title: Effects of aerobic exercise, resistance exercise or both, on patient-reported health status and well-being in type 2 diabetes mellitus: a randomised trial.
abstract: OBJECTIVE
  The Diabetes Aerobic and Resistance Exercise (DARE) study showed that aerobic and resistance exercise training each improved glycaemic control and that a combination of both was superior to either type alone in patients with type 2 diabetes mellitus. Here we report effects on patient-reported health status and well-being in the DARE Trial.
  
  
  METHODS
  We randomised 218 inactive participants with type 2 diabetes mellitus in parallel to 22 weeks of aerobic exercise (n = 51), resistance exercise (n = 58), combined aerobic and resistance exercise (n = 57) or no exercise (control; n = 52). Intervention allocation was managed by a central office. Outcomes included health status as assessed by the physical and mental component scores of the Medical Outcomes Trust Short-Form 36-item version (SF-36) and well-being as measured by the Well-Being Questionnaire 12-item version (WBQ-12); these were measured at the Ottawa Hospital.
  
  
  RESULTS
  Using a p value of 0.0125 for statistical significance due to multiple comparisons, mixed model analyses indicated that resistance exercise led to clinically but not statistically significant improvements in the SF-36 physical component score compared with aerobic exercise (Delta = 2.7 points; p = 0.048) and control (i.e. no exercise; Delta = 3.3 points; p = 0.015). For mental component scores, there were clinically important improvements favouring no (control) compared with resistance (Delta = 7.6 points; p < 0.001) and combined (Delta = 7.2 points; p < 0.001) exercise. No effects on WBQ-12 scores were noted. Overall, 59/218 (27%) of participants included in this analysis sustained an adverse event during the course of the study, including 16 participants in the combined exercise group, 19 participants in the resistance exercise group, 16 participants in the aerobic exercise group, and eight participants in the control group. All participants were included in the intent-to-treat analyses. The trial is now closed to follow-up.
  
  
  CONCLUSIONS
  Resistance exercise was better than aerobic or no exercise for improving physical health status in these patients. No exercise was superior to resistance or combined exercise for improving mental health status. Well-being was unchanged by intervention.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT00195884
  
  
  BACKGROUND
  This study was funded by the Canadian Institutes of Health Research (grant MCT-44155) and the Canadian Diabetes Association (The Lillian Hollefriend Grant).
authors.affiliation: University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, Canada. breid@ottawaheart.ca
authors.forename: R D
authors.initials: RD
authors.lastname: Reid
authors.forename: H E
authors.initials: HE
authors.lastname: Tulloch
authors.forename: R J
authors.initials: RJ
authors.lastname: Sigal
authors.forename: G P
authors.initials: GP
authors.lastname: Kenny
authors.forename: M
authors.initials: M
authors.lastname: Fortier
authors.forename: L
authors.initials: L
authors.lastname: McDonnell
authors.forename: G A
authors.initials: GA
authors.lastname: Wells
authors.forename: N G
authors.initials: NG
authors.lastname: Boulé
authors.forename: P
authors.initials: P
authors.lastname: Phillips
authors.forename: D
authors.initials: D
authors.lastname: Coyle
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015992:Body Mass Index; D003404:Creatinine / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology* / Q000523:psychology*; D015444:Exercise; D005081:Exercise Therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006304:Health Status; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010809:Physical Fitness / Q000502:physiology / Q000523:psychology*; D011795:Surveys and Questionnaires
chemical_list: D000959:Antihypertensive Agents; D003404:Creatinine; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents