Effects of a home-based physical activity programme on blood biomarkers and health-related quality of life indices in Saudi Arabian type-2 diabetes mellitus patients: a randomized controlled trial

Abstract

The purpose of this study was to undertake a randomized control trial, examining the effects of a 12-week home-based physical activity programme in Saudi Arabian adults with type-2 diabetes. Sixty-four patients with type-2 diabetes mellitus were recruited from the Jazan Diabetes and Endocrinology Center, located in Jazan region of southwestern Saudi Arabia. Patients were randomly assigned to either control i.e. usual care (males = 46.9% & females = 53.1%, age = 45.88±8.51yrs, mass = 76.30±15.16kg, stature = 160.59±8.94cm, body mass index (BMI) = 29.73±6.24kg/m2, years since diagnosis = 8.12±6.22yrs) or a home-based physical activity (males = 50% & females = 50%, age = 42.07±9.72yrs, mass = 74.58±13.67kg, stature = 158.94±9.38cm, BMI = 29.44±4.38kg/m2, years since diagnosis = 12.17±8.38yrs) trial arms. The home-based physical activity group were required to undertake aerobic training by increasing their habitual step count by 2000 steps per day and performed resistance training 3-times per week for 12-weeks. The primary outcome was haemoglobin A1c (HbA1c), and secondary measures of anthropometric, blood biomarkers, physical fitness and patient‐reported quality of life outcomes pertinent to type-2 diabetes, were measured at timepoints i.e., baseline, 12-weeks and 24-weeks (follow-up). Intention-to-treat analyses revealed no significant alterations in the primary outcome (control: baseline=8.71%, 12-weeks=8.35% and follow-up=8.72% & home-based physical activity: base-line=8.32%, 12-weeks=8.06% and follow-up=8.39%) between trial arms. However, improvements in psychological wellbeing at follow-up measured using the Patient Health Questionnaire‐9 were significantly greater in the home-based physical activity group (baseline=6.84, 12-weeks=5.96 and follow up=5.00) compared to control (baseline=6.81, 12-weeks=5.73 and follow-up=8.53). No other statistically significant observations were observed. Home based physical activity is not effective in mediating improvements in HbA1c levels or secondary haematological, blood pressure, anthropometric or fitness indices. However, the link between psychological wellbeing and the aetiology/progression of disease activity in type-2 diabetes, home-based physical activity may be effective for tertiary disease management. Future trials should examine the efficacy of relative exercise intensities greater than those in the current study.