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This study showed that a significant proportion of diabetic patients had a sedentary lifestyle. Interestingly, diabetic patients were more active than the age-matched con - trol population, and authors considered this finding a result of education. This result is very important and show us precious data. Education in patients with T2DM and follow-up in a training program have useful results and increase the value of the study. The importance of community-based studies is obvious. Internationally recognized training programs and physical activity assessment scales should be validated before being accepted in each society; especially in T2DM. Before implementation of these programs and scales, community-based assessment is required for suitability, both in this study and in others (1-3). We think that a larger control group should have been included in the study, which was referred to as a limitation. We believe that the power of the study would increase with an appropriately larger control group. Interestingly, there was no comparison with the metabolic status of patients (such as HbA1c) and their physical activity status in the study. We think that patients' cardiac status should have been mentioned in detail in the study. Furthermore, prior guidelines suggested that before recommending a physical activity program, the physician should screen patients with multiple cardiovascular risk factors for coronary artery disease (CAD) in T2DM. However, the screening of asymptomatic diabetic patients for CAD remains unclear, and a recent American Diabetes Association (ADA) consensus statement on this issue concluded that routine screening is not recommended. Certainly, high-risk patients should be encouraged to start with short periods of low-intensity exercise and slowly increase the intensity and duration (4). We think that a study (the present study as well) that investigates the effects of physical activity on diabetic patients should be carried out based on the classification of patients according to their cardiac status and should model physical activity according to this classification, providing better information about the outco

What is the contribution of physical activity on outcome in patients with type 2 diabetes mellitus?