Rinco Siregar, Karnirius Harefa, Eva Kartika Hasibuan


The purpose of this quasi- experimental study was to determine the effect of exercise consultation program based on Transtheoretical Model (TTM) approach on exercise behavioral change, blood glucose and body mass index (BMI)  in patients of T2DM with overweight. The two comparison groups, quasi-experimental study were purposively designed for pre-test/post-test procedures; 61 patients of T2DM allocated into the experimental (31 patients) and the control (30 patients) groups. While the experimental group received the exercise consultation for 12 weeks, the control group received routine care. Comparative assessments on differences in exercise behavioral changes, blood glucose and BMI were examined both within and between groups using Chi-Square test and t-test. After receiving exercise consultation program, 54.8 % of participants of the experimental group had progressed to the action stage of change of TTM, while the majority of the participants in the control group (43.3%) remained in the same stages of TTM, and only 3.3 % of the participants had progressed to the maintenance stage. This proportion of exercise behavior change between the groups was significantly statistical different (Chi-Square = 000, p <0.05). Blood glucose significantly decreased in the experimental group (p < .05), but there was no significant difference in the control group.No significant difference of mean scores of BMI of participants between the experimental group and the control group post-intervention of exercise consultation program (p > .05). In conclusion, the exercise consultation program could promote the exercise behaviors. This also improves health outcome on blood glucose among patients of T2DM who.Keywords: transtheoretical model; physical exercise; type 2 diabetes

Full Text:



Allen, N. A., J. A. Fain, B. Braun and S. R. Chipkin. 2008. Continuous glucose monitoring counseling improves physical activity behaviors of individuals with type 2 diabetes: a randomized clinical trial. Diabetes Research and Clinical Practice 80 (3): 371-379.

American Diabetes Association. 2011. Standards of medical care in diabetes. Diabetes Care 34 (suppl.1): S11-S61.

American Diabetes Association. 2004. Physical activity/exercise and diabetes. Diabetes Care 27 (Suppl. 1): S58-S62.

Annan, F. 2011. The connection between better health and exercise in diabetes. Practice Nursing22(1): 17-20.

Basic Health Research (BHR)/Riset Kesehatan Dasar (Riskesdas). 2013. Laporan Nasional 2007: Badan penelitian dan perkembangan Departemen Kesehatan Republik Indonesia. Available Source: Nasional Riskesdas 2007.pdf. July 6, 2012.

Cohen, J. 1988. Statistic power analysis for the behavioral science. 2nd ed. Lawrence Erlbaum Associates.

Colberg, S.R., R.J. Sigal, B.Fernhal, J.G. Regesteiner, B.J.Blismer, R.R. Rubin., L.C.Tabler, A.L.Albright and B. Braund. 2010. Exercise and type 2 diabetes. The American College of Sports Medicine and the American Diabetes Association : joint position statement. Diabetes Care 33(12):147-167

Corbin ,C.B., W.R.Corbin, G.J.Welk and K.A.Welk. 2008. Concepts of physical fitness: Active lifestyle for wellness.14th ed. McGraw Hill Companies.

DeMoura, B. P., J. Natali, J. C. B. Marins and P. R. S. Amorim. 2011. Different approaches of physical training used in the management of type 2 diabetes : A brief systematic review of randomized clinical trials. British Journal of Diabetes Vascular Dissease 11:210-216.

Ferguson, S. 1997. Exercise adherence in person with type 2 diabetes and relationship to diabetes control. Available June 27, 2012.

Fischer, D.V. and J.Bryiant. 2008. Effect of certified personal trainer services on stage of exercise behavior and exercise mediators in female collage students. Journal of American College Health 56 (4):369-376.

Hasler,T.D., B. M.Fisher, P.D. MacIntyre and N.Mutrie. 2000. Exercise consultation and physical activity in patients with type 1 Diabetes. Practical Diabetes International 17(2):44-48.

Indriyani, P., H. Supriyantno and A. Santoso. 2007. Pengaruh latihan fisik: senam aerobic terhadap penurunan kadar gula darah pada penderita DM tipe 2.Media Ners.1(2): 49-99.

International Diabetes Federation (IDF). 2013. IDF diabetes atlas: The global burden. 5th ed. International Diabetes Federation, Belgium.

