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Ungvari Z, Fazekas-Pongor V, Csiszar A, Kunutsor SK. The multifaceted benefits of walking for healthy aging: from Blue Zones to molecular mechanisms. GeroScience 2023; 45:3211-3239. [PMID: 37495893 PMCID: PMC10643563 DOI: 10.1007/s11357-023-00873-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/11/2023] [Indexed: 07/28/2023] Open
Abstract
Physical activity, including walking, has numerous health benefits in older adults, supported by a plethora of observational and interventional studies. Walking decreases the risk or severity of various health outcomes such as cardiovascular and cerebrovascular diseases, type 2 diabetes mellitus, cognitive impairment and dementia, while also improving mental well-being, sleep, and longevity. Dose-response relationships for walking duration and intensity are established for adverse cardiovascular outcomes. Walking's favorable effects on cardiovascular risk factors are attributed to its impact on circulatory, cardiopulmonary, and immune function. Meeting current physical activity guidelines by walking briskly for 30 min per day for 5 days can reduce the risk of several age-associated diseases. Additionally, low-intensity physical exercise, including walking, exerts anti-aging effects and helps prevent age-related diseases, making it a powerful tool for promoting healthy aging. This is exemplified by the lifestyles of individuals in Blue Zones, regions of the world with the highest concentration of centenarians. Walking and other low-intensity physical activities contribute significantly to the longevity of individuals in these regions, with walking being an integral part of their daily lives. Thus, incorporating walking into daily routines and encouraging walking-based physical activity interventions can be an effective strategy for promoting healthy aging and improving health outcomes in all populations. The goal of this review is to provide an overview of the vast and consistent evidence supporting the health benefits of physical activity, with a specific focus on walking, and to discuss the impact of walking on various health outcomes, including the prevention of age-related diseases. Furthermore, this review will delve into the evidence on the impact of walking and low-intensity physical activity on specific molecular and cellular mechanisms of aging, providing insights into the underlying biological mechanisms through which walking exerts its beneficial anti-aging effects.
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Affiliation(s)
- Zoltan Ungvari
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary.
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
| | | | - Anna Csiszar
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Setor K Kunutsor
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4WP, UK.
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2
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Amin M, Kerr D, Atiase Y, Yakub Y, Driscoll A. Understanding Physical Activity Behavior in Ghanaian Adults with Type 2 Diabetes: A Qualitative Descriptive Study. J Funct Morphol Kinesiol 2023; 8:127. [PMID: 37754960 PMCID: PMC10532145 DOI: 10.3390/jfmk8030127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/28/2023] Open
Abstract
Despite a relatively low prevalence rate, sub-Saharan Africa bears a substantial diabetes burden. Physical activity (PA) plays a crucial role in managing type 2 diabetes mellitus (T2DM). However, PA levels among this population remain suboptimal. This study aimed to explore patients' perspectives on the barriers and facilitators to PA participation among Ghanaian adults with T2DM. Thirteen adults with T2DM were recruited from Korle-Bu Teaching Hospital, Ghana, for this qualitative descriptive study. Semi-structured interviews were conducted, and the data were analyzed using thematic analysis. Two overarching themes (personal factors and socio-structural factors) and 10 sub-themes relating to PA barriers and facilitators were identified. Participants had limited awareness of the recommended PA guidelines for T2DM management. Chronic illness-related factors hindered exercise participation. Difficulty differentiating between PA and exercise impeded the achievement of PA targets. Socio-structural barriers include concerns about social ridicule or embarrassment, safety during outdoor activities, a lack of culturally appropriate exercise facilities, and high social and work demands. Despite these barriers, participants were motivated by their understanding of the health benefits of PA. They emphasized integrating PA into daily routines through walking, work-related tasks, and household chores. Motivation and PA education from healthcare professionals are valued supports in achieving PA targets. Our findings showed that PA behaviour in Ghanaian adults with T2DM is influenced by both personal and external factors. Tailored PA interventions for this population should address identified barriers while leveraging facilitators to implement successful PA programs.
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Affiliation(s)
- Mohammed Amin
- Centre for Quality and Patient Safety, Institute for Health Transformation, Faculty of Health, School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Melbourne, VIC 3125, Australia; (D.K.); (A.D.)
| | - Debra Kerr
- Centre for Quality and Patient Safety, Institute for Health Transformation, Faculty of Health, School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Melbourne, VIC 3125, Australia; (D.K.); (A.D.)
| | - Yacoba Atiase
- National Diabetes Management and Research Centre, Korle-Bu Teaching Hospital, University of Ghana Medical School, Accra P.O. Box GP 4236, Ghana;
| | - Yusif Yakub
- Faculty of Medicine and Health, The University of Sydney, Science Road, Sydney, NSW 2050, Australia;
| | - Andrea Driscoll
- Centre for Quality and Patient Safety, Institute for Health Transformation, Faculty of Health, School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Melbourne, VIC 3125, Australia; (D.K.); (A.D.)
