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 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 HbA_1c 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 a average decrease in HbA_1c 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 HbA_1c.

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.

目的缺乏有效的促进行为改变的策略阻碍了坚持体育锻炼（PA）的建议。意大利糖尿病与运动研究_2是一项随机对照试验，评估一种新的行为干预策略，以增加2型糖尿病患者的PA并减少其久坐时间（SED-time）。

研究设计和方法该研究将300例身体不活动和久坐的2型糖尿病患者按1：1比例随机分配，接受为期3年（干预组[INT]）或标准护理（对照组[CON]）的理论和实践咨询。在这里，我们报告了客观（加速度计）测量的每日光强度PA（LPA），中度至剧烈强度PA（MVPA）和SED时间以及心血管危险因素对4个月的影响。

结果两组的LPA和MVPA均增加，SED时间减少，尽管INT参与者的变化更为明显（LPA和SED时间大约是两倍，MVPA大约是六倍）。仅在INT受试者中观察到HbA _1c的显着降低。LPA> 0.92 h·天^-1的增加和MVPA> 7.33 min·天^-1的SED时间减少> 1.05 h·天^-1的减少与HbA _1c的平均减少约1％有关，并且与空腹血糖，体重，腰围和hs-CRP的显着改善有关。PA和SED时间的变化是HbA _1c改善的独立预测因子。

结论这种行为干预在短期内有效增加LPA和MVPA并减少SED时间。即使PA / SED时间低于建议水平，受试者的PA和SED时间变化也最为明显，心脏代谢风险显着改善。