Cost-sparing effect of twice-weekly targeted endurance training in type 2 diabetics: A one-year controlled randomized trial

Abstract

Objective We evaluated the effects of targeted, moderate endurance training on healthcare cost, body composition and fitness in type 2 diabetes patients routinely followed within the French healthcare system. Design and methods A total of 25 type 2 diabetic patients was randomly assigned to one of two groups: 13 underwent a training programme (eight sessions, followed by training twice a week for 30–45 minutes at home at the level of the ventilatory threshold [ V T]); and 12 received their usual routine treatment. Both groups were followed for one year to evaluate healthcare costs, exercise effectiveness and a six-minute walking test. Results The training prevented loss of maximum aerobic capacity, which decreased slightly in the untrained group ( P = 0.014), and resulted in a higher maximum power output ( P = 0.041) and six-minute walking distance ( P = 0.020). The Voorrips activity score correlated with both V O 2max ( r = 0.422, P < 0.05) and six-minute walking distance ( r = 0.446, P < 0.05). Changes in V O 2max were negatively correlated with changes in body weight ( r = 0.608, P < 0.01). Training decreased the insulin-resistance index (HOMA-IR) by 26% ( P < 0.05). Changes in percentages of fat were correlated to changes in waist circumference ( r = 0.436, P < 0.05). The total healthcare cost was reduced by 50% in the trained group (€1.65 ± 1 per day versus €3.00 ± 1.47 per day in the untrained group; P < 0.02) due to fewer hospitalizations ( P = 0.05) and less use of sulphonylureas ( P < 0.05). Conclusion Endurance training at V T level prevented the decline in aerobic working capacity seen in untrained diabetics over the study period, and resulted in a marked reduction in healthcare costs due to less treatments and fewer hospitalizations.