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3
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Simon L, Primeaux SD, Levitt DE, Bourgeois B, Johannsen NM, Peters A, Ahmed J, Marshall RH, Fairchild AH, Ferguson TF, Molina PE. An aerobic exercise intervention to improve metabolic health among people living with HIV with at-risk alcohol use: the ALIVE-Ex research study protocol. AIDS Res Ther 2023; 20:35. [PMID: 37296413 PMCID: PMC10251573 DOI: 10.1186/s12981-023-00530-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Effective antiretroviral therapy (ART) in people living with HIV (PLWH) has improved life expectancy and increased risk of age-associated cardiometabolic comorbidities. At-risk alcohol use is more frequent among PLWH and increases the risk of health challenges. PLWH with at-risk alcohol use are more likely to meet criteria for prediabetes/diabetes and this is associated with impaired whole-body glucose-insulin dynamics. METHODS The Alcohol & Metabolic Comorbidities in PLWH: Evidence Driven Interventions Study (ALIVE-Ex Study, NCT03299205) is a longitudinal, prospective, interventional study to determine the effects of an aerobic exercise protocol on improving dysglycemia among PLWH with at-risk alcohol use. The intervention is a moderate intensity aerobic exercise protocol implemented 3 days per week for 10 weeks at the Louisiana State University Health Sciences Center-New Orleans. Participants who have a fasting blood glucose level between 94 and 125 mg/dl will be enrolled in the study. Oral glucose tolerance tests, fitness assessments, and skeletal muscle biopsies will be performed pre- and post-exercise intervention. The primary outcome is to determine whether the exercise protocol improves measures of whole-body glucose-insulin dynamics, cardiorespiratory fitness, and skeletal muscle metabolic and bioenergetic function. Secondary outcomes are to determine whether the exercise intervention improves cognitive function and overall quality of life. Results generated will demonstrate the effect of exercise on glycemic measures in PLWH with subclinical dysglycemia and at-risk alcohol use. CONCLUSIONS The proposed intervention will also have the potential to be scalable to promote lifestyle changes among PLWH, particularly in underserved communities.
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Affiliation(s)
- Liz Simon
- Department of Physiology, LSU Health Sciences Center, 1901 Perdido Street, MEB/7205, New Orleans, LA, 70112, USA
- Comprehensive Alcohol HIV/AIDS Research Center, LSU Health Sciences Center, New Orleans, LA, 70112, USA
| | - Stefany D Primeaux
- Department of Physiology, LSU Health Sciences Center, 1901 Perdido Street, MEB/7205, New Orleans, LA, 70112, USA
- Joint Diabetes, Endocrinology & Metabolism Program, Pennington Biomedical Research Center, Baton Rouge, LA, 70808, USA
| | - Danielle E Levitt
- Department of Physiology, LSU Health Sciences Center, 1901 Perdido Street, MEB/7205, New Orleans, LA, 70112, USA
- Comprehensive Alcohol HIV/AIDS Research Center, LSU Health Sciences Center, New Orleans, LA, 70112, USA
- Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, 79409, USA
| | - Brianna Bourgeois
- Department of Physiology, LSU Health Sciences Center, 1901 Perdido Street, MEB/7205, New Orleans, LA, 70112, USA
- Comprehensive Alcohol HIV/AIDS Research Center, LSU Health Sciences Center, New Orleans, LA, 70112, USA
| | - Neil M Johannsen
- School of Kinesiology, Louisiana State University, Baton Rouge, LA, 70803, USA
| | - Adrianna Peters
- Department of Physiology, LSU Health Sciences Center, 1901 Perdido Street, MEB/7205, New Orleans, LA, 70112, USA
- Comprehensive Alcohol HIV/AIDS Research Center, LSU Health Sciences Center, New Orleans, LA, 70112, USA
| | - Jameel Ahmed
- Department of Medicine, LSU Health Sciences Center, New Orleans, LA, 70112, USA
| | - Richard H Marshall
- Department of Radiology, Tulane University School of Medicine, New Orleans, LA, 70112, USA
| | | | - Tekeda F Ferguson
- Joint Diabetes, Endocrinology & Metabolism Program, Pennington Biomedical Research Center, Baton Rouge, LA, 70808, USA
- Department of Epidemiology, LSU Health Sciences Center, New Orleans, LA, 70112, USA
| | - Patricia E Molina
- Department of Physiology, LSU Health Sciences Center, 1901 Perdido Street, MEB/7205, New Orleans, LA, 70112, USA.
