Home-based And Hospital-based Exercise Interventions Improve Hemoglobin A1c In Diabetic And Pre-diabetic U.S. Veterans

Abstract

PURPOSE: To assess the effects of a 12-week hospital-based exercise program (supervised) and home-based exercise counseling intervention in diabetic Veterans. METHODS: Veterans were enrolled in a12-week hospital-based exercise program or in a home-based exercise program. The hospital-based exercise component consisted of twice weekly exercise sessions of aerobic and resistance exercise. Exercise intensity was maintained at 50% -80% of heart rate reserve. Participants were instructed to supplement their exercise with daily walks aiming to accumulate at least 150 minutes of exercise/week. Participants enrolled in the home-based component met monthly with the clinical exercise physiologist. They received intensive exercise counseling and were instructed to accumulate 150 minutes/week of moderate intensity exercise. Patients in both interventions received individualized dietary counseling provided by a registered dietician. Patients were stratified according to baseline hemoglobin A1c (HbA1c): Group 1: HbA1c<7.0%; Group 2: HbA1c 7.0-8.9 % and Group 3: HbA1c ≥10.0%. Peak exercise capacity, blood chemistries, and blood pressure were recorded at baseline and after program completion. RESULTS: Baseline values were similar for all groups. HbA1c improved significantly in both hospital-based and home-based exercise programs, but did not change in non-participants. The degree of improvement was proportional to the baseline values (Table). Similar changes were noted in blood glucose level. CONCLUSION: Home exercise counseling and hospital-based exercise were equally effective in improving health outcomes for veterans with Type 2 DM.Table: HbA1c in Exercise and No-Exercise Groups