Effect of a Behavioral Intervention Strategy for Adoption and Maintenance of a Physically Active Lifestyle: The Italian Diabetes and Exercise Study 2 (IDES_2)
Open accessAbstract
OBJECTIVE Adherence to physical activity (PA) recommendations is hampered by the lack of effective strategies to promote behavior change. The Italian Diabetes and Exercise Study 2 (IDES_2) is a randomized controlled trial evaluating a novel behavioral intervention strategy for increasing PA and decreasing sedentary time (SED-time) in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS The study randomized 300 physically inactive and sedentary patients with type 2 diabetes 1:1 to receive theoretical and practical counseling once yearly for 3 years (intervention group [INT]) or standard care (control group [CON]). Here, we report the 4-month effects on objectively (accelerometer) measured daily light-intensity PA (LPA), moderate-to-vigorous–intensity PA (MVPA), and SED-time, and cardiovascular risk factors. RESULTS LPA and MVPA both increased, and SED-time decreased in both groups, although changes were significantly more marked in INT participants (approximately twofold for LPA and SED-time and approximately sixfold for MVPA). A significant reduction in HbA1c was observed only in INT subjects. An increase in LPA >0.92 h · day−1 and in MVPA >7.33 min · day−1 and a decrease in SED-time >1.05 h · day−1 were associated with an average decrease in HbA1c of ∼1% and also with significant improvements in fasting glucose, body weight, waist circumference, and hs-CRP. Changes in PA and SED-time were independent predictors of improvements in HbA1c. CONCLUSIONS This behavioral intervention is effective in the short term for increasing LPA and MVPA and reducing SED-time. Significant improvements in cardiometabolic risk profiles were observed in subjects experiencing the most pronounced changes in PA and SED-time, even if below the recommended level.
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Several studies reported a decrease in sedentary time after the interventions.
“Several studies reported a decrease in sedentary time after the interventions [16,24,30].”
The behavioural scaffolding in supervised exercise interventions remains largely shaped by interpersonal support.
“However, the behavioural scaffolding remains largely shaped by interpersonal support [16,24,25,27].”
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Cites
Physical activity/exercise and diabetes: A position statement of the American Diabetes Association
Colberg, S. R., Sigal, R. J., Yardley, J. E., Riddell, M. C., Dunstan, D. W., Dempsey, P. C., Horton, E. S., Castorino, K., & Tate, D. F. (2016) · Diabetes Care · doi:10.2337/dc16-1728 · Cited by 2,991 · see citing works
Too Much Sitting: The Population Health Science of Sedentary Behavior
Owen, N., Healy, G. N., Matthews, C. E., & Dunstan, D. W. (2010) · Exercise and Sport Sciences Reviews · doi:10.1097/jes.0b013e3181e373a2 · Cited by 2,202 · see citing works
Blair, S. N. (1996) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1996.03540030039029 · Cited by 1,819 · see citing works
Limits to the measurement of habitual physical activity by questionnaires
Shephard, R. J. (2003) · British Journal of Sports Medicine · doi:10.1136/bjsm.37.3.197 · Cited by 1,694 · see citing works
Healy, G. N., Dunstan, D. W., Salmon, J., Cerin, E., Shaw, J. E., Zimmet, P. Z., & Owen, N. (2008) · Diabetes Care · doi:10.2337/dc07-2046 · Cited by 1,465 · see citing works
Dunstan, D. W., Barr, E. L. M., Healy, G. N., Salmon, J., Shaw, J. E., Balkau, B., Magliano, D. J., Cameron, A. J., Zimmet, P. Z., & Owen, N. (2010) · Circulation · doi:10.1161/circulationaha.109.894824 · Cited by 825 · see citing works
Exercise capacity and body composition as predictors of mortality among men with diabetes
Church, T. S., Cheng, Y. J., Earnest, C. P., Barlow, C. E., Gibbons, L. W., Priest, E. L., & Blair, S. N. (2004) · Diabetes Care · doi:10.2337/diacare.27.1.83 · Cited by 469 · see citing works
Exercise and Cardiovascular Health
MYERS, J. N. (2003) · Circulation · doi:10.1161/01.cir.0000048890.59383.8d · Cited by 462 · see citing works
Dempsey, P. C., Larsen, R. N., Sethi, P., Sacre, J. W., Straznicky, N. E., Cohen, N. D., Cerin, E., Lambert, G. W., Owen, N., Kingwell, B. A., et al. (2016) · Diabetes Care · doi:10.2337/dc15-2336 · Cited by 405 · see citing works
Prince, S. A., Saunders, T. J., Gresty, K., & Reid, R. D. (2014) · Obesity Reviews · doi:10.1111/obr.12215 · Cited by 382 · see citing works
Physical activity, sedentary behavior, and health: Paradigm paralysis or paradigm shift?
