Sports Medicine

, Volume 44, Issue 11, pp 1557–1572 | Cite as

Association between Physical Activity Advice Only or Structured Exercise Training with Blood Pressure Levels in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

  • Franciele R. Figueira
  • Daniel Umpierre
  • Felipe V. Cureau
  • Alessandra T. N. Zucatti
  • Mériane B. Dalzochio
  • Cristiane B. Leitão
  • Beatriz D. Schaan
Systematic Review



Diabetes is associated with marked cardiovascular morbidity and mortality. However, the association between different types of exercise training and blood pressure (BP) changes is not fully clear in type 2 diabetes.


The aim of this systematic review and meta-analysis of randomized controlled clinical trials (RCTs) was to determine the effects of structured exercise training (aerobic [AER], resistance [RES], or combined [COMB]) and physical activity (PA) advice only on BP changes in patients with type 2 diabetes.


Searches in five electronic databases were conducted to retrieve studies published from 1980 to 2013. Eligible studies were RCTs consisting of structured exercise training or PA advice versus no intervention in patients with type 2 diabetes. We used random effect models to derive weighted mean differences (WMDs) of exercises on absolute changes in systolic BP (SBP) and diastolic BP (DBP).


A total of 30 RCTs of structured training (2,217 patients) and 21 of PA advice (7,323 patients) were included. Data were extracted independently in duplicate. Structured exercise was associated with reductions in SBP (WMD −4.22 mmHg; 95 % confidence interval [CI] −5.89 to −2.56) and DBP (WMD −2.07 mmHg; 95 % CI −3.03 to −1.11) versus controls. In structured exercise interventions, AER and RES were associated with declines in BP, and COMB was not associated with BP changes. However, in sensitivity analysis, a high-intensity protocol within COMB was associated with declines in SBP (WMD −3.30 mmHg; 95 % CI −4.71 to −1.89). Structured exercise longer than 150 min/week was associated with greater BP reductions. PA advice only was associated with reduction in SBP (WMD −2.97 mmHg; 95 % CI −4.52 to −1.43) and DBP (WMD −1.41 mmHg; 95 % CI −1.94 to −0.88) versus controls.


AER, RES, and high-intensity combined training are associated with BP reduction in patients with type 2 diabetes, especially in exercise programs lasting more than 150 min/week. PA advice only is also associated with lower BP levels.


Exercise Training Resistance Training Blood Pressure Reduction Aerobic Exercise Training Electronic Supplementary Material Figure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Mrs. Figueira had full access to the data and takes full responsibility for its integrity.

Conception and design: Schaan, Leitão, Umpierre. Data search: Schaan, Leitão, Umpierre, Figueira, Zucatti. Analysis and interpretation of data: Schaan, Leitão, Umpierre, Figueira, Cureau, Dalzochio. Drafting of the manuscript: Schaan, Leitão, Umpierre, Figueira, Cureau. Revising the manuscript critically for important intellectual content: Schaan, Leitão, Umpierre, Figueira, Cureau. Final approval of the manuscript submitted: Schaan, Leitão, Umpierre, Figueira, Cureau, Zucatti, Dalzochio.

Funding for this manuscript was partially provided by Fundo de Incentivo à Pesquisa do HCPA (FIPE), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES, PNPD 2818/2011).

Role of funding source: the sponsor of the manuscript had no role in the design of the review and meta-analysis, data collection, data analysis, data interpretation, or writing of the report.

All authors have no conflicts of interest to declare.

