title: 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.
  
  
  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(O2max) (r=0.422, P<0.05) and six-minute walking distance (r=0.446, P<0.05). Changes in V(O2max) 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 (euro 1.65+/-1 per day versus euro 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: ERI 25, Inserm, 34000 Montpellier, France. drjfrbrun@dixinet.com
authors.forename: J-F
authors.initials: JF
authors.lastname: Brun
authors.forename: S
authors.initials: S
authors.lastname: Bordenave
authors.forename: J
authors.initials: J
authors.lastname: Mercier
authors.forename: A
authors.initials: A
authors.lastname: Jaussent
authors.forename: M-C
authors.initials: MC
authors.lastname: Picot
authors.forename: C
authors.initials: C
authors.lastname: Préfaut
mesh_terms: D015992:Body Mass Index; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D003924:Diabetes Mellitus, Type 2 / Q000191:economics* / Q000503:physiopathology / Q000534:rehabilitation*; D015444:Exercise; D005260:Female; D005602:France; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010807:Physical Endurance / Q000502:physiology*; D011795:Surveys and Questionnaires