Katzmarzyk, P. T. (2010) · Diabetes · doi:10.2337/db10-0822 · Cited by 365 · see citing works
Changing Physical Activity Behavior in Type 2 Diabetes
Avery, L., Flynn, D., van Wersch, A., Sniehotta, F. F., & Trenell, M. I. (2012) · Diabetes Care · doi:10.2337/dc11-2452 · Cited by 340 · see citing works
Balducci, S. (2010) · Archives of Internal Medicine · doi:10.1001/archinternmed.2010.380 · Cited by 329 · see citing works
Self-citationInterventions with potential to reduce sedentary time in adults: systematic review and meta-analysis
Martin, A., Fitzsimons, C., Jepson, R., Saunders, D. H., van der Ploeg, H. P., Teixeira, P. J., Gray, C. M., & Mutrie, N. (2015) · British Journal of Sports Medicine · doi:10.1136/bjsports-2014-094524 · Cited by 326 · see citing works
Thorp, A. A., Healy, G. N., Owen, N. G., Salmon, J., Ball, K., Shaw, J. E., Zimmet, P., & Dunstan, D. W. (2009) · Diabetes Care · doi:10.2337/dc09-0493 · Cited by 310 · see citing works
Korkiakangas, E. E., Alahuhta, M. A., & Laitinen, J. H. (2009) · Health Promotion International · doi:10.1093/heapro/dap031 · Cited by 276 · see citing works
Physical activity, cardiovascular risk factors, and mortality among Finnish adults with diabetes
Hu, G., Jousilahti, P., Barengo, N. C., Qiao, Q., Lakka, T. A., & Tuomilehto, J. (2005) · Diabetes Care · doi:10.2337/diacare.28.4.799 · Cited by 265 · see citing works
Variability in energy expenditure and its components
Donahoo, W. T., Levine, J. A., & Melanson, E. L. (2004) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/00075197-200411000-00003 · Cited by 236 · see citing works
Behavioral Programs for Type 2 Diabetes Mellitus: A Systematic Review and Network Meta-analysis
Pillay, J., Armstrong, M. J., Butalia, S., Donovan, L. E., Sigal, R. J., Vandermeer, B., Chordiya, P., Dhakal, S., Hartling, L., Nuspl, M., et al. (2015) · Annals of Internal Medicine · doi:10.7326/m15-1400 · Cited by 223 · see citing works
Loreto, C. D., Fanelli, C. G., Lucidi, P., Murdolo, G., Cicco, A. D., Parlanti, N., Santeusanio, F., Brunetti, P., & Feo, P. D. (2003) · Diabetes Care · doi:10.2337/diacare.26.2.404 · Cited by 216 · see citing works
Duvivier, B. M. F. M., Schaper, N. C., Hesselink, M. K. C., van Kan, L., Stienen, N., Winkens, B., Koster, A., & Savelberg, H. H. C. M. (2017) · Diabetologia · doi:10.1007/s00125-016-4161-7 · Cited by 212 · see citing works
Make Your Diabetic Patients Walk
Loreto, C. D., Fanelli, C. G., Lucidi, P., Murdolo, G., Cicco, A. D., Parlanti, N., Ranchelli, A., Fatone, C., Taglioni, C., Santeusanio, F., et al. (2005) · Diabetes Care · doi:10.2337/diacare.28.6.1295 · Cited by 208 · see citing works
Cooper, A. R., Sebire, S., Montgomery, A. A., Peters, T. J., Sharp, D. J., Jackson, N., Fitzsimons, K., Dayan, C. M., & Andrews, R. C. (2012) · Diabetologia · doi:10.1007/s00125-011-2408-x · Cited by 195 · cited 1× · see citing works
