Exercise intervention for people with type 2 Diabetes Mellitus.

Recruitment: The Netherlands.



Sufficient exercise is important for people with Type 2 Diabetes Mellitus, as it can prevent future health problems. Still, the majority of people with type 2 Diabetes Mellitus do not exercise enough. 376 people with type 2 Diabetes Mellitus – who exercise less than advised in the Dutch Guidelines for Physical Activity – will be included in a program, with the aim to support them to increase their level of exercise and improve health related quality of life, diabetes parameters, physical fitness, quality of sleep, depression and quality of care.

Participants who are confident that they can independently increase their amount of exercise (represented by a high exercise-self-efficacy score), receive a patient-tailored exercise plan. This plan will be carried out at home, by the patient. Participants who are not convinced that they can increase their amount of exercise independently (represented by a low exercise-self-efficacy score) receive a more intensive exercise intervention under supervision of a physiotherapist. 568 people will be included in a ‘care as usual’ matched control group.

1. Effect on physical activity: It is hypothesized that both
interventions will increase the level of physical activity compared to care-as-usual;

2. Successful change of the level of physical activity: It is
hypothesized that particularly a high level of exercise self-efficacy, low BMI and low depression at baseline are related to a successful change of the amount of physical activity in the intervention groups;

3. Effect on health status: It is hypothesized that health status (both the physical and mental component) will improve in the intervention groups compared to care-as-usual;

4. Effects on cardiovascular risk factors: It is hypothesized that BMI, waist-hip ratio and blood pressure will improve in the intervention groups compared to care-as-usual.

1. Baseline;

2. After 12 weeks;

3. After 24 weeks;

4. After 36 weeks;

5. After 1 year;

6. After 1 year and 36 weeks.

Interventiongroup:

1. Phase 1: Assessment of exercise self-efficacy.
Participants are asked whether they believe that they can independently increase their exercise levels, without help from others (level of self-efficacy);

2. Phase 2:

A. Participants with a high level of exercise self-efficacy receive a patient-tailored exercise plan. This consists of an intake and three individual consultations with a physiotherapist. These participants are supposed to exercise at home (at least 3 times a week). Progression is evaluated at the individual consultations;

B. Participants with low levels of exercise self-efficacy receive a more intensive exercise intervention. This consists of an intake, group exercises supervised by a physiotherapist (first 8 weeks: 2x/week, 1 hour each time; next 8 weeks: 1x/week, 1 hour each time), at-home exercise (first 8 weeks: 1x/week; next 8 weeks: 2x/week; last 8 weeks: 3x/week) and two individual consultations in which progression is evaluated.



Control: Care as usual.