Supplementary material

40279_2014_226_MOESM1_ESM.doc (532 kb)
Supplementary material 1 (DOC 533 kb)


  1. 1.
    Preis SR, Hwang SJ, Coady S, et al. Trends in all-cause and cardiovascular disease mortality among women and men with and without diabetes mellitus in the Framingham Heart Study, 1950 to 2005. Circulation. 2009;119:1728–35.Google Scholar
  2. 2.
    Bahia LR, Araujo DV, Schaan BD, et al. The costs of type 2 diabetes mellitus outpatient care in the Brazilian public health system. Value Health. 2011;14:S137–40.PubMedCrossRefGoogle Scholar
  3. 3.
    Stamler J, Vaccaro O, Neaton JD, et al. Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care. 1993;16:434–44.PubMedCrossRefGoogle Scholar
  4. 4.
    Stratton IM, Cull CA, Adler AI, et al. Additive effects of glycaemia and blood pressure exposure on risk of complications in type 2 diabetes: a prospective observational study (UKPDS 75). Diabetologia. 2006;49:1761–9.PubMedCrossRefGoogle Scholar
  5. 5.
    UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ. 1998;317:703–13.PubMedCentralCrossRefGoogle Scholar
  6. 6.
    Cushman WC, Evans GW, Byington RP, et al. Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med. 2010;362:1575–85.PubMedCrossRefGoogle Scholar
  7. 7.
    Standards of medical care in diabetes. Diabetes Care. 2013;36:S11–66.CrossRefGoogle Scholar
  8. 8.
    Sacks FM, Svetkey LP, Vollmer WM, et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med. 2001;344:3–10.PubMedCrossRefGoogle Scholar
  9. 9.
    Kelley GA, Kelley KS. Progressive resistance exercise and resting blood pressure : a meta-analysis of randomized controlled trials. Hypertension. 2000;35:838–43.PubMedCrossRefGoogle Scholar
  10. 10.
    Whelton PK, He J, Appel LJ, et al. Primary prevention of hypertension: clinical and public health advisory from The National High Blood Pressure Education Program. JAMA. 2002;288:1882–8.PubMedCrossRefGoogle Scholar
  11. 11.
    Cornelissen VA, Fagard RH, Coeckelberghs E, et al. Impact of resistance training on blood pressure and other cardiovascular risk factors: a meta-analysis of randomized, controlled trials. Hypertension. 2011;58:950–8.PubMedCrossRefGoogle Scholar
  12. 12.
    Cornelissen VA, Smart NA. Exercise training for blood pressure: a systematic review and meta-analysis. J Am Heart Assoc. 2013;2:e004473.PubMedPubMedCentralCrossRefGoogle Scholar
  13. 13.
    Chudyk A, Petrella RJ. Effects of exercise on cardiovascular risk factors in type 2 diabetes: a meta-analysis. Diabetes Care. 2011;34:1228–37.PubMedPubMedCentralCrossRefGoogle Scholar
  14. 14.
    Thomas D, Elliott EJ, Naughton GA, et al. Exercise for type 2 diabetes mellitus. Cochrane Database Syst Rev. 2006;(3):CD002968.Google Scholar
  15. 15.
    Snowling N, Hopkins WG. Effects of different modes of exercise training on glucose control and risk factors for complications in type 2 diabetic patients. Diabetes Care. 2006;11:2518–27.CrossRefGoogle Scholar
  16. 16.
    Hayashino Y, Jackson JL, Fukumori N, et al. Effects of supervised exercise on lipid profiles and blood pressure control in people with type 2 diabetes mellitus: a meta-analysis of randomized controlled trials. Diabetes Res Clin Pract. 2012;98:349–60.PubMedCrossRefGoogle Scholar
  17. 17.
    Pi-Sunyer X, Blackburn G, Brancati FL, et al. Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial. Diabetes Care. 2007;30:1374–83.PubMedCrossRefGoogle Scholar
  18. 18.