International Diabetes Federation (IDF). 2013. IDF diabetes atlas: Western Pacific (WP). 5th ed. International Diabetes Federation, Belgium.

Januszewska, A.G., Z. Szybinski, K. S. Skarbek, B. P. Solska., D. Pach, R.T.Mardy, J. Tuomilehto, J. Linstrom, M. Peltonen, P. E. Schwarz and A. H. Dydejczyk. 2011. Prevention of type 2 diabetes by lifestyle in primary health care setting in Poland: diabetes in Europe prevention using lifestyle activity and nutritional intervention (DE-PLAN) project. British Journal of Diabetes Vascular Disease 11(4): 198-203

Jackson, R., K. Asimakopoulou and A. Scammell. 2007. Assessment of the transtheoretical model as used by dietitians in promoting physical activity in people with type 2 diabetes.Journal of Human Nutrition and Dietetics20 (1): 27-36.

Jeanne, G., K. Marcus, H. Eduard and H. Daniel. 2004. Applying the transtheoretical model to exercise adherence in clinical setting. American Journal of Health Studies 19(1): p1.

Khairunnas. 2012. Kontrol kadar gula darah dengan olahraga pada pasien DM tipe 2. Thesis. University of Sari Mutiara Indonesia.

Kirk, A., F. MacMillian and N. Webster. 2010. Application of transtheoretical model to physical activity in older adult with type 2 diabetes and/or cardiovascular disease. Journal Psychology of Sport and Exercise 11(4):320-324.

Krik, A. F. and G. Leese. 2009. Encouraging physical activity interventions among people with type 2 diabetes. J. Diabetes Nurs. 13(1):26-31.

Krik, A. F., J. Barnett and N. Mutrie. 2007. Review article: Physical activity consultation for people with type 2 diabetes evidence and guideline. Diabetes Medical 24:809-816.

Krik, A., N. Mutrie, P. MacIntyre and M. Fisher. 2003. Increasing physical activity in people with type 2 diabetes. Diabetes Care 26 (4):1186-1192

Kirk A.F, L.a.Higgins, A.R. Hughes, B.M.Fisher, N.Mutrie, S.Hillis, and P.D. MacIntyre. 2001. A randomized, controlled trial to study the effect of exercise consultation on the promotion of physical activity in people with type 2 diabetes: a pilot study. Diabetes Medical 18:887-882

Loughlan, C and N. Mutrie. 1995. Conducting an exercise consultation: guidelines for health professionals. J. Ins. Health Edu. 33:78-82.

Marcus, B. H., V. C. Selby, R.S.Niaura and J.S.Rossi. 1992. Self-efficacy and the stage of exercise behavior change. Reseach Quarterly for Exercise and Sport 63:60-66.

Marcus, R. L., S. Smith, G. Morrell, O. Adison, L .E. Dibble, D.W. Stice and P. LaStayo. 2008. Comparison of combined aerobic and high-force exercise resistance exercise with aerobic exercise only for people with type 2 diabetes. Physical therapy 88 (11):1345-54(54 ref).

Mawarti, S. and F.Sriwahyuniati. 2012. Pengaruh latihan kontinyu Senam Diabetes Indonesia dalam menurunkan kadar gula darah pada penderita diabetes mellitus.Thesis. University of Yogyakarta, Indonesia.

Nigg, C. R., G. J. Norman, J. S. Rossi and S.V. Benisovich. 1999. Processes of exercise behavior change: redeveloping the scale. Ann. Behav. Med. 21: S79

Orti, E. S. and M. Donagry. 2004. A cognitive- behavioral intervention to increase adherence of adult women exercise. Advance in Physiotherapy 6: 84-92.

Pan, F. C and C. H. Chen. 2010. Application of the transtheoretical model of exercise behavior change plan in high school students. International Journal of Human and Social Science 5 (10): 682-685.

Plotnikoff , R. C., L.Trinh, K. S. Courneya, M. N. Karunamuni and R. J. Sigal. 2011. Predictors of physical activity in adults with type 2 diabetes. Am. J. Health Behav.35(3):359-370.

