{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T06:27:23Z","timestamp":1787120843559,"version":"build-2736575974"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Objective<\/jats:title>\n To evaluate the association between an individualized exercise management program based on shared decision-making (SDM) and short-term glycemic control, self-care behaviors, and quality of life in patients with type 2 diabetes mellitus (T2DM).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective cohort study used data from electronic medical records and a diabetes management platform (January 2019 \u2013 December 2023). After propensity score matching (1:1 nearest-neighbor, caliper\u202f=\u202f0.02 SD), 178 patients were included (89 in SDM-based intervention group, 89 in routine care control group). The intervention group received an SDM-driven personalized exercise program plus routine care, while controls received routine care alone. Outcomes included HbA1c, fasting plasma glucose (FPG), 2\u202fh postprandial glucose (2hPG), time in range (TIR), mean amplitude of glycemic excursions (MAGE), 6-meter walking speed, medication adherence, Summary of Diabetes Self-Care Activities (SDSCA) score, and Diabetes-Specific Quality of Life (DSQL) score. Assessments were performed at baseline, 1\u202fmonth, and 2\u202fmonths.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n At 1 and 2\u202fmonths, the intervention group showed significantly greater reductions in HbA1c, FPG, 2hPG, and MAGE, and a significantly greater increase in TIR compared to controls (all\n p<\/jats:italic>\n \u202f&lt;\u202f0.05). At 2\u202fmonths, TIR was higher (67.72\u202f\u00b1\u202f15.52% vs. 61.65\u202f\u00b1\u202f23.12%,\n p<\/jats:italic>\n \u202f=\u202f0.004) and MAGE lower (5.35\u202f\u00b1\u202f2.02 vs. 6.22\u202f\u00b1\u202f1.86,\n p<\/jats:italic>\n \u202f=\u202f0.027) in the intervention group. The 6-meter walking speed also improved more in the intervention group (1.05\u202f\u00b1\u202f0.11 vs. 0.98\u202f\u00b1\u202f0.12\u202fm\/s,\n p<\/jats:italic>\n \u202f=\u202f0.003). Medication adherence across five domains (medication, diet, glucose monitoring, aerobic exercise, daily routine) was significantly better in the intervention group (all\n p<\/jats:italic>\n \u202f&lt;\u202f0.05). The intervention group had significantly higher SDSCA scores and lower DSQL scores at 2\u202fmonths (both\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), indicating enhanced self-management and improved quality of life.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n An individualized exercise management program based on the SDM model was associated with improved short-term glycemic control, treatment adherence, self-management behaviors, and quality of life in T2DM patients. Future prospective randomized studies with longer follow-up are needed to establish causality and determine the sustainability of these improvements.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1867433","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T05:45:24Z","timestamp":1787118324000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A shared decision-making approach to individualized exercise management enhances glycemic control, self-care behaviors, and quality of life in type 2 diabetes: a retrospective cohort study"],"prefix":"10.3389","volume":"14","author":[{"given":"Tingting","family":"Feng","sequence":"first","affiliation":[{"name":"Surgical Room Professional Medicine, Hangzhou Women's Hospital","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengcheng","family":"Cai","sequence":"additional","affiliation":[{"name":"Labor and Delivery Center, Hangzhou Women's Hospital","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuangyan","family":"Xu","sequence":"additional","affiliation":[{"name":"Labor and Delivery Center, Hangzhou Women's Hospital","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1016\/S2213-8587(25)00299-2","article-title":"11th edition of the IDF diabetes atlas: global, regional, and national diabetes prevalence estimates for 2024 and projections for 2050","volume":"14","author":"Genitsaridi","year":"2026","journal-title":"Lancet Diabetes Endocrinol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2515","DOI":"10.1001\/jama.2017.7596","article-title":"Prevalence and ethnic pattern of diabetes and prediabetes in China in 2013","volume":"317","author":"Wang","year":"2017","journal-title":"JAMA"},{"key":"ref3","first-page":"1","article-title":"App-technology to increase physical activity among patients with diabetes type 2-the DiaCert-study, a randomized controlled trial","author":"Bonn","year":"2018"},{"key":"ref4","first-page":"803","article-title":"Changing patients\u2019 treatment preferences and values with a decision aid for type 2 diabetes mellitus: results from the treatment arm of a randomized controlled trial","author":"Bailey","year":"2018"},{"key":"ref5","first-page":"49","article-title":"Comparative effectiveness of team-based care with and without a clinical decision support system for diabetes management: a cluster randomized trial","author":"Shi","year":"2023"},{"key":"ref6","first-page":"1212","article-title":"The effectiveness of goal setting on glycaemic control for people with type 2 diabetes and prediabetes: a systematic review and meta-analysis","author":"Whitehead","year":"2022"},{"key":"ref7","first-page":"408","article-title":"Effectiveness of interventions for promoting objectively measured physical activity of adults with type 2 diabetes: a systematic review","author":"Alothman","year":"2017"},{"key":"ref8","first-page":"e0306296","article-title":"Effectiveness of shared decision-making for glycaemic control among type 2 diabetes mellitus adult patients: a systematic review and meta-analysis","author":"Geta","year":"2024"},{"key":"ref9","first-page":"1172","article-title":"Effectiveness of shared goal setting and decision making to achieve treatment targets in type 2 diabetes patients: a cluster-randomized trial (OPTIMAL)","author":"Den Ouden","year":"2017"},{"key":"ref10","first-page":"821","article-title":"Effects of a 12-month physical activity counselling intervention on glycaemic control and on the status of cardiovascular risk factors in people with type 2 diabetes","author":"Kirk","year":"2004"},{"key":"ref11","first-page":"115","article-title":"HbA1c as a shared treatment goal in type 2 diabetes? 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