Background: Diabetes mellitus is a systemic disease affecting both the quality and duration of life. There is rapid escalation in prevalence of diabetes all over the globe due to population growth, urbanization, sedentary life style etc. As per the published data in recent years, the new epidemic of type 2 diabetes stands as one of the major causes of morbidity and mortality affecting the youth and that's why has became a clinical and health economic priority in developing countries. Before the patients are diagnosed as Diabetic they undergo pre-diabetic state in which there is evidence of glucose intolerance with bouts of hyper and hypo glycemia which can causes impairment in neuro physiological indices. Exercise is considered as cornerstone for management of diabetes and its benefits in preventing and treating diabetes are extensively accepted in elderly population. Not much data is availiable on the newly diagnosed T2DM patients. Therefore, this study was designed to evaluate the effect of exercise therapy on neuro physiological functions in T2DM patients of age group 20-45 years. 

Aim
1. To study the effects of six months structured exercise therapy neurophysiological parameters in young adults with newly diagnosed T2DM on dietary control and anti-diabetic drug of age group 20-45 years.
2. To study short term effects of the intervention (structured exercise therapy) on  neurophysiological parameters among interventional group at the end of 2nd month, 4th month and 6th month.


Method
The present study was conducted in the Research Laboratory, Department of Physiology, Jawaharlal Nehru Medical College, KLE University, Belagavi. All potentially eligible participants were informed about the study and screened for eligibility.Institutional Ethics Committee Approval and  individual Informed consent was obtained. The total of 148 patients were enrolled as per inclusion criteria and then randomly divided into Diabetic group (74) and Interventional Group (74) by computer generated, randomized number sequence. Sex, age and mean education level matched healthy individuals were taken into study as normal controls (74). Data management system was developed with help of Project engineer from the Research unit of J.N Medical College. Data was entered regularly along with the enrollment of the patients to ensure the integrity of the research project. The Primary Outcome measures were Nerve conduction Study and Audio Visual reaction time and Secondary Outcome measure were Socio Demographic Profile, HbA1c, BMI, Waist Hip Ratio, Body Fat%, Basal & Maximal Heart Rate, VO2 max. and Physical Fitness Index. The intervention therapy was six months of individually designed program of regular exercise consisting of aerobic and resistance exercises. First two weeks of the regimen consisted of supervised exercise training in Research Laboratory, Department of Physiology, J.N. Medical College, Belgaum. Later on the participants were advised to continue the exercise at their home regularly. Difference between two groups for categorical data was evaluated by Chi-square test. 

Differences between two groups for continuous data was evaluated by unpaired ‘t” test. Trends of improvement were evaluated by repeated measures of ANOVA. Analysis was carried out by IBM, SPSS. Statistics 22.0. South Asia Pvt. Ltd.

Results
Nerve conduction velocity and visual reaction time for red, yellow, white and green colour stimuli was improved significantly in interventional group as compared to the diabetic controls at the end of 6 months. PFI and VO2 max, has shown statistically significant improvement at the end of six months of interventional therapy in patients with T2DM. On comparison with diabetic controls at the end of six months of interventional therapy, BMI, waist circumference and WHR have significantly improved in interventional group (p<0.001) but there was no significant change in body fat %. p value less than 0.05 was considered significant. 

Discussion
Diabetic control in younger adults is a formidable challenge to the healthcare system. Exercise therapy along with dietary control and anti-diabetic medication has a positive influence on various parameters mentioned above. The low cost, non-pharmacological nature of exercise enhances its therapeutic appeal. 
I have no potential conflict of interest to disclose

Effects of structured exercise therapy on neuro-physiological parameters in newly diagnosed adults with T2DM - An RCT