    Robinson KA, Dickersin K. Development of a highly sensitive search strategy for the retrieval of reports of controlled trials using PubMed. Int J Epidemiol. 2002;31:150–3.PubMedCrossRefGoogle Scholar
  19. 19.
    Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(264–269):W264.CrossRefGoogle Scholar
  20. 20.
    Higgins JPT. Analysing data and undertaking metaanalysis. In: Higgins JPT, Green S, editors. Cochrane handbook for systematic reviews of interventions. Version 5.1.0 [updated March 2011]. CCAa. Accessed 20 May 2013.
  21. 21.
    Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336:924–6.PubMedPubMedCentralCrossRefGoogle Scholar
  22. 22.
    American Diabetes Association. Standars of medical care in diabetes. Diabetes Care. 2014;37(Suppl 1):S14–80.CrossRefGoogle Scholar
  23. 23.
    Harbord RM, Higgins JPT. Meta-regression in Stata. In: Sterne JAC, Newton HJ, Cox NJ, eds. Meta-analysis in Stata. College Station (TX): Stata Press; 2009.Google Scholar
  24. 24.
    Indrayan A. Medical biostatistics. 2nd ed. Boca Raton, FL: Chapman & Hall/CRC; 2008.Google Scholar
  25. 25.
    Peters JL, Sutton AJ, Jones DR, et al. Contour-enhanced meta-analysis funnel plots help distinguish publication bias from other causes of asymmetry. J Clin Epidemiol. 2008;61:991–6.PubMedCrossRefGoogle Scholar
  26. 26.
    Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557–60.PubMedPubMedCentralCrossRefGoogle Scholar
  27. 27.
    Duval S, Tweedie R. Trim and fill: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000;56:455–63.PubMedCrossRefGoogle Scholar
  28. 28.
    Lewington S, Clarke R, Qizilbash N, et al. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360:1903–13.PubMedCrossRefGoogle Scholar
  29. 29.
    Bangalore S, Kumar S, Lobach I, et al. Blood pressure targets in subjects with type 2 diabetes mellitus/impaired fasting glucose: observations from traditional and bayesian random-effects meta-analyses of randomized trials. Circulation. 2011;123(2799–2810):2799.PubMedCrossRefGoogle Scholar
  30. 30.
    Law MR, Morris JK, Wald NJ. Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies. BMJ. 2009;338:b1665.PubMedPubMedCentralCrossRefGoogle Scholar
  31. 31.
    Kingwell BA, Berry KL, Cameron JD, et al. Arterial compliance increases after moderate-intensity cycling. Am J Physiol. 1997;273:H2186–91.PubMedGoogle Scholar
  32. 32.
    Larose J, Sigal RJ, Boulé NG, et al. Effect of exercise training on physical fitness in type II diabetes mellitus. Med Sci Sports Exerc. 2010;8:1439–47.CrossRefGoogle Scholar
  33. 33.
    Earnest CP, Johannsen NM, Swift DL, et al. Aerobic and strength training in concomitant metabolic syndrome and type 2 diabetes. Med Sci Sports Exerc. 2014;46:1293–301.Google Scholar
  34. 34.
    Rossi A, Dikareva A, Bacon SL, et al. The impact of physical activity on mortality in patients with high blood pressure: a systematic review. J Hypertens. 2012;30:1277–88.PubMedCrossRefGoogle Scholar
  35. 35.
    Balducci S, Zanuso S, Nicolucci A, et al. Effect of an intensive exercise intervention strategy on modifiable cardiovascular risk factors in subjects with type 2 diabetes mellitus: a randomized controlled trial: the Italian Diabetes and Exercise Study (IDES). Arch Intern Med. 2010;170:1794–803.PubMedCrossRefGoogle Scholar
  36. 36.
    Umpierre D, Ribeiro PA, Kramer CK, et al. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. JAMA. 2011;305:1790–9.PubMedCrossRefGoogle Scholar
  37. 37.