- Comprehensive Alcohol HIV/AIDS Research Center, LSU Health Sciences Center, New Orleans, LA, 70112, USA.
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Cigarroa I, Bravo-Leal M, Petermann-Rocha F, Parra-Soto S, Concha-Cisternas Y, Matus-Castillo C, Vásquez-Gómez J, Zapata-Lamana R, Parra-Rizo MA, Álvarez C, Celis-Morales C. Brisk Walking Pace Is Associated with Better Cardiometabolic Health in Adults: Findings from the Chilean National Health Survey 2016-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085490. [PMID: 37107772 PMCID: PMC10139031 DOI: 10.3390/ijerph20085490] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/15/2023] [Accepted: 03/15/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND Although the importance of walking for promoting a better cardiometabolic health is widely known (this includes both cardiovascular and metabolic/endocrine systems), there is little knowledge regarding its appropriate pace to provide adults with more cardiometabolic benefits. AIM To analyze the associations between different walking pace categories and cardiometabolic health markers in the adult Chilean population. METHODS Cross-sectional study. A total of 5520 participants aged 15 to 90 years old from the Chilean National Health Survey (CNHS) 2016-2017 were included. Walking pace categories (slow, average, and brisk) were collected through self-reported methods. Glycaemia, glycosylated hemoglobin (HbA1c), gamma glutamyl transferase (GGT), vitamin D2, vitamin D3, systolic and diastolic blood pressure, and lipid profile (Total, HDL, LDL, VLDL, No HDL cholesterol and triglycerides) were determined using blood sample tests and measured with the standardized methods described in the CNHS 2016-2017. RESULTS People who had a brisk walking pace were associated with lower levels of glycaemia, HbA1c, GGT, systolic and diastolic blood pressure, and higher vitamin D3 levels compared with those with a slow walking pace. Moreover, people with a brisk walking pace had lower levels of VLDL cholesterol compared with those with a slow walking pace. However, after adjusting the model to include sociodemographic background, nutritional status, and lifestyle variables, the differences remained only for glycaemia, HbA1c and systolic blood pressure levels. CONCLUSIONS A brisk walking pace was associated with better cardiometabolic health markers and lipid profile compared with a slow walking pace.
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Affiliation(s)
- Igor Cigarroa
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Los Ángeles 4440000, Chile
- Correspondence:
| | - Michelle Bravo-Leal
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Los Ángeles 4440000, Chile
| | - Fanny Petermann-Rocha
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago 8370068, Chile
| | - Solange Parra-Soto
- Department of Nutrition and Public Health, Universidad del Bío-Bío, Chillan 3780000, Chile
- School Cardiovascular and Metabolic Health, University of Glasgow, Glasgow G12 8TA, UK
| | - Yeny Concha-Cisternas
- Pedagogía en Educación Física, Facultad de Educación, Universidad Autónoma de Chile, Talca 3460000, Chile
| | - Carlos Matus-Castillo
- Departamento de Ciencias del Deporte y Acondicionamiento Físico, Universidad Católica de la Santísima Concepción, Concepción 4030000, Chile
| | - Jaime Vásquez-Gómez
- Centro de Investigación de Estudios Avanzados del Maule (CIEAM), Universidad Católica del Maule, Talca 3460000, Chile
- Laboratorio de Rendimiento Humano, Grupo de Estudios en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca 3460000, Chile
| | | | - María Antonia Parra-Rizo
- Faculty of Health Sciences, Valencian International University—VIU, 46002 Valencia, Spain
- Department of Health Psychology, Faculty of Social and Health Sciences, Campus of Elche, Miguel Hernandez University (UMH), 03202 Elche, Spain
| | - Cristian Álvarez
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile
| | - Carlos Celis-Morales
- School Cardiovascular and Metabolic Health, University of Glasgow, Glasgow G12 8TA, UK
- Laboratorio de Rendimiento Humano, Grupo de Estudios en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca 3460000, Chile
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Kandari FA, Albahlal AA, Algethami RA. Spontaneous Resolution of Tractional Retinal Detachment in a Type II Diabetic Patient. Cureus 2023; 15:e38010. [PMID: 37228550 PMCID: PMC10208001 DOI: 10.7759/cureus.38010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2023] [Indexed: 05/27/2023] Open
Abstract
A 43 years old male with diabetes type II was under treatment for diabetic retinopathy with extramacular tractional retinal detachment (TRD) in the left eye OS. During the follow-up visit, the patient had a drop in vision from 20/25 to 20/60. The TRD was found to have progressed to involve the macula and was threatening the fovea; therefore, vitrectomy was thought to be inevitable. Meanwhile, the patient adopted exercise and tight glycemic control, and during the preoperative evaluation of three months duration, we observed resolution of traction and return of visual acuity to baseline (20/20). In conclusion, spontaneous resolution of TRD is extremely rare. If it occurs, the patient may be spared from undergoing a vitrectomy.
