Abstract / Summary
Regular exercise is known to improve glycemic control and health outcomes in Type 2 diabetes, but many patients struggle to achieve recommended activity levels. Knowledge-Attitude-Practice (KAP)-based education may help bridge this gap by improving exercise adherence and related outcomes. This study is aimed at assessing whether a structured KAP-based outdoor exercise education program leads to better 6-month glycemic and weight control than traditional exercise guidance in adults with Type 2 diabetes. We conducted a 6-month single-center, parallel-group, assessor-blinded randomized controlled trial in Shanghai, China. A total of 220 adults with Type 2 diabetes were randomized 1:1 to either a KAP-based exercise education intervention or a traditional exercise guidance control. The KAP group received a multicomponent educational session (covering exercise knowledge, motivational counseling, and practical skills training for safe outdoor exercise) with biweekly follow-up reinforcement, whereas the control group received one session of standard exercise advice and continued usual care. The primary outcomes (HbA1c and body weight) were assessed at baseline and 6 months. Analyses were performed on an intention-to-treat basis. Of 242 patients screened, 220 were randomized, and a 6-month follow-up was completed for all. Both groups achieved significant improvements in HbA1c and modest weight loss over 6 months. At 6 months, body weight also declined by a similar amount in both groups (between-group difference: -0.261 [95% CI -0.785, 0.262; p = 0.328]). HbA1c had decreased by about 1.3% in each group; the adjusted between-group difference was -0.045% (95% CI -0.18, 0.09; p = 0.498). No other metabolic or functional outcomes differed significantly between groups. However, exercise adherence was higher in the KAP group: By 6 months, 80.4% of KAP participants achieved ≥ 150 min/week of exercise compared to 57.8% in the control group, and the KAP arm averaged 178.5 ± 40.3 min of exercise per week versus 154.8 ± 35.8 min in the control arm; both differences were statistically significant (p < 0.05). In this randomized trial, a KAP-based outdoor exercise education program did not significantly outperform traditional one-time exercise guidance in improving 6-month glycemic control or body weight in adults with Type 2 diabetes. Both interventions yielded clinically meaningful improvements in HbA1c and other health metrics over 6 months. ClinicalTrials.gov identifier: ChiCTR2500104389.
Primary Source
Journal of diabetes research
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