ArticleFrontiers in public health2026
A shared decision-making approach to individualized exercise management enhances glycemic control, self-care behaviors, and quality of life in type 2 diabetes: a retrospective cohort study.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To evaluate the association between an individualized exercise management program based on shared decision-making (SDM) and short-term glycemic control, self-care behaviors, and quality of life in patients with type 2 diabetes mellitus (T2DM). Methods: This retrospective cohort study used data from electronic medical records and a diabetes management platform (January 2019 - December 2023). After propensity score matching (1:1 nearest-neighbor, caliper = 0.02 SD), 178 patients were included (89 in SDM-based intervention group, 89 in routine care control group). The intervention group received an SDM-driven personalized exercise program plus routine care, while controls received routine care alone. Outcomes included HbA1c, fasting plasma glucose (FPG), 2 h postprandial glucose (2hPG), time in range (TIR), mean amplitude of glycemic excursions (MAGE), 6-meter walking speed, medication adherence, Summary of Diabetes Self-Care Activities (SDSCA) score, and Diabetes-Specific Quality of Life (DSQL) score. Assessments were performed at baseline, 1 month, and 2 months. Results: At 1 and 2 months, the intervention group showed significantly greater reductions in HbA1c, FPG, 2hPG, and MAGE, and a significantly greater increase in TIR compared to controls (all Conclusion: An individualized exercise management program based on the SDM model was associated with improved short-term glycemic control, treatment adherence, self-management behaviors, and quality of life in T2DM patients. Future prospective randomized studies with longer follow-up are needed to establish causality and determine the sustainability of these improvements.
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