We used tele-monitoring to attempt to improve exercise adherence (number of hours of exercise completed), peak VO₂, HbA1c% and quality of life in an unsupervised, home based exercise program in people with type II diabetes, a cost analysis was also conducted. Thirty-nine patients with type II diabetes were randomized to tele-monitoring (TELE) or control (CON) groups. All patients were asked to complete 6 months exercise training and complete an exercise activity diary. The TELE group was instructed to record their exercise heart rates using a monitor and received weekly telephone calls from an exercise physiologist. Six TELE patients and seven CON patients did not complete the 6 month testing. TELE patients completed a mean weekly volume of 138 minutes, moderate intensity exercise, while CON patients completed 58 minutes weekly (p < 0.02). Neither group achieved the American Heart Association statement guideline for weekly exercise volume of 150 minutes. TELE patients improved peak VO₂ (5.5 %), but neither group improved HbA1c% or quality of life. The CON group showed a 4.9% reduction in peak VO₂. While tele-monitored patients completed more hours of exercise and demonstrated improved peak VO₂ compared to controls, the exercise volume completed was insufficient to improve glycemic control. There is the potential via tele-monitoring to enable people with diabetes to meet exercise training guidelines.

• Weekly telephone calls from a health professional providing encouragement, increases the amount of exercise completed by people with diabetes

• Weekly telephone calls will result in improved fitness

• At least 150 minutes weekly exercise is required to improve diabetes control

• The cost of home exercise with telephone monitoring is cheaper (and more convenient for the patient) than delivering an exercise program at the hospital

• Longer term research is needed to examine whether telephone supervised exercise will prevent serious events such as heart attack, strokes and death