Plotnikoff, R.C., M.A. Pickering, N.Glenn, S.L.Doze, M.L.Matthews, L.J. McLeod, D.C.Lau, G.H.Fick, S.T.Johnson and L.Flaman. 2011. The effects of a supplemental, theory-based physical activity counseling intervention for adults with type 2 diabetes. J. Phys. Act. Health. 8(7):944-54.

Polit, D.F.,Beck,C.T,Hungler, B.P.2001. Essentials of nursing research : methods, appraisal and utilisation(5th edn). Philadelphia: Lippincott.

Pramono, L.A., S. Setiati, P. Soewondo, I.Subekti, A. Adisasmita, N.Kodim and B.Sutrisna. 2010. Prevalence and predictors of undiagnosed diabetes mellitus in Indonesia. Acta. Med. Indones. 42(4): 216-223.

Perkumpulan Endokrinologi Indonesia (Perkeni). 2011. Konsensuspengendaliandanpencegahan diabetes mellitus tipe 2 di Indonesia. Available source: Sepember 19, 2012.

Prochaska, J. O., C.A. Redding and K.E. Evers. 2008. The transtheoretical model and stage of change. Cited in Glanz, K., B.K.Rimer and K.Viswanath. eds., Health behavior and health education: theory, research and practice. 4th ed. Pp.97-121. Jossey-Bass, San Francisco.

Prochaska, J.O. and W.F.Velicer. 1997. The transtheoretical model of health behavior change. American Journal of Health Promotion 12:38-48.

Prochaska, J.O., C. C. DiClemente and J.C.Norcross. 1992. In search of how people change: Applications to addictive behaviors. American Psychologist 47(9):1102-1114.

Sinaga, M., Hiswani and Jemadi. 2011. Karakteristik penderita diabetes mellitus dengan komplikasi yang dirawat inap di rumah sakit Vita Insani. Thesis. University of North Sumatera, Indonesia.

Santoso, M. 2010. Senam Diabetes Indonesia seri 5. Persatuan Diabetes Indonesia (PERSADIA) (Indonesian Diabetes Association), Yayasan Diabetes Indonesia (YADINA). Jakarta.

Shi, Q., S.K.Ostwald and S.Wang. 2009. Improving glycemic control self efficacy and glycaemic control behavior in Chinese patients with type 2 diabetes mellitus: Randomized controlled trial. J.Clin Nurs.19: 398–404.

Sigal, R.J., G.P.Kenny, D.H.Wasserman, C.C.Sceppa and R.D. White. 2006. Physical activity/ exercise and type 2 diabetes: a consensus statement from the American Diabetes Association. Diabetes Care 29 (6):1433-8

Sincree,R., J.Shaw, P.Zimmet. 2010. The global burden: Diabetes and impaired glucose tolerance. Available source: September 11, 2012

Sluijs, E.M.F.V., M.N.M.V.Poppel, J.W.A.R.Twisk, M.J.C.A, K.J.Kalfs and W.V. Mechelen. 2005. Effect of a tailored physical activity intervention delivered in general practice settings: Results of a Randomized Controlled Trial. Am J Public Health. 95(10):1825-1831.

Toledo, F.G.S., E.V.Menshikova, V.B.Ritov, K.Azuma, Z.Radikova, J.Delany and D.E.Kelley. 2007. Effect of physical activity and weight less on skeletal muscle mitochondria and relationship with glucose control in type 2 diabetes.Diabetes Care56 (8): 2142-2147.

Unairawati,W. and L. Soetjiatie. 2011. Efek senam diabetes terhadap penurunan kadar gula darah pasien diabetes mellitus tipe 2 di RW.II. Krembangan Bhakti, Surabaya, Indonesia.Jurnal Keperawatan 4 (2):75-79.

Utomo, O.M., M. Azam and D.N.A.Ningrum. 2012. Pengaruh senam terhadap kadar gula darah penderita diabetes. Unnes Journal of Public Health 1(1).37-40.

World Health Organization.2011. Non-ommunicable Disease and Mental Health: United Nations high-level meeting on non-communicable disease prevention and control. Available source: June 12, 2012.



  • There are currently no refbacks.

This journal is indexed by:


 Creative Commons License

This journal (p-ISSN:2527-8800; e-ISSN:2527-8819) is licensed under a Creative Commons Attribution 4.0 International License.