***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Introduction Regular physical activity is an important aspect of self-management among older people with type 2 diabetes but many remain inactive . Interventions to improve physical activity levels have been studied but few studies have evaluated the effects of personalized feedback ( PF ) or peer support ( PS ) ; and there was no study on older people of Asian heritage . Hence , this trial evaluated whether PF only or combined with PS improves physical activity among older Malays with type 2 diabetes ( T2DM ) compared to usual care only . Material s and methods A three-arm r and omized controlled trial was conducted in a primary healthcare clinic in Malaysia . Sixty-nine sedentary Malays aged 60 years and older with T2DM who received usual diabetes care were r and omized to PF or PS interventions or as controls for 12 weeks with follow-ups at weeks 24 and 36 . Intervention groups performed unsupervised walking activity and received written feedback on physical activity . The PS group also received group and telephone contacts from trained peer mentors . The primary outcome was pedometer steps . Secondary outcomes were self-reported physical activity , cardiovascular risk factors , cardiorespiratory fitness , balance , quality of life , and psychosocial wellbeing . Results Fifty-two ( 75.4 % ) completed the 36-week study . The PS group showed greater daily pedometer readings than the PF and controls ( p = 0.001 ) . The PS group also had greater improvement in weekly duration ( p < 0.001 ) and frequency ( p < 0.001 ) of moderate intensity physical activity , scores on the Physical Activity Scale for Elderly ( p = 0.003 ) , 6-min walk test ( p < 0.001 ) , and social support from friends ( p = 0.032 ) than PF and control groups . Conclusion The findings suggest that PF combined with PS  in older Malays with T2DM improved their physical activity levels , cardiorespiratory fitness , and support from friends . Trial registration Current Controlled Trials IS RCT N71447000 Aims : The aim of this study was to evaluate the effect of combined resistance and home-based walking exercise on glycemic and metabolic control , depression and quality of life in type-2 diabetes patients . Methods : This prospect i ve study was conducted at a private hospital in Turkey . Thirty-six type-2 diabetic patients participated in the study . Subjects were r and omly distributed in one 8 week exercise intervention or in one control group . Exercise program consisted of resistance training and home-based walking . Before and after the training program , muscular strength , fasting blood glucose , hemoglobin A1C , ( HbA1C ) and plasma lipid values , quality of life and symptoms of depression of the patients were assessed . Results : Exercise group 's baseline HbA1C was significantly higher than the control groups ( p < 0.05 ) ; other blood parameters were similar between the two groups ( p>0.05 ) . At the baseline no significant differences were observed in the depression and four subscales ( physical function , physical role , bodily pain , and general health perceptions ) of the SF-36 between the exercise and control groups ( p>0.05 ) . The exercise group had higher scores of emotional role , vitality and mental health subscales than the control groups after the training programs ( p<0.05 ) . Conclusion : Exercise training which included resistance training and home- based walking could be safe , effective and beneficial in diabetic patients OBJECTIVE Diabetes negatively impacts the health-related quality of life ( HRQOL ) of patients with type 2 diabetes . An earlier analysis showed HRQOL to be associated with mortality , which suggests that measuring HRQOL could have clinical implication s. We studied the association between  HRQOL  and total and cardiovascular mortality in patients with type 2 diabetes during long-term follow-up and specifically focused on old age and sex differences . RESEARCH DESIGN AND METHODS HRQOL was measured in a prospect ively followed cohort of 1,353 patients with type 2 diabetes using the R AND -36 . Cox proportional hazard models were used to measure the independent effect of baseline HRQOL on mortality . RESULTS During a mean follow-up of 9.6 years , 570 ( 42 % ) patients  died , 280 of whom died of cardiovascular disease ( 49 % ) . The Physical Component