Impact of a 2-Year Structured Program on Physical Fitness and Physical Activity in T2D Patients with Rapid Renal Function Decline-the ACTIDIANE RCT
Abstract
Background Long-term structured physical activity (PA) programs remain insufficiently evaluated in real-life settings for individuals living with type 2 diabetes (T2D). We assessed the effects of a 2-year high-intensity physical activity (HIPA) program on physical fitness and spontaneous PA. Methods ACTIDIANE was a 21-center, open-label, randomized controlled trial comparing HIPA with standard PA recommendations (PAR) in 103 adults with T2D and rapid renal function decline. The HIPA intervention consisted of two supervised sessions per week delivered by certified adapted physical activity professionals over 24 months. Physical fitness and spontaneous PA were pre-specified secondary outcomes of the trial. Mixed models assessed group-by-time interactions over 24 months. Results Baseline characteristics were similar between groups. Estimated V ˙ O 2 peak changed from 19.3 ± 3.1 to 22.0 ± 4.0 mL.min −1 .kg −1 in the HIPA group vs. 19.9 ± 3.6 to 19.7 ± 3.7 mL.min −1 .kg −1 in PAR ( p for interaction <0.01). No group-by-time interaction was observed for sedentary time or moderate-to-vigorous PA, whether assessed by questionnaires or accelerometry. Adherence to HIPA was heterogeneous and declined over time. Conclusions In adults with T2D and rapid renal function decline, a 2-year structured HIPA program significantly improved estimated cardiorespiratory fitness, a clinically meaningful finding given the strong association between V ˙ O 2 peak and long-term cardiovascular and all-cause mortality, but did not modify spontaneous PA or sedentary behaviours. These findings highlight both the potential physiological benefit and the feasibility challenges of implementing long-term high-intensity PA in real-life clinical settings. Strategies enhancing adherence are needed to optimize clinical impact.
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BibTeX
@article{bosquet2026impact,
title = {{Impact of a 2-Year Structured Program on Physical Fitness and Physical Activity in T2D Patients with Rapid Renal Function Decline-the ACTIDIANE RCT}},
author = {Laurent Bosquet and Martine Duclos and Gaël Ennequin and Elsa Heyman and Mélanie Marias and Laurent Mourot and Philippe Sosner and Oualid Ayad and Edith Bigot Corbel and Sophie Borot and Claire Carette and Bertrand Cariou and Nicolas Chevalier and Cécile Ciangura and Severine Clerjaud and Pierre-Henri Ducluzeau and Lisa Durocher and Jean François Gautier and Pierre Gourdy and Amine Kasmi and Laurence Kessler and Arnaud Monier and Pierre Morcel and Myriam Moret and Philippe Moulin and Nicolas Paquot and Stéphanie Ragot and Vincent Rigalleau and Pierre-Jean Saulnier and André Scheen and Igor Tauveron and Anne Vambergue and Tiphaine Vidal Trecan and Samy Hadjadj},
journal = {Frontiers in Sports and Active Living},
year = {2026},
month = oct,
doi = {10.3389/fspor.2026.1892496},
url = {https://hal.science/hal-05784422v1},
note = {CC BY},
}
RIS
TY - JOUR
TI - Impact of a 2-Year Structured Program on Physical Fitness and Physical Activity in T2D Patients with Rapid Renal Function Decline-the ACTIDIANE RCT
AU - Laurent Bosquet
AU - Martine Duclos
AU - Gaël Ennequin
AU - Elsa Heyman
AU - Mélanie Marias
AU - Laurent Mourot
AU - Philippe Sosner
AU - Oualid Ayad
AU - Edith Bigot Corbel
AU - Sophie Borot
AU - Claire Carette
AU - Bertrand Cariou
AU - Nicolas Chevalier
AU - Cécile Ciangura
AU - Severine Clerjaud
AU - Pierre-Henri Ducluzeau
AU - Lisa Durocher
AU - Jean François Gautier
AU - Pierre Gourdy
AU - Amine Kasmi
AU - Laurence Kessler
AU - Arnaud Monier
AU - Pierre Morcel
AU - Myriam Moret
AU - Philippe Moulin
AU - Nicolas Paquot
AU - Stéphanie Ragot
AU - Vincent Rigalleau
AU - Pierre-Jean Saulnier
AU - André Scheen
AU - Igor Tauveron
AU - Anne Vambergue
AU - Tiphaine Vidal Trecan
AU - Samy Hadjadj
PY - 2026
DA - 2026/10/07
JO - Frontiers in Sports and Active Living
DO - 10.3389/fspor.2026.1892496
UR - https://hal.science/hal-05784422v1
AB - Background Long-term structured physical activity (PA) programs remain insufficiently evaluated in real-life settings for individuals living with type 2 diabetes (T2D). We assessed the effects of a 2-year high-intensity physical activity (HIPA) program on physical fitness and spontaneous PA. Methods ACTIDIANE was a 21-center, open-label, randomized controlled trial comparing HIPA with standard PA recommendations (PAR) in 103 adults with T2D and rapid renal function decline. The HIPA intervention consisted of two supervised sessions per week delivered by certified adapted physical activity professionals over 24 months. Physical fitness and spontaneous PA were pre-specified secondary outcomes of the trial. Mixed models assessed group-by-time interactions over 24 months. Results Baseline characteristics were similar between groups. Estimated V ˙ O 2 peak changed from 19.3 ± 3.1 to 22.0 ± 4.0 mL.min −1 .kg −1 in the HIPA group vs. 19.9 ± 3.6 to 19.7 ± 3.7 mL.min −1 .kg −1 in PAR ( p for interaction <0.01). No group-by-time interaction was observed for sedentary time or moderate-to-vigorous PA, whether assessed by questionnaires or accelerometry. Adherence to HIPA was heterogeneous and declined over time. Conclusions In adults with T2D and rapid renal function decline, a 2-year structured HIPA program significantly improved estimated cardiorespiratory fitness, a clinically meaningful finding given the strong association between V ˙ O 2 peak and long-term cardiovascular and all-cause mortality, but did not modify spontaneous PA or sedentary behaviours. These findings highlight both the potential physiological benefit and the feasibility challenges of implementing long-term high-intensity PA in real-life clinical settings. Strategies enhancing adherence are needed to optimize clinical impact.
SN - 2624-9367
ER -