    Sluik D, Buijsse B, Muckelbauer R, et al. Physical activity and mortality in individuals with diabetes mellitus: a prospective study and meta-analysis. Arch Intern Med. 2012;172:1285–95.PubMedCrossRefGoogle Scholar
  38. 38.
    Umpierre D, Ribeiro PA, Schaan BD, et al. Volume of supervised exercise training impacts glycaemic control in patients with type 2 diabetes: a systematic review with meta-regression analysis. Diabetologia. 2013;56:242–51.PubMedCrossRefGoogle Scholar
  39. 39.
    Colberg SR, Albright AL, Blissmer BJ, et al. Exercise and type 2 diabetes: American College of Sports Medicine and the American Diabetes Association: joint position statement. Exercise and type 2 diabetes. Med Sci Sports Exerc. 2010;42:2282–303.PubMedCrossRefGoogle Scholar
  40. 40.
    Gaede P, Lund-Andersen H, Parving HH, et al. Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med. 2008;358:580–91.PubMedCrossRefGoogle Scholar
  41. 41.
    Gaede P, Vedel P, Parving HH, et al. Intensified multifactorial intervention in patients with type 2 diabetes mellitus and microalbuminuria: the Steno type 2 randomised study. Lancet. 1999;353:617–22.PubMedCrossRefGoogle Scholar
  42. 42.
    Hallal PC, Andersen LB, Bull FC, et al. Global physical activity levels: surveillance progress, pitfalls, and prospects. Lancet. 2012;380:247–57.PubMedCrossRefGoogle Scholar
  43. 43.
    Arora E, Shenoy S, Sandhu JS. Effects of resistance training on metabolic profile of adults with type 2 diabetes. Indian J Med Res. 2009;129:515–9.PubMedGoogle Scholar
  44. 44.
    Balducci S, Zanuso S, Nicolucci A, et al. Anti-inflammatory effect of exercise training in subjects with type 2 diabetes and the metabolic syndrome is dependent on exercise modalities and independent of weight loss. Nutr Metab Cardiovasc Dis. 2010;20:608–17.PubMedCrossRefGoogle Scholar
  45. 45.
    Belli T, Ribeiro LF, Ackermann MA, et al. Effects of 12-week overground walking training at ventilatory threshold velocity in type 2 diabetic women. Diabetes Res Clin Pract. 2011;93:337–43.PubMedCrossRefGoogle Scholar
  46. 46.
    Bjørgaas M, Vik JT, Saeterhaug A, et al. Relationship between pedometer-registered activity, aerobic capacity and self-reported activity and fitness in patients with type 2 diabetes. Diabetes Obes Metab. 2005;7:737–44.PubMedCrossRefGoogle Scholar
  47. 47.
    Gram B, Christensen R, Christiansen C, et al. Effects of nordic walking and exercise in type 2 diabetes mellitus: a randomized controlled trial. Clin J Sport Med. 2010;20:355–61.PubMedGoogle Scholar
  48. 48.
    Jorge ML, de Oliveira VN, Resende NM, et al. The effects of aerobic, resistance, and combined exercise on metabolic control, inflammatory markers, adipocytokines, and muscle insulin signaling in patients with type 2 diabetes mellitus. Metabolism. 2011;60:1244–52.PubMedCrossRefGoogle Scholar
  49. 49.
    Kadoglou NP, Perrea D, Iliadis F, et al. Exercise reduces resistin and inflammatory cytokines in patients with type 2 diabetes. Diabetes Care. 2007;30:719–21.PubMedCrossRefGoogle Scholar
  50. 50.
    Kadoglou NP, Iliadis F, Angelopoulou N, et al. The anti-inflammatory effects of exercise training in patients with type 2 diabetes mellitus. Eur J Cardiovasc Prev Rehabil. 2007;14:837–43.PubMedCrossRefGoogle Scholar
  51. 51.
    Kadoglou NP, Vrabas IS, Sailer N, et al. Exercise ameliorates serum MMP-9 and TIMP-2 levels in patients with type 2 diabetes. Diabetes Metab. 2010;36:144–51.PubMedCrossRefGoogle Scholar