Score ( PCS ) and the Mental Component Score ( MCS ) were inversely associated with total mortality , with hazard ratios of 0.988 ( 95 % CI 0.983–0.993 ) and 0.990 ( 95 % CI 0.985–0.995 ) , respectively . A 10-point-higher score on the PCS and MCS decreased the risk for total mortality by 11 and 10 % , respectively . An inverse relationship with mortality was also seen for men , women , and for patients aged > 75 years . Mental health was significantly related to mortality in men but not in women . CONCLUSIONS Lower physical and mental HRQOL was associated with a higher total mortality and cardiovascular mortality in patients with type 2 diabetes ; this is also the case when study ing men and women and the elderly separately . The dimension mental health , related to depression and anxiety , was only associated with mortality in men , not in women Objective To evaluate the effect of 8-week moderate intensity aerobic ( heart-rate reserve 40–60 % ) exercise on neuropathy quality of life in type 2 diabetes . Methods A single blind , parallel-group , r and omized controlled trial was carried out in a tertiary setting . People with type 2 diabetes were eligible for the study if they had clinical neuropathy which was defined by a minimum score of seven on the Michigan diabetic neuropathy score . Following which , the patients were r and omly assigned to an 8-week program by a computer-generated r and om number tables to intervention or control group . Repeated measure analysis of variance was used for data analysis ( p < 0.05 was considered significant ) . Results There were 47 participants in the control group and 40 participants in the study group after r and omization but 37 from the control group and 29 from the intervention group completed the final analysis . The two groups had a significant difference , pre – post intervention in scores of pain ( F = 7 , p = 0.01 ) , sensory symptoms ( F = 4.60 , p = 0.04 ) , restricted activities of daily living ( F = 4.97 , p = 0.03 ) , disruptions in social relationships ( F = 5.43 , p = 0.02 ) , specific impact on quality of life ( F = 9.28 , p < 0.001 ) overall quality of life ( F = 28.72 , p < 0.001 ) , and total score ( F = 31.10 , p < 0.001 ) . Degrees of freedom for all the components were 1 , 62 . Conclusion Moderate intensity aerobic exercise is cornerstone in improving the quality of life of individuals with peripheral neuropathy in type 2 diabetes Objective : Both Nordic walking and Exercise on Prescription have potential as elements in the management of type 2 diabetes mellitus .  These programs are recommended , but their effectiveness has not yet been established . The aim was to evaluate the efficacy of these 2 interventions compared with st and ard information on physical activity . Design : Single-blinded , r and omized , controlled intervention study . Setting : Sixty-eight patients ( 37 men and 31 women ) were r and omized into 3 groups :  Nordic walking ( NW ; n = 22 ) , Exercise on Prescription ( EP ; n = 24 ) , and control ( CG ; n = 22 ) . Patients : Patients were recruited from a diabetes outpatient clinic and via newspaper advertisement . Interventions : Consisted of a 4-month intervention period followed by an 8-month follow-up , during which the participants were recommended to train on their own . Main Outcome Measures : HbA1c . Results : There was no difference in HbA1c when comparing the intervention groups relative to the control group : ΔNW = −0.4 % [ 95 % confidence intervals ( CI ) , −0.9 % to 0.1 % ] and ΔEP = −0.2 % ( 95 % CI , −0.6 % to 0.2 % ) after 4 months ; ΔNW = 0.0 % ( 95 % CI , −0.6 % to 0.5 % ) and ΔEP = 0.3 % ( 95 % CI , −0.3 % to 0.9 % ) after 12 months . However , fat mass assessed by dual energy X-ray absorptiometry ( DXA ) decreased significantly in the NW group after 4 months [ −1.0 kg ( 95 % CI , −1.7 to 0.1 ) ] and after 12 months in both NW [ −1.8 kg ( 95 % CI , −3.2 to −0.4 ) ] and EP [ −1.5 kg ( 95 % CI , −2.9 to −0.05 ) ] groups . No significant changes in other variables . Conclusions : Four-month exercise programs at moderate intensity of either Nordic walking or Exercise on Prescription did not significantly improve HbA1c  in patients with type 2 diabetes either at the end of the program or at the follow-up PURPOSE The purpose of this study was to determine the effect of 10 weeks of moderate aerobic exercise