title: Physical Activity in Obese Type 2 Diabetes After Gastric Bypass or Medical Management.
abstract: BACKGROUND
  The purpose of this study was to compare effects of Roux-en-Y gastric bypass versus a multidisciplinary, group-based medical diabetes and weight management program on physical fitness and behaviors.
  
  
  METHODS
  Physical behavior and fitness were assessed in participants of the study Surgery or Lifestyle With Intensive Medical Management in the Treatment of Type 2 Diabetes (SLIMM-T2D) (NCT01073020), a randomized, parallel-group trial conducted at a US academic hospital and diabetes clinic with 18- to 24-month follow-up. Thirty-eight type 2 diabetes patients with hemoglobin A1c≥6.5% and body mass index 30-42 kg/m2were randomized to Roux-en-Y gastric bypass or the medical program. A 6-minute walk test to evaluate fitness, self-reported physical activity, standardized physical surveys, and cardiometabolic risk assessment were performed at baseline and after intervention.
  
  
  RESULTS
  Both groups similarly improved 6-minute walk test distance, with greater improvements in oxygen saturation and reduced heart rate after surgery. Self-reported physical activity improved similarly at 18-24 months after interventions, although exercise increased gradually after surgery, whereas early substantial increases in the medical group were not fully sustained. Self-reported total and physical health were similar by Short Form-36 but improved more in the Impact of Weight on Quality of Life survey after surgery. Improvement in cardiovascular risk scores, HbA1c, and body mass index were greater after surgery.
  
  
  CONCLUSIONS
  In this small, randomized study, both interventions led to therapeutic lifestyle changes and improved objective and self-reported physical fitness. Greater improvements in heart rate, oxygen saturation, and perceived impact of weight on health were seen after surgery, which could be attributable to greater weight loss. The clinical importance of these improvements with greater weight loss warrants further investigation.
authors.affiliation: Research Division, Section of Clinical Behavioral and Outcomes Research, Joslin Diabetes Center, Boston, Mass.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Panosian
authors.affiliation: Research Division, Section of Clinical Behavioral and Outcomes Research, Joslin Diabetes Center, Boston, Mass; Harvard Medical School, Boston, Mass.
authors.forename: Su-Ann
authors.initials: SA
authors.lastname: Ding
authors.affiliation: Research Division, Section of Clinical Behavioral and Outcomes Research, Joslin Diabetes Center, Boston, Mass; Harvard Medical School, Boston, Mass.
authors.forename: Marlene
authors.initials: M
authors.lastname: Wewalka
authors.affiliation: Harvard Medical School, Boston, Mass; Division of Endocrinology, Brigham and Women's Hospital, Boston, Mass.
authors.forename: Donald C
authors.initials: DC
authors.lastname: Simonson
authors.affiliation: Research Division, Section of Clinical Behavioral and Outcomes Research, Joslin Diabetes Center, Boston, Mass; Harvard Medical School, Boston, Mass.
authors.forename: Ann
authors.initials: A
authors.lastname: Goebel-Fabbri
authors.affiliation: Research Division, Section of Clinical Behavioral and Outcomes Research, Joslin Diabetes Center, Boston, Mass.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Foster
authors.affiliation: Research Division, Section of Clinical Behavioral and Outcomes Research, Joslin Diabetes Center, Boston, Mass; Harvard Medical School, Boston, Mass; Division of Endocrinology, Brigham and Women's Hospital, Boston, Mass.
authors.forename: Florencia
authors.initials: F
authors.lastname: Halperin
authors.affiliation: Harvard Medical School, Boston, Mass; Division of Endocrinology, Brigham and Women's Hospital, Boston, Mass; Division of General & Gastrointestinal Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, Mass.
authors.forename: Ashley
authors.initials: A
authors.lastname: Vernon
authors.affiliation: Research Division, Section of Clinical Behavioral and Outcomes Research, Joslin Diabetes Center, Boston, Mass; Harvard Medical School, Boston, Mass; Division of Endocrinology, Brigham and Women's Hospital, Boston, Mass. Electronic address: Allison.Goldfine@Joslin.Harvard.Edu.
authors.forename: Allison B
authors.initials: AB
authors.lastname: Goldfine
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D015444:Exercise; D005260:Female; D015390:Gastric Bypass / Q000706:statistics & numerical data; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000601:surgery* / Q000628:therapy; D010809:Physical Fitness; D061217:Weight Reduction Programs
keywords: Bariatric surgery; Obesity; Physical activity; Physical fitness; Roux-en-Y gastric bypass; Type 2 diabetes