  52. 52.
    Kadoglou NP, Iliadis F, Sailer N, et al. Exercise training ameliorates the effects of rosiglitazone on traditional and novel cardiovascular risk factors in patients with type 2 diabetes mellitus. Metabolism. 2010;59:599–607.PubMedCrossRefGoogle Scholar
  53. 53.
    Kadoglou NP, Vrabas IS, Kapelouzou A, et al. The impact of aerobic exercise training on novel adipokines, apelin and ghrelin, in patients with type 2 diabetes. Med Sci Monit. 2012;18:CR290–295.Google Scholar
  54. 54.
    Kadoglou NP, Fotiadis G, Kapelouzou A, et al. The differential anti-inflammatory effects of exercise modalities and their association with early carotid atherosclerosis progression in patients with Type 2 diabetes. Diabet Med. 2013;30:e41–50.PubMedCrossRefGoogle Scholar
  55. 55.
    Kurban S, Mehmetoglu I, Yerlikaya HF, et al. Effect of chronic regular exercise on serum ischemia-modified albumin levels and oxidative stress in type 2 diabetes mellitus. Endocr Res. 2011;36:116–23.PubMedCrossRefGoogle Scholar
  56. 56.
    Leehey DJ, Moinuddin I, Bast JP, et al. Aerobic exercise in obese diabetic patients with chronic kidney disease: a randomized and controlled pilot study. Cardiovasc Diabetol. 2009;8:62.PubMedPubMedCentralCrossRefGoogle Scholar
  57. 57.
    Madden KM, Lockhart C, Cuff D, et al. Aerobic training-induced improvements in arterial stiffness are not sustained in older adults with multiple cardiovascular risk factors. J Hum Hypertens. 2013;27:335–9.PubMedPubMedCentralCrossRefGoogle Scholar
  58. 58.
    Middlebrooke AR, Elston LM, Macleod KM, et al. Six months of aerobic exercise does not improve microvascular function in type 2 diabetes mellitus. Diabetologia. 2006;49:2263–71.PubMedCrossRefGoogle Scholar
  59. 59.
    Monteiro LZ, Fiani CR, Freitas MC, et al. Decrease in blood pressure, body mass index and glycemia after aerobic training in elderly women with type 2 diabetes. Arq Bras Cardiol. 2010;95:563–70.PubMedCrossRefGoogle Scholar
  60. 60.
    Negri C, Bacchi E, Morgante S, et al. Supervised walking groups to increase physical activity in type 2 diabetic patients. Diabetes Care. 2010;33:2333–5.PubMedPubMedCentralCrossRefGoogle Scholar
  61. 61.
    Shenoy S, Guglani R, Sandhu JS. Effectiveness of an aerobic walking program using heart rate monitor and pedometer on the parameters of diabetes control in Asian Indians with type 2 diabetes. Prim Care Diabetes. 2010;4:41–5.PubMedCrossRefGoogle Scholar
  62. 62.
    Sigal RJ, Kenny GP, Boule NG, et al. Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial. Ann Intern Med. 2007;147:357–69.PubMedCrossRefGoogle Scholar
  63. 63.
    Yavari A, Hajiyev AM, Naghizadeh F. The effect of aerobic exercise on glycosylated hemoglobin values in type 2 diabetes patients. J Sports Med Phys Fitness. 2010;50:501–5.PubMedGoogle Scholar
  64. 64.
    Castaneda C, Layne JE, Munoz-Orians L, et al. A randomized controlled trial of resistance exercise training to improve glycemic control in older adults with type 2 diabetes. Diabetes Care. 2002;25:2335–41.PubMedCrossRefGoogle Scholar
  65. 65.
    Dunstan DW, Puddey IB, Beilin LJ, et al. Effects of a short-term circuit weight training program on glycaemic control in NIDDM. Diabetes Res Clin Pract. 1998;40:53–61.PubMedCrossRefGoogle Scholar
  66. 66.
    Dunstan DW, Daly RM, Owen N, et al. High-intensity resistance training improves glycemic control in older patients with type 2 diabetes. Diabetes Care. 2002;25:1729–36.PubMedCrossRefGoogle Scholar
