{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T15:01:39Z","timestamp":1784818899108,"version":"3.55.0"},"reference-count":24,"publisher":"American Diabetes Association","issue":"6","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2005,6,1]]},"abstract":"<jats:p>OBJECTIVE\u2014To establish the impact of different amounts of increased energy expenditure on type 2 diabetes care.<\/jats:p>\n               <jats:p>RESEARCH DESIGN AND METHODS\u2014Post hoc analysis of long-term effects of different amounts of increased energy expenditure (metabolic equivalents [METS] per hour per week) through voluntary aerobic physical activity was performed in 179 type 2 diabetic subjects (age 62 \u00b1 1 years [mean \u00b1 SE]) randomized to a physical activity counseling intervention. Subjects were followed for 2 years and divided into six groups based on their increments in METs per hour per week: group 0 (no activity, n = 28), group 1\u201310 (6.8 \u00b1 0.3, n = 27), group 11\u201320 (17.1 \u00b1 0.4, n = 31), group 21\u201330 (27.0 \u00b1 0.5, n = 27), group 31\u201340 (37.5 \u00b1 0.5, n = 32), and group &amp;gt;40 (58.3 \u00b1 1.8, n = 34).<\/jats:p>\n               <jats:p>RESULTS\u2014At baseline, the six groups did not differ for energy expenditure, age, sex, diabetes duration, and all parameters measured. After 2 years, in group 0 and in group 1\u201310, no parameter changed; in groups 11\u201320, 21\u201330, 31\u201340, and &amp;gt;40, HbA1c, blood pressure, total serum cholesterol, triglycerides, and estimated percent of 10-year coronary heart disease risk improved (P &amp;lt; 0.05). In group 21\u201330, 31\u201340, and &amp;gt;40, body weight, waist circumference, heart rate, fasting plasma glucose, serum LDL and HDL cholesterol also improved (P &amp;lt; 0.05). METs per hour per week correlated positively with changes of HDL cholesterol and negatively with those of other parameters (P &amp;lt; 0.001). After 2 years, per capita yearly costs of medications increased (P = 0.008) by $393 in group 0, did not significantly change in group 1\u201310 ($206, P = 0.09), and decreased in group 11\u201320 (\u2212$196, P = 0.01), group 21\u201330 (\u2212$593, P = 0.009), group 31\u201340 (\u2212$660, P = 0.003), and group &amp;gt;40 (\u2212$579, P = 0.001).<\/jats:p>\n               <jats:p>CONCLUSIONS\u2014Energy expenditure &amp;gt;10 METs \u00b7 h\u22121 \u00b7 week\u22121 obtained through aerobic leisure time physical activity is sufficient to achieve health and financial advantages, but full benefits are achieved with energy expenditure &amp;gt;20 METs \u00b7 h\u22121 \u00b7 week\u22121.<\/jats:p>","DOI":"10.2337\/diacare.28.6.1295","type":"journal-article","created":{"date-parts":[[2007,3,5]],"date-time":"2007-03-05T22:51:27Z","timestamp":1173135087000},"page":"1295-1302","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":155,"title":["Make Your Diabetic Patients Walk"],"prefix":"10.2337","volume":"28","author":[{"given":"Chiara","family":"Di Loreto","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Section of Internal Medicine, Endocrine and Metabolic Sciences, University of Perugia, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmine","family":"Fanelli","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Internal Medicine, Endocrine and Metabolic Sciences, University of Perugia, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Lucidi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Internal Medicine, Endocrine and Metabolic Sciences, University of Perugia, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Murdolo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Internal Medicine, Endocrine and Metabolic Sciences, University of Perugia, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"De Cicco","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Internal Medicine, Endocrine and Metabolic Sciences, University of Perugia, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natascia","family":"Parlanti","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Internal Medicine, Endocrine and Metabolic Sciences, University of Perugia, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Ranchelli","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Internal Medicine, Endocrine and Metabolic Sciences, University of Perugia, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Fatone","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Internal Medicine, Endocrine and Metabolic Sciences, University of Perugia, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Taglioni","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Internal Medicine, Endocrine and Metabolic Sciences, University of Perugia, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fausto","family":"Santeusanio","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Internal Medicine, Endocrine and Metabolic Sciences, University of Perugia, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierpaolo","family":"De Feo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Internal Medicine, Endocrine and Metabolic Sciences, University of Perugia, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","reference":[{"key":"2022031218423077700_R1","doi-asserted-by":"crossref","unstructured":"Klein S, Sheard NF, Pi-Sunyer X, Daly A, Wylie-Rosett J, Kulkarni K, Clark NG, American Diabetes Association, North American Association for the Study of Obesity, American Society for Clinical Nutrition: Weight management through lifestyle modification for the prevention and management of type 2 diabetes: rationale and strategies. 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