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

• Published in: Diabetes & metabolism Vol. 34; no. 3; pp. 258 - 265
• Main Authors: Brun, J.-F, Bordenave, S, Mercier, J, Jaussent, A, Picot, M.-C, Préfaut, C
• Format: Journal Article
• Language: English
• Published: Paris Elsevier Masson SAS 01.06.2008; Masson
• Subjects: Biological and medical sciences; Body Mass Index; Cost-Benefit Analysis; Costs and Cost Analysis; Coût de santé; Diabetes Mellitus, Type 2 - economics; Diabetes Mellitus, Type 2 - physiopathology; Diabetes Mellitus, Type 2 - rehabilitation; Diabetes. Impaired glucose tolerance; Diabétiques de type 2; Endocrine pancreas. Apud cells (diseases); Endocrinology & Metabolism; Endocrinopathies; Entraînement; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Exercice physique; Exercise; Exercise training; Female; formula omitted; France; Healthcare cost; Humans; Internal Medicine; Life Style; Male; Medical sciences; Middle Aged; Physical Endurance - physiology; Physical exercise; Seuil ventilatoire; Surveys and Questionnaires; Type 2 diabetes; Ventilatory threshold; France; Type 2 diabetes; Physical exercise; Seuil ventilatoire; Entraînement; Diabétiques de type 2; Exercice physique; V O 2max; Exercise training; Coût de santé; Ventilatory threshold; Healthcare cost; Endocrinopathy; Human; Costs; Health economy; Metabolic diseases; Endurance
• ISSN: 1262-3636; 1878-1780
• DOI: 10.1016/j.diabet.2008.01.010

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 [ VT ]); 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 VT 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.