title: Relationship of exercise volume to improvements of quality of life with supervised exercise training in patients with type 2 diabetes in a randomised controlled trial: the Italian Diabetes and Exercise Study (IDES).
abstract: OBJECTIVE
  A positive impact of exercise intervention programmes on quality of life (QoL) may be important for long-term patient compliance to exercise recommendations. We have previously shown that QoL improves significantly with supervised exercise, whereas it worsens with counselling alone, in patients with type 2 diabetes from the Italian Diabetes and Exercise Study (IDES). Here, we report data on the relationship between changes in QoL and volume of physical activity/exercise in these individuals.
  
  
  METHODS
  This multicentre parallel randomised controlled, open-label, trial enrolled sedentary patients with type 2 diabetes (n = 606 of 691 eligible) in 22 outpatient diabetes clinics. Patients were randomised by centre, age and diabetes treatment using a permuted-block design to twice-a-week supervised aerobic and resistance training plus exercise counselling (exercise group) versus counselling alone (control group) for 12 months. Health-related QoL was assessed by the 36-Item Short Form (SF-36) Health Survey.
  
  
  RESULTS
  In the exercise group (n = 268 of 303 randomised), there was a trend for increasing QoL with increasing exercise volume, with significant improvement of the physical component summary (PCS) measure only above 17.5 metabolic equivalents h⁻¹ week⁻¹ and a clear volume-relationship for the mental component summary (MCS) measure. A relationship with volume of physical activity also was observed in the control group (n = 260 of 303 randomised), despite overall deterioration of all scores. Independent correlates of improvements in both PCS and MCS were exercise volume, study arm and, inversely, baseline score.
  
  
  CONCLUSIONS
  This large trial shows a relationship between changes in physical and mental health-related QoL measures and volume of physical activity/exercise, with supervised exercise training also providing volume-independent benefits.
authors.affiliation: Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, S Maria Imbaro, Chieti, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Nicolucci
authors.forename: S
authors.initials: S
authors.lastname: Balducci
authors.forename: P
authors.initials: P
authors.lastname: Cardelli
authors.forename: S
authors.initials: S
authors.lastname: Cavallo
authors.forename: S
authors.initials: S
authors.lastname: Fallucca
authors.forename: A
authors.initials: A
authors.lastname: Bazuro
authors.forename: P
authors.initials: P
authors.lastname: Simonelli
authors.forename: C
authors.initials: C
authors.lastname: Iacobini
authors.forename: S
authors.initials: S
authors.lastname: Zanuso
authors.forename: G
authors.initials: G
authors.lastname: Pugliese
mesh_terms: D015992:Body Mass Index; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000523:psychology* / Q000628:therapy*; D015444:Exercise / Q000523:psychology*; D005260:Female; D020446:Fitness Centers / Q000379:methods*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007558:Italy; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D055070:Resistance Training; D057185:Sedentary Behavior; D011795:Surveys and Questionnaires
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human