Effects of lifestyle modification and active risk factor intervention on myocardial and vascular structure and reactivity in diabetes mellitus

Intervention/s: The intervention group will undergo a 3-year program targeting lifestyle factors important in the development of cardiovascular complications of diabetes, and comprising 3 components; 1) Exercise training (both aerobic and strength training) will start with 1 month of twice-weekly supervised training, in combination with a home training program. After the supervised period, the program will be adjusted and patients will continue with this at home. Ongoing telephone contact will be maintained and the program altered according to progress. 2) Dietary advice will start with weekly dietician visits for 3 months. These will include weighing, 6 minute walk, review of dietary intake and education. Ongoing dietary advice will continue by provision of telephone contact and “refresher” courses every 6 months. 3) Ongoing personalized support and counselling by the study nurse, to ensure attendance for testing and optimize compliance with guideline-based medical therapy by the patient’s general practitioner, including aggressive management of insulin resistance and glucose levels.