The Effect of Tele-Monitoring on Exercise Training Adherence, Functional Capacity, Quality of Life and Glycemic Control in Patients With Type II Diabetes.

ABSTRACT We used tele-monitoring to attempt to improve exercise adherence (number of hours of exercise completed), peak VO2, HbA1c% and quality of life in an unsupervised, home based exercise program in people with type II diabetes, a cost analysis was also conducted. Thirty-nine patients with type II diabetes were randomized to tele-monitoring (TELE) or control (CON) groups. All patients were asked to complete 6 months exercise training and complete an exercise activity diary. The TELE group was instructed to record their exercise heart rates using a monitor and received weekly telephone calls from an exercise physiologist. Six TELE patients and seven CON patients did not complete the 6 month testing. TELE patients completed a mean weekly volume of 138 minutes, moderate intensity exercise, while CON patients completed 58 minutes weekly (p < 0.02). Neither group achieved the American Heart Association statement guideline for weekly exercise volume of 150 minutes. TELE patients improved peak VO2 (5.5 %), but neither group improved HbA1c% or quality of life. The CON group showed a 4.9% reduction in peak VO2. While tele-monitored patients completed more hours of exercise and demonstrated improved peak VO2 compared to controls, the exercise volume completed was insufficient to improve glycemic control. There is the potential via tele-monitoring to enable people with diabetes to meet exercise training guidelines. KEY POINTS Weekly telephone calls from a health professional providing encouragement, increases the amount of exercise completed by people with diabetesWeekly telephone calls will result in improved fitnessAt least 150 minutes weekly exercise is required to improve diabetes controlThe cost of home exercise with telephone monitoring is cheaper (and more convenient for the patient) than delivering an exercise program at the hospitalLonger term research is needed to examine whether telephone supervised exercise will prevent serious events such as heart attack, strokes and death.