Patients with diabetes mellitus type 2 will come to Muhammad physical therapy clinic and rehabilitation centre, Multan. And after their consent, we will start our study on them.

Data collection procedure

Data will be collected after getting the approval from ethical committee, providing information to the patients Informed consent will be taken from the patient and the attendant.

Osteocalcin levels  will be measured using serum concentration assays (ELISA).

Insulin levels  will be assessed through fasting insulin tests

Interleukin-6 (IL-6) levels will be quantified via serum cytokine assays (ELISA).

Blood Glucose levels (Random and fasting blood glucose level)will be monitored using  fasting blood glucose tests

Hemoglobin A1c (HbA1c) for long-term glycemic control.

Body Mass Index (BMI) will be calculated using height and weight measurements.

Diabetes self-management will be assessed using the  Diabetes Self-Management Questionnaire (DSMQ) , while  

Quality of life  will be evaluated using the  Diabetes Quality of Life (DQoL)

Lipid profile ( LDH,HDL,Triglycerides)

Blood pressure

VO2 max  

Physical fitness  will be evaluated using the  6-minute walk test

Interventions

Metformin dosage

Dosage of 1000 mg/day of metformin is given to patients of all groups.

Physical therapy interventions

The treatment regime distributed in 6-week period 5 days per week exercise sessions lasted for 30 minutes in group B and C. Aerobic exercises include walking, cycling and elliptical training.

Walking 5 days per week includes 5 min slow walking,20 min brisk,5 min cools down and stretching exercises

Cycling exercise includes 5 min slow ,20-30 min moderate,5 min easy and stretching 

Elliptical training includes 5 min warm up, 5 min low intensity exercise,10 min moderate intensity exercise, cool down and stretching