Effects of a problem-solving counseling program to facilitate intensified walking on Koreans with type 2 diabetes.

ABSTRACT

AIM: This study aimed to evaluate the immediate and long-term effects of a 12 week problem-solving (PS) counseling program to facilitate intensified walking with machinery monitoring on persons with type 2 diabetes mellitus in Korea. METHODS: The study used a quasi-experimental design. The participants were 57 patients with diabetes from three endocrinology or internal medicine clinics in an urban city of South Korea. Moderate-intensity walking and PS counseling were recommended to both groups. The difference between the two groups was whether the intensity of the exercise was monitored by an ambulatory heart rate monitor (experimental group) or was self-regulated (comparison group). Those programs were evaluated in relation to BMI, glycemic control (blood glucose level, glycosylated hemoglobin [HbA1c]), a vascular complication index (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, tissue plasminogen activator [t-PA], plasminogen activator inhibitor-1 [PAI-1], Parma Cardiovascular Risk Index), and coping strategies at 3 and 6 months. RESULTS: The experimental group members showed dramatic decreases in their glucose and HbA1c levels at 3 months. The values of t-PA decreased significantly at baseline, compared to at 3 months. The levels of PAI-1 continuously declined and the Parma Cardiovascular Risk Index score did not change significantly from baseline to at 3 months, but showed significant effects at 6 months. CONCLUSION: A combined program of intensified walking, using a heart rate monitor, with PS counseling is more helpful to prevent complications than self-regulated exercise for persons with type 2 diabetes in Korea.