Exercise but not metformin improves health-related quality of life and mood states in older adults with type 2 diabetes

The aim of this cohort study is to analyse the effect of three types of treatment: (i) exercise training with multicomponent exercise (E); (ii) pharmacologic treatment with oral hypoglycaemic drug - metformin (M); and (iii) a combined therapy - exercise and metformin (E+M) on health-related quality of life (HRQoL) and mood states in older adults with type 2 diabetes (T2D) with comorbidity in an early stage of the disease. Participants (n=284) underwent 1 of the following 3 conditions: (i) E (n=59) trained three times/week; (ii) M (n=30) used 850 mg of metformin twice daily; and (iii) E+M (n=195) combined exercise and metformin. Furthermore, participants completed baseline and 2-year follow-up evaluations including a Shortform Health Survey 36, Profile of Mood States - Short-form, the health history questionnaires, anthropometric, and blood biochemistry. E and E+M revealed improved mood states, with large effect size on the vigour domain, and moderate effect size in the anger and total mood disturbance (TMD) domains (P<0.05), in comparison with the M group. After 24 months' intervention, the E and E+M groups perceived better physical and mental HRQoL than the M group. The M group unchanged HRQoL domains (P>0.05). Metformin had no significant effect on the self-referred HRQoL in T2D participants aged above 60 years, in an early stage of the disease. The E and E+M were the most effective long-term therapies to improve mood states and HRQoL in older adults with T2D.