Cost-sparing effect of twice-weekly targeted endurance training in type 2 diabetics: A one-year controlled randomized trial

Objective. - We evaluated the effects of targeted, moderate endurance training on healthcare cost, body composition and fitness in type 2 diabetes patients routinely followed within the French healthcare system. Design and methods. - A total of 25 type 2 diabetic patients was randomly assigned to one of two groups: 13 underwent a training programme (eight sessions, followed by training twice a week for 30-45 minutes at home at the level of the ventilatory threshold [V-T]); and 12 received their usual routine treatment. Both groups were followed for one year to evaluate healthcare costs, exercise effectiveness and a six-minute walking test. Results. - The training prevented loss of maximum aerobic capacity, which decreased slightly in the untrained group (P=0.014), and resulted in a higher maximum power output (P=0.041) and six-minute walking distance (P=0.020). The Voorrips activity score correlated with both V-O2max (r=0.422, P<0.05) and six-minute walking distance (r=0.446, P<0.05). Changes in V-O2max were negatively correlated with changes in body weight (r=0.608, P<0.01). Training decreased the insulin-resistance index (HOMA-IR) by 26% (P<0.05). Changes in percentages of fat were correlated to changes in waist circumference (r=0.436, P<0.05). The total healthcare cost was reduced by 50% in the trained group ((sic)1.65 +/- 1 per day versus (sic)3.00 +/- 1.47 per day in the untrained groups P<0.02) due to fewer hospitalizations (P=0.05) and less use of sulphonylureas (P<0.05). Conclusion. - Endurance training at V-T level prevented the decline in aerobic working capacity seen in untrained diabetics over the stud period, and resulted in a marked reduction in healthcare costs due to less treatments and fewer hospitalizations. (C) 2008 Elsevier Masson SAS. All rights reserved.