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Randomised controlled trial
A 12-month intensive supervised exercise intervention and counselling reduces HbA1c, blood pressure and other modifiable cardiovascular risk factors in people with type 2 diabetes
  1. Gail D'Eramo Melkus
  1. New York University College of Nursing, New York, USA
  1. Correspondence to Gail D'Eramo Melkus
    726 Broadway, 10th Floor, New York, NY 10003, USA; gail.melkus{at}

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Implications for nursing practice and research

  • Physical activity (PA), exercise performance and counselling require demonstration, supervision and support similar to other self-management behaviour for day-to-day chronic illness management.

  • Structured individual PA counselling should acknowledge the benefit and importance of occupational, home, leisure time and commuting PA.

  • Healthcare providers and settings should consider partnering with fitness centres/exercise facilities for structured, supervised exercise interventions for chronic illness prevention and management.

  • Further research is needed to develop and utilise more objective measures of PA than self-report accounts. Programmable pedometers or accelerometers for non-supervised PA, in combination with supervised PA training, may be options for further research to more accurately account for total PA.

  • Electronic PA metres should be studied for non-supervised PA in combination with structured individual exercise counselling to determine feasibility and efficacy.


Diabetes and its related complications continue to be a global health concern. More than 285 million individuals worldwide have diabetes; a number that is growing due to …

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  • Competing interests None.