title: Movement in health: housing a diabetes centre within a gym (and vice versa).
abstract: BACKGROUND
  In Giarre, Sicily, we have created a diabetes center in which the medical center and exercise gym share the same physical space. When a patient leaves the doctor's office he/she immediately enters a functioning gym. In the present paper, we report on our experiences with this integrated medical/exercise approach.
  
  
  METHODS
  Exercise, and the subsequent achievement of physical conditioning, is a cornerstone of treatment for metabolic syndrome and Type 2 diabetes. We initiate each patient on a tailored, phased, and sustainable exercise program administered by experts in sport, diet, and behavioral change with the immediate support of a range of medical disciplines.
  
  
  RESULTS
  More than 1100 patients have joined our program since its inception in 2005, with 180 passing through the center each day. Measurable and sustainable improvements in cardiovascular conditioning, quality of life indices, blood glucose control, and weight have been documented. The financial structure permits patients of all socioeconomic strata to access the service.
  
  
  CONCLUSIONS
  We believe that health care workers should teach by doing, and exercise is best taught by doing activities that the patients should do using the same facilities as the instructors. We target one of the most difficult patient groups, people with metabolic syndrome or Type 2 diabetes, and we ask them to do one of the hardest things in life: change it radically at a relatively advanced age by beginning to exercise regularly. Our approach appears to be unique in the world. We invite others who may have similar experiences to share their knowledge with us.
authors.affiliation: Department of Diabetology, University of Ricercatore, Catania, Giarre, Sicily, Italy.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Leotta
authors.forename: Viviana
authors.initials: V
authors.lastname: Fedele
authors.forename: Chiara
authors.initials: C
authors.lastname: Schifilliti
authors.forename: Carmela
authors.initials: C
authors.lastname: Ingegnosi
authors.forename: Giusi
authors.initials: G
authors.lastname: Savoca
authors.forename: Lelio
authors.initials: L
authors.lastname: Cucinotta
authors.forename: Kenneth
authors.initials: K
authors.lastname: Strauss
mesh_terms: D000368:Aged; D003153:Community Health Services / Q000458:organization & administration*; D003299:Cooperative Behavior; D003376:Counseling; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D015444:Exercise; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D012802:Sicily; D015431:Weight Loss