Fostering regular exercise behaviour to improve metabolic control in patients with diabetes

Abstract

Background: Research evidence consistently supports the benefits of exercise on people living with diabetes. In addition, regular exercise is crucial for the prevention of diabetes and other related metabolic disorders. In order to understand the exercise pattern among patients with diabetes, a survey was conducted and a set of exercise in the form of a dance going with a song, was promulgated in our Hospital to facilitate patients to perform safe and appropriate exercise.

Method: The program was conducted in two phases. Phase 1 was a cross-sectional survey to understand exercise behavior and metabolic control in patients with type 2 diabetes. Phase 2 was a feasibility study to test the effectiveness of a Diabetes Dance training program. The Diabetes Dance as a safe and appropriate exercise for people with diabetes had been endorsed by a panel of experts, including physiotherapists and diabetes educators. The diabetes nurses who conduct the exercise program had received specific professional training to do the coaching. In addition, the precautions about performing exercise (e.g., hypoglycaemia, heart conditions) were well explained for alertness at the beginning of the exercise program. A DVD containing the exercise movement and important messages on self-management through the meaningful lyrics and delightful melody was given to patients for take-home practice.

Results: A total of 328 subjects were recruited in the exercise behavioral survey with mean age 64% and 45% were male. The mean hemoglobin A1c level was 7.6% and mean body mass index (BMI) 27. 113 subjects (36%) reported they had less than 150 minutes exercise per week and other 35% even did not have any exercise at all. For Phase 2 study, eighteen patients were recruited (female = 17) with mean age 54 and mean BMI 31.9. Blood glucose level was significantly lower after the 30-min dance (P < 0.01). Improvement of exercise knowledge was also noted after the training.

Conclusion: Although the beneficial effect of regular exercise on metabolic control is highly acknowledged, there are still many barriers, such as lack of time and low motivation, for people to initiate exercise habit. The exercise program of this study was established based on the use of dance and music in order to facilitate the enjoyment of exercise and improve exercise habit adherence. It is suggested to develop large-scale and structured study in future to evaluate the effectiveness of exercise activity on long term glycemic and metabolic outcomes.