training on quality of life ( QOL ) and selected physiological parameters in previously sedentary persons with diabetes . METHODS A quality -of-life survey ( SF36v2 health survey ) and measurement of physiological parameters were completed before and after 10 weeks of supervised aerobic exercise training 3 days a week for 20 to 45 minutes by subjects with diabetes ( n=9 ) and control subjects ( n=1 0 ) . Nontraining subjects with diabetes ( n=12 ) and control subjects ( n=1 0 ) also completed the QOL survey at equivalent times . RESULTS Participants in all groups had similar characteristics . A training effect was evident in exercisers , with an increase in lactate threshold and a decrease in percent body fat for both groups . Training did not affect body mass index or interstitial nitric oxide levels . Physical and mental component scores on the QOL survey in the training and nontraining groups did not differ significantly before or after the training , and diabetes status had no significant effect on these scores . CONCLUSIONS No physiological changes were significantly associated with scores on the SF36v2 health survey . In addition , neither training nor the presence of type 2 diabetes significantly affected the physical or mental component scores on the QOL survey The objective of this study was to determine the impact of an aerobic physical exercise program in the treatment of a group of elderly patients with type 2 diabetes mellitus ( DM ) in relation to metabolic control , physical capacity , quality of life ( QOL ) and attitudes toward diabetes . Patients were r and omly assigned to either an experimental ( n=19 ) or a control ( n=20 ) group . The following measurements were conducted at baseline and after week 16 : glycosylated hemoglobin ( hbA1c ) , fructosamine , 3 h oral glucose tolerance test , treadmill test ( Balke-Naughton ) , and a question naire on QOL and attitudes toward DM . After the intervention , the experimental group showed a significant decrease of glucose excursion during the oral glucose tolerance test ( OGTT ) ( area under the curve ) ( 16.6+/-3.8 vs. 15.3+/-3.1 , P<0.05 ) and an increase in total time on the treadmill ( s ) ( 423+/-207 vs. 471+/-230 , P<0.05 ) . An improvement in the attitudes toward DM was observed in the experimental group ( P=0.01 ) but not in the control group . Female gender , higher body mass index and hbA1c were factors associated with a response to the intervention . This study suggests that physical exercise has significant effects on glucose excursion during an OGTT and exercise tolerance in elderly patients with type 2 DM Purpose The aim was to assess the effects of a Tai Chi – based program on health-related quality of life ( HR-QOL ) in people with elevated blood glucose or diabetes who were not on medication for glucose control . Method 41 participants were r and omly allocated to either a Tai Chi intervention group ( N = 20 ) or a usual medical-care control group ( N = 21 ) . The Tai Chi group involved 3 × 1.5 h supervised and group-based training sessions per week for 12 weeks . Indicators of HR-QOL were assessed by self-report survey immediately prior to and after the intervention . Results There were significant improvements in favor of the Tai Chi group for the SF36 subscales of physical functioning ( mean difference = 5.46 , 95 % CI = 1.35–9.57 , P < 0.05 ) , role physical ( mean difference = 18.60 , 95 % CI = 2.16–35.05 , P < 0.05 ) , bodily pain ( mean difference = 9.88 , 95 % CI = 2.06–17.69 , P < 0.05 ) and vitality ( mean difference = 9.96 , 95 % CI = 0.77–19.15 , P < 0.05 ) . Conclusions The findings show that this Tai Chi program improved indicators of HR-QOL including physical functioning , role physical , bodily pain and vitality in people with elevated blood glucose or diabetes who were not on diabetes medication Background The aim of this study was to evaluate the effects of an 8-week aerobic exercise program on physiological parameters and quality of life in patients with type 2 diabetes mellitus . Methods Patients att 
    Output:
    
Aerobic exercise showed a significant effect between groups .
Resistance and combined exercise showed mixed results .
Yoga also showed good intervention effects on quality of life .
Conclusions The effect of aerobic exercise on the quality of life in people with type 2 diabetes was safe and effective .