Who Needs a Gym Membership?

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Effect of a low-resource-intensive lifestyle modification program incorporating gymnasium-based and home-based resistance training on type 2 diabetes risk in Australian adults, by Warren R. Payne and colleagues. Diabetes Care 31:2244–225, 2008

What is the problem and what is known about it so far?

People who have impaired glucose tolerance (IGT) have some problems with the way their body processes glucose but do not yet have full diabetes. Some studies have shown that people with IGT can greatly lower their risk of getting diabetes through exercise programs. However, these studies involved intensive efforts and professional assistance that aren't available to many people in the "real-world." Also, they did not include people who have other risk factors for diabetes in addition to IGT. Studies that have tested less-intensive exercise programs among people at risk for diabetes have had mixed results. These studies have mostly involved programs offered at clinics or gyms and did not include strength-training exercises. More information is needed about whether strength exercise that can be carried out at home can help people avoid diabetes.

Why did researchers do this particular study?

The researchers wanted to see how well a simple exercise program that included strength-training helped people avoid diabetes and to see if doing these exercises at home worked as well as doing them at a gym.

Who was studied?

The study included 122 Australian adults who were at risk of developing diabetes. Some of the patients had IGT or impaired fasting glucose (another condition that may lead to diabetes), while others had different diabetes risk factors.

How was the study done?

All participants had a 6-week group diabetes education class, either a home-based or a gym-based 12-week strength-building exercise program, and a 34-week maintenance program. Researchers measured their glucose, cholesterol, and blood pressure levels and their body muscle and fat and asked about their exercise and diet habits at the start and end of the study.

What did the researchers find?

The exercise program reduced participants' risk of getting diabetes as much as programs tested in previous studies—even those that were more intensive and difficult to provide. The home-based program worked as well as the gym-based program.

What are the limitations of the study?

Because of the study design, researchers could not tell how each separate part of their program—the diabetes education, the 12-week exercise regimen, or the 34-week maintenance phase—affected diabetes risk. Also, the study took place in Australia, so results may not completely apply to people in other health care systems. The study did not include many people of poorer economic status, who may have fewer available resources. Finally, because participants' behavior and health may have continued to change as a result of the program, the study may have over- or underestimated the program's full effects.

What are the implications of the study?

Strength-building exercise programs that don't require a lot of resources and can be easily carried out in the real world can help people lower their risk of getting diabetes.

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