Background
Type 2 diabetes mellitus (T2DM) can be successfully treated by lifestyle change. However, comprehensive lifestyle interventions need local settings and are cost intensive. Instead of early and increasing anti-diabetic medication, motivational, low-threshold interventions are needed. Interactive exercise games (exergames) are a new and alternative tool to promote physical activity. They can be interfaced with a television set and offer different games (e.g. table tennis, bowling) in order to substitute sedentary leisure time with active time. There are some reports addressing health benefits of exercise gaming, however, data are lacking for clinical endpoints of diseases (i.e. HbA1c) or possible effects for quality of life. Elderly T2DM patients are particularly interesting candidates for exercise games because of their usually sedentary lifestyle. Therefore, in a randomized-controlled trial we investigated the hypothesis that autonomous use of the interactive exercise game Wii Fit Plus over a period of 12 weeks is able to improve HbA1c (primary outcome) as well as weight, cardiometabolic risk factors, physical activity and quality of life (secondary outcomes) in T2DM patients.