, mean adherence to the Intervention was 82.2%. No one was determined to be a low adherent participant.