  67. 67.
    Hameed UA, Manzar D, Raza S, et al. Resistance training leads to clinically meaningful improvements in control of glycemia and muscular strength in untrained middle-aged patients with type 2 diabetes mellitus. N Am J Med Sci. 2012;4:336–43.PubMedPubMedCentralCrossRefGoogle Scholar
  68. 68.
    Kadoglou NP, Fotiadis G, Athanasiadou Z, et al. The effects of resistance training on ApoB/ApoA-I ratio, Lp(a) and inflammatory markers in patients with type 2 diabetes. Endocrine. 2012;42:561–9.PubMedCrossRefGoogle Scholar
  69. 69.
    Plotnikoff RC, Eves N, Jung M, et al. Multicomponent, home-based resistance training for obese adults with type 2 diabetes: a randomized controlled trial. Int J Obes (Lond). 2010;34:1733–41.Google Scholar
  70. 70.
    Dobrosielski DA, Gibbs BB, Ouyang P, et al. Effect of exercise on blood pressure in type 2 diabetes: a randomized controlled trial. J Gen Intern Med. 2012;27:1453–9.PubMedPubMedCentralCrossRefGoogle Scholar
  71. 71.
    Okada S, Hiuge A, Makino H, et al. Effect of exercise intervention on endothelial function and incidence of cardiovascular disease in patients with type 2 diabetes. J Atheroscler Thromb. 2010;17:828–33.PubMedCrossRefGoogle Scholar
  72. 72.
    Agurs-Collins TD, Kumanyika SK, Ten Have TR, et al. A randomized controlled trial of weight reduction and exercise for diabetes management in older African-American subjects. Diabetes Care. 1997;20:1503–11.PubMedCrossRefGoogle Scholar
  73. 73.
    Allen NA, Fain JA, Braun B, et al. Continuous glucose monitoring counseling improves physical activity behaviors of individuals with type 2 diabetes: a randomized clinical trial. Diabetes Res Clin Pract. 2008;80:371–9.PubMedPubMedCentralCrossRefGoogle Scholar
  74. 74.
    Andrews RC, Cooper AR, Montgomery AA, et al. Diet or diet plus physical activity versus usual care in patients with newly diagnosed type 2 diabetes: the Early ACTID randomised controlled trial. Lancet. 2011;378:129–39.PubMedCrossRefGoogle Scholar
  75. 75.
    Goldhaber-Fiebert JD, Goldhaber-Fiebert SN, Tristan ML, et al. Randomized controlled community-based nutrition and exercise intervention improves glycemia and cardiovascular risk factors in type 2 diabetic patients in rural Costa Rica. Diabetes Care. 2003;26:24–9.PubMedCrossRefGoogle Scholar
  76. 76.
    Hare JL, Hordern MD, Leano R, et al. Application of an exercise intervention on the evolution of diastolic dysfunction in patients with diabetes mellitus: efficacy and effectiveness. Circ Heart Fail. 2011;4:441–9.PubMedCrossRefGoogle Scholar
  77. 77.
    Schultz MG, Hordern MD, Leano R, et al. Lifestyle change diminishes a hypertensive response to exercise in type 2 diabetes. Med Sci Sports Exerc. 2011;43:764–9.PubMedCrossRefGoogle Scholar
  78. 78.
    Sun J, Wang Y, Chen X, et al. An integrated intervention program to control diabetes in overweight Chinese women and men with type 2 diabetes. Asia Pac J Clin Nutr. 2008;17:514–24.PubMedGoogle Scholar
  79. 79.
    Toobert DJ, Glasgow RE, Strycker LA, et al. Biologic and quality-of-life outcomes from the Mediterranean Lifestyle Program: a randomized clinical trial. Diabetes Care. 2003;26:2288–93.PubMedCrossRefGoogle Scholar
  80. 80.
    Wing RR, Epstein LH, Paternostro-Bayles M, et al. Exercise in a behavioural weight control programme for obese patients with Type 2 (non-insulin-dependent) diabetes. Diabetologia. 1988;31:902–9.PubMedCrossRefGoogle Scholar
