WILL OLDER SEDENTARY PEOPLE WITH NON-INSULIN-DEPENDENT DIABETES-MELLITUS START EXERCISING - A HEALTH PROMOTION MODEL

Exercise and diet are the cornerstones of management of non-insulin-de pendent diabetes mellitus (NIDDM). Many older people have difficulty i n exercising, missing benefits on glycaemic control, weight, cardiac d isease and mood. We report the outcomes of a 6 month structured exerci se and support programme based on a health promotion model, on physica l activity, glycaemic control and parameters of cardiovascular risk in non-exercisers, compared with standard outpatient clinic education. A total of 26 non-exercising patients were randomised to an interventio n or control group (ten men, 16 women; mean age (+/- S.D.) 60 +/- 8 ye ars). Programme participation was not associated with any significant increase in activity. Glycated hemoglobin (HbA(1C)) levels tended to s tabilise in the intervention group during the 6 month programme and to deteriorate in the control group (P = 0.03); by 12 months HbA(1C) lev els deteriorated to a similar level in both. Programme participation d id not cause significant change in anthropometric or metabolic paramet ers. Examining the cohort as a whole, increased activity over 6 months was associated with improvements in weight, body mass index (BMI), bo dy fat and fasting insulin. Activity increases over 12 months were ass ociated with improvements in weight and BMI. These changes could not b e attributed to changes in energy intake or dietary composition. We co nclude that while exercise can benefit older people with NIDDM, a prog ramme based on a model of health promotion was not effective in increa sing physical activity. (C) 1997 Elsevier Science Ireland Ltd.