“Recent findings indicate that higher SED-time in individuals with type 2 diabetes is associated with higher metabolic risk, independently of time spent in moderate-tovigorous–intensity PA (MVPA) (7,8), thus suggesting that the biological responses”
BackgroundBehavioral Programs for Type 1 Diabetes Mellitus
Pillay, J., Armstrong, M. J., Butalia, S., Donovan, L., Sigal, R. J., Chordiya, P., Dhakal, S., Vandermeer, B., Hartling, L., Nuspl, M., et al. (2015) · Annals of Internal Medicine · doi:10.7326/m15-1399 · Cited by 180 · see citing works
Penno, G., Solini, A., Bonora, E., Fondelli, C., Orsi, E., Zerbini, G., Trevisan, R., Vedovato, M., Gruden, G., Laviola, L., et al. (2013) · Journal of Internal Medicine · doi:10.1111/joim.12073 · Cited by 151 · see citing works
Self-citationDempsey, P. C., Blankenship, J. M., Larsen, R. N., Sacre, J. W., Sethi, P., Straznicky, N. E., Cohen, N. D., Cerin, E., Lambert, G. W., Owen, N. G., et al. (2016) · Diabetologia · doi:10.1007/s00125-016-4169-z · Cited by 129 · see citing works
Cooper, A., Brage, S., Ekelund, U., Wareham, N. J., Griffin, S. J., & Simmons, R. K. (2013) · Diabetologia · doi:10.1007/s00125-013-3069-8 · Cited by 114 · see citing works
Metabolic effects of interventions to increase exercise in adults with type 2 diabetes
Conn, V. S., Hafdahl, A. R., Mehr, D. R., LeMaster, J. W., Brown, S. A., & Nielsen, P. J. (2007) · Diabetologia · doi:10.1007/s00125-007-0625-0 · Cited by 103 · see citing works
The effect of exercise on non‐exercise physical activity and sedentary behavior in adults
Melanson, E. L. (2017) · Obesity Reviews · doi:10.1111/obr.12507 · Cited by 103 · see citing works
Dombrowski, S. U., Sniehotta, F. F., Avenell, A., & Coyne, J. (2007) · Psychology and Health · doi:10.1080/08870440701520973 · Cited by 77 · see citing works
Balducci, S., Zanuso, S., Massarini, M., Corigliano, G., Nicolucci, A., Missori, S., Cavallo, S., Cardelli, P., Alessi, E., Pugliese, G., et al. (2008) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2007.07.006 · Cited by 59 · see citing works
Self-citationEvaluation of the MyWellness Key accelerometer
Herrmann, S. D., Hart, T., Lee, C. D., & Ainsworth, B. E. (2009) · British Journal of Sports Medicine · doi:10.1136/bjsm.2009.062182 · Cited by 29 · see citing works
for the Italian Diabetes and Exercise Study 2 (IDES_2) Investigators, Balducci, S., Sacchetti, M., Haxhi, J., Orlando, G., Zanuso, S., Cardelli, P., Cavallo, S., D’Errico, V., Ribaudo, M. C., et al. (2015) · Trials · doi:10.1186/s13063-015-1088-0 · Cited by 25 · see citing works
Self-citationReliability and validity of the Mywellness Key physical activity monitor
Sieverdes, J. C., Wickel, E. E., Hand, Bergamin, M., Moran, & Blair, S. N. (2013) · Clinical Epidemiology · doi:10.2147/clep.s38370 · Cited by 20 · see citing works
Validation of the mywellness key in walking and running speeds.