  81. 81.
    Araiza P, Hewes H, Gashetewa C, et al. Efficacy of a pedometer-based physical activity program on parameters of diabetes control in type 2 diabetes mellitus. Metabolism. 2006;55:1382–7.PubMedCrossRefGoogle Scholar
  82. 82.
    Christian JG, Bessesen DH, Byers TE, et al. Clinic-based support to help overweight patients with type 2 diabetes increase physical activity and lose weight. Arch Intern Med. 2008;168:141–6.PubMedCrossRefGoogle Scholar
  83. 83.
    De Greef K, Deforche B, Tudor-Locke C, et al. A cognitive-behavioural pedometer-based group intervention on physical activity and sedentary behaviour in individuals with type 2 diabetes. Health Educ Res. 2010;25:724–36.PubMedPubMedCentralCrossRefGoogle Scholar
  84. 84.
    Diedrich A, Munroe DJ, Romano M. Promoting physical activity for persons with diabetes. Diabetes Educ. 2010;36:132–40.PubMedCrossRefGoogle Scholar
  85. 85.
    Ferrer-Garcia JC, Sanchez Lopez P, Pablos-Abella C, et al. Benefits of a home-based physical exercise program in elderly subjects with type 2 diabetes mellitus. Endocrinol Nutr. 2011;58(8):387–94.Google Scholar
  86. 86.
    Kirk A, Mutrie N, MacIntyre P, et al. Increasing physical activity in people with type 2 diabetes. Diabetes Care. 2003;26:1186–92.PubMedCrossRefGoogle Scholar
  87. 87.
    Krousel-Wood MA, Berger L, Jiang X, et al. Does home-based exercise improve body mass index in patients with type 2 diabetes? Results of a feasibility trial. Diabetes Res Clin Pract. 2008;79:230–6.PubMedCrossRefGoogle Scholar
  88. 88.
    Piette JD, Richardson C, Himle J, et al. A randomized trial of telephonic counseling plus walking for depressed diabetes patients. Med Care. 2011;49:641–8.PubMedPubMedCentralCrossRefGoogle Scholar
  89. 89.
    Plotnikoff RC, Pickering MA, Glenn N, et al. The effects of a supplemental, theory-based physical activity counseling intervention for adults with type 2 diabetes. J Phys Act Health. 2011;8:944–54.PubMedGoogle Scholar
  90. 90.
    Tudor-Locke C, Bell RC, Myers AM, et al. Controlled outcome evaluation of the First Step Program: a daily physical activity intervention for individuals with type II diabetes. Int J Obes Relat Metab Disord. 2004;28:113–9.PubMedCrossRefGoogle Scholar
  91. 91.
    Wisse W, Rookhuizen MB, de Kruif MD, et al. Prescription of physical activity is not sufficient to change sedentary behavior and improve glycemic control in type 2 diabetes patients. Diabetes Res Clin Pract. 2010;88:e10–3.PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Franciele R. Figueira
    • 1
    • 2
  • Daniel Umpierre
    • 1
    • 3
  • Felipe V. Cureau
    • 2
  • Alessandra T. N. Zucatti
    • 2
  • Mériane B. Dalzochio
    • 1
  • Cristiane B. Leitão
    • 2
  • Beatriz D. Schaan
    • 2
    • 3
    • 4
    • 5
  1. 1.Exercise Pathophysiology Research LaboratoryHospital de Clinicas de Porto AlegrePorto AlegreBrazil
  2. 2.Postgraduate Program in Health Sciences: EndocrinologyUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
  3. 3.Postgraduate Program in Health Sciences, Cardiovascular SciencesUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
  4. 4.Endocrine Division, Serviço de Endocrinologia, Hospital de Clínicas de Porto AlegrePorto AlegreBrazil
  5. 5.Department of Internal Medicine, Faculty of MedicineUniversidade Federal do Rio Grande do SulPorto AlegreBrazil

Personalised recommendations