Author(s): DORO, A., SILVA, C., FARIAS, G., SANTOS, A., ANDRADE, E., DORO, M., LEME, G., BOCALINI, D., FIGUEIRA JUNIOR, A., Institution: UNIVERSIDADE SÃO JUDAS TADEU (USJT), Country: BRAZIL, Abstract-ID: 269

INTRODUCTION:
Type 2 diabetes (T2D) management has evolved from an exclusive focus on glycemic control as a strategy that integrates cardiorenal protection, obesity control, and reduction of T2D chronic complications. In this context, multidisciplinary approaches may facilitate sustained behavioral changes and improved clinical outcomes. The purpose of this study was to investigate the association between physical activity levels, stages of behavioral change, and clinical parameters (HbA1c and LDL-cholesterol) in the elderly with T2D followed within a multiprofessional program
METHODS:
This study included 65 patients with T2D (mean age 66.0 ± 10.7 years; 58.5% men; 60% non–insulin-dependent). At baseline, 78.5% had low physical activity (mean 304.01 ± 437.04 MET-min/week). Participants were followed for 12 months in a Diabetes Care Program comprising Endocrinology, Nursing, Psychology, Nutrition, Physical Education, and Social Work, delivered online or in person. During Physical Education visits, the IPAQ-short was administered, and participants received guidance on increasing or maintaining physical activity. Statistical analyses used Wilcoxon, McNemar, Chi-square, Cramer’s V, and Spearman tests (SPSS) with p < 0.05 significance.
RESULTS:
After 12 months, physical activity increased significantly in both sexes, both categorically and continuously. In men, median MET-min/week increased from 0.0 to 783.30 (p < 0.001), and in women, from 0.0 to 547.50 (p = 0.005). A strong association was found between stages of behavior change and physical activity levels (p < 0.001), which was maintained at follow-up, with Cramer’s V pre vs. post of 0.88 vs. 0.89 (men) and 1.00 vs. 0.81 (women). In continuous analyses, Spearman’s rho (rs) pre vs. post was 0.93 vs. 0.84 (men) and 0.98 vs. 0.83 (women) (p < 0.001). Clinically, HbA1c decreased in men from 7.7 to 7.0% (p < 0.001) and women from 7.5 to 6.9% (p = 0.024). A decrease in LDL-cholesterol was observed only in men (72 to 69 mg/dL, p = 0.008). Only men showed a positive baseline correlation between physical activity and HbA1c (p = 0.022). Post-intervention, no significant correlations were found between stages of behavior change/physical activity and HbA1c/LDL-cholesterol in either sex.
CONCLUSION:
Physical activity showed a very strong association with stages of behavior change in people with T2D. Multidisciplinary follow-up was effective in reducing HbA1c in both men and women. LDL-cholesterol reduction occurred only in men and did not correlate with behavioral engagement or physical activity levels at the end of the program.