Background/Purpose: The American Diabetes Association projects the incidence of type 2 diabetes (T2DM) among pediatric patients will increase to 49% by 2050. Physical activity and exercise modifications are primary recommendations in controlling diabetes. The purpose of this study is to describe the effects of a physical therapist (PT) prescribed personalized fitness plan to improve cardiovascular fitness in adolescents with T2DM.

Methods: Data was collected from patients treated at a multidisciplinary T2DM clinic at Children’s Hospital Los Angeles (CHLA). Physical therapy assessments were done when the patient visited the PT in clinic and included post-exercise heart rate, resting heart rate, rating of perceived exertion, and VO2 max. Multiple regression analysis was used to assess associations between change in fitness and covariates: age, sex, time since diagnosis, and time between first and last PT assessment.

Results: Fifty two patients who had at least 2 PT assessments at the T2DM clinic from April 2016 to October 2018 were included in the study. Patients with higher initial post-exercise heart rate experienced the greatest benefit from an individualized exercise program. Patients with lower initial VO2 max scores also experienced the greatest increase in VO2 max over time. There was no significant association with resting heart rate and rating of perceived exertion in regards to age, sex, time since diabetes diagnosis, and time between first and last PT assessment.

Conclusion: Prescribing a personalized fitness plan can improve fitness measures in patients with the lowest baseline fitness levels.

Implications: Maintaining a healthy and active lifestyle can be difficult for youth with T2DM especially if they lived a sedentary lifestyle prior to diagnosis. Health care providers and educators must consider the age and interests of the patient and family when creating a personalized fitness program.


L.B. Europa: None. L.N. Buennagel: None.


Good Hope Medical Foundation

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at