OBJECTIVE—To evaluate effect of exercise consultation on physical activity and resultant physiological and biochemical variables at 6 months in people with type 2 diabetes. RESEARCH DESIGN AND METHODS—A total of 70 inactive people with type 2 diabetes were given standard exercise information and were randomized to receive an exercise consultation (n = 35) or not (n = 35). Exercise consultation, based on the transtheoretical model, combines motivational theory and cognitive behavioral strategies into an individualized intervention to promote physical activity. Changes from baseline to 6 months were assessed in 1) physical activity (7-day recall, accelerometer, cardiorespiratory fitness, stage, and processes of change), 2) physiological variables (blood pressure and BMI), and 3) biochemical variables (HbA_1c, lipid profile, and fibrinogen). RESULTS—Between-group differences were recorded for the change in minutes of moderate activity (P < 0.001) and activity counts (P < 0.001) per week. Experimental participants recorded an increase in activity counts per week and minutes of moderate activity per week (P < 0.001). The control group recorded no significant changes. More experimental participants increased stage of change (χ² = 22.6, P < 0.001). Between-group differences were recorded for the change in total exercise duration and peak gradient (P < 0.005), HbA_1c (P = 0.02), systolic BP (P = 0.02), and fibrinogen (P = 0.03). CONCLUSIONS—Exercise consultation increased physical activity and improved glycemic control and cardiovascular risk factors in people with type 2 diabetes.

To systematically review physical activity and/or sedentary behavior intervention studies for youth with type 1 diabetes. Several databases were searched for articles reporting on randomized-controlled trials (RCTs) in youth (<18 yr) with type 1 diabetes. Data was extracted and bias assessed to evaluate study characteristics, intervention design, and efficacy of interventions on physical activity and health. Where sufficient data were available meta-analyses of health outcomes [for hemoglobin A1c (HbA1c)] were performed. Weighted mean differences (WMD) were calculated using fixed and random effect models. The literature search identified 12/2397 full-text articles reporting on 11 studies. Two interventions were wholly unsupervised and only one was based on behavior change theory with no studies exploring changes in behavior processes. Nine interventions aimed to improve fitness or physical activity, two aimed to improve health, and none aimed at changing sedentary behavior. Eight interventions improved physical activity and/or fitness. At least one beneficial effect on health was found in each intervention group apart from two studies where no changes were found. Meta-analysis of 10 studies showed the interventions have a significant beneficial reduction of HbA1c (%), indicating an improvement in glycemic control [WMD, -0.85% (95% CI, -1.45 to -0.25%)]. There were insufficient data to pool other health outcome data. Few RCTs explored the efficacy of unsupervised theory-based physical activity and/or sedentary behavior interventions in youth with type 1 diabetes. Limited reporting made comparison of findings challenging. There was an overall significant beneficial effect of physical activity on HbA1c.