Bergamin, M., Ermolao, A., Sieverdes, J. C., Zaccaria, M., & Zanuso, S. (2012) · Europe PMC (PubMed Central) · Cited by 18 · see citing works
Self-citationAssessment of the MyWellness Key accelerometer in people with type 2 diabetes
McGinley, S. K., Armstrong, M. J., Khandwala, F., Zanuso, S., & Sigal, R. J. (2015) · Applied Physiology Nutrition and Metabolism · doi:10.1139/apnm-2015-0169 · Cited by 10 · see citing works
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Research works printed but not linked: 2
- Balducci S, Zanuso S, Nicolucci A, et al.; Italian Diabetes Exercise Study (IDES) Investigators. Ef- fect of an intensive exercise intervention strategy on modifiable cardiovascular risk factors in subjects with type 2 diabetes mellitus: a randomized con- trolled trial: the Italian Diabetes and Exercise Study (IDES). Arch Intern Med 2010;170:1794-1803
- Dombrowski SU, Sniehotta FF, Avenell S. Towards a cumulative science of behaviour change: do current conduct and reporting of behavioural interventions fall short of good practice? Psychol Health 2007;22:869-874
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Balducci, S., D’Errico, V., Haxhi, J., Sacchetti, M., Orlando, G., Cardelli, P., Vitale, M., Bollanti, L., Conti, F., Zanuso, S., et al. (2019) · JAMA · doi:10.1001/jama.2019.0922 · Cited by 158 · see citing works
Self-citationLaffi, A., Persiani, M., Piras, A., Meoni, A., & Raffi, M. (2025) · Healthcare · doi:10.3390/healthcare13192422 · Cited by 9 · see citing works
Masuda, H., Ishiyama, D., Yamada, M., Iwashima, F., Kimura, Y., Otobe, Y., Tani, N., Suzuki, M., & Nakajima, H. (2021) · Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy · doi:10.2147/dmso.s307070 · Cited by 6 · see citing works
- Authors
- Balducci, S., D’Errico, V., Haxhi, J., Sacchetti, M., Orlando, G., Cardelli, P., Vitale, M., Bollanti, L., Conti, F., Zanuso, S., Nicolucci, A., Pugliese, G., & for the Italian Diabetes and Exercise Study 2 (IDES_2) Investigators
- Affiliations
- Azienda Ospedaliera Sant'Andrea (IT)
- Foro Italico University of Rome (IT)
- Coventry University (GB)
- Center for Outcomes Research and Clinical Epidemiology (IT)
- Corresponding author
- Pugliese, Giuseppe
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2017-08-18
- Volume
- 40
- Issue
- 11
- Pages
- 1444-1452
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2750355072
- Cited by
- 42
- References
- 36
- Citations by year
- 2026: 8 · 2025: 1 · 2024: 4 · 2023: 3 · 2022: 6 · 2021: 6 · 2020: 7 · 2019: 3 · 2018: 4
- FWCI
- 2.83
- Type
- journal article
- Language
- en
- Open access
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Funders
- Metabolic Fitness Association
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- type 2 diabetes, physical activity, sedentary behavior, behavioral interventions, physical activity counseling, HbA1c, glycemic control, cardiovascular risk factors, cardiometabolic risk, light physical activity, moderate-to-vigorous physical activity, body weight, high-sensitivity C-reactive protein, waist circumference, fasting blood glucose
- MeSH terms
- Adult, Aged, Aged, 80 and over, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Female, Follow-Up Studies, Humans, Italy, Life Style, Male, Middle Aged, Risk Factors, Health Behavior, Exercise, Treatment Outcome, Endpoint Determination, Waist Circumference, Sedentary Behavior, Accelerometry
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