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Affiliation(s)
- Fahad A Kandari
- Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, SAU
| | | | - Rahma A Algethami
- Ophthalmology, King Faisal Specialist Hospital & Research Center, Riyadh, SAU
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6
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Kim H, Lee H. Risk of Stroke and Cardiovascular Disease According to Diabetes Mellitus Status. West J Nurs Res 2023; 45:520-527. [PMID: 37114972 DOI: 10.1177/01939459231158212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
The purpose of this study was to investigate the importance of prevention and management of diabetes by analyzing stroke and cardiovascular disease (CVD) incidence among people with diabetes. This secondary analysis of the Korea National Health and Nutrition Examination Survey Ⅶ (2016-2018) data included 15,039 adults. Diabetes status was significantly associated with sex, age, marital status, household size, education level, employment status, household income, hypertension, dyslipidemia, stroke, CVD, osteoarthritis, osteoporosis, kidney failure, depression, level of stress, smoking, drinking, body mass index, weight control, and the number of days of walking per week; however, it was not associated with rheumatoid arthritis. Stroke and CVD risk significantly increased in the presence of diabetes (by 4.123 times and 3.223 times, respectively). The incidences of stroke and CVD were significantly higher among participants with diabetes than among those without diabetes. Thus, preventing and systematically managing diabetes is crucial to reducing related complications and mortality.
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Affiliation(s)
- Hyunsu Kim
- College of Nursing, Kyungdong University, Wonju, Republic of Korea
| | - Hyunjung Lee
- College of Nursing, Kyungdong University, Wonju, Republic of Korea
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Zhang LY, Liu QL, Yick KL, Yip J, Ng SP. Analysis of Diabetic Foot Deformation and Plantar Pressure Distribution of Women at Different Walking Speeds. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3688. [PMID: 36834384 PMCID: PMC9965013 DOI: 10.3390/ijerph20043688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/17/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
Official guidelines state that suitable physical activity is recommended for patients with diabetes mellitus. However, since walking at a rapid pace could be associated with increased plantar pressure and potential foot pain, the footwear condition is particularly important for optimal foot protection in order to reduce the risk of tissue injury and ulceration of diabetic patients. This study aims to analyze foot deformation and plantar pressure distribution at three different walking speeds (slow, normal, and fast walking) in dynamic situations. The dynamic foot shape of 19 female diabetic patients at three walking speeds is obtained by using a novel 4D foot scanning system. Their plantar pressure distributions at the three walking speeds are also measured by using the Pedar in-shoe system. The pressure changes in the toes, metatarsal heads, medial and lateral midfoot, and heel areas are systematically investigated. Although a faster walking speed shows slightly larger foot measurements than the two other walking speeds, the difference is insignificant. The foot measurement changes at the forefoot and heel areas, such as the toe angles and heel width, are found to increase more readily than the measurements at the midfoot. The mean peak plantar pressure shows a significant increase at a faster walking speed with the exception of the midfoot, especially at the forefoot and heel areas. However, the pressure time integral decreases for all of the foot regions with an increase in walking speed. Suitable offloading devices are essential for diabetic patients, particularly during brisk walking. Design features such as medial arch support, wide toe box, and suitable insole material for specific area of the foot (such as polyurethane for forefoot area and ethylene-vinyl acetate for heel area) are essential for diabetic insole/footwear to provide optimal fit and offloading. The findings contribute to enhancing the understanding of foot shape deformation and plantar pressure changes during dynamic situations, thus facilitating the design of footwear/insoles with optimal fit, wear comfort, and foot protection for diabetic patients.
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Affiliation(s)
- Li-Ying Zhang
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hong Kong, China
- Laboratory for Artificial Intelligence in Design, Hong Kong Science Park, Hong Kong, China
| | - Qi-Long Liu
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hong Kong, China
| | - Kit-Lun Yick
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hong Kong, China
- Laboratory for Artificial Intelligence in Design, Hong Kong Science Park, Hong Kong, China
| | - Joanne Yip
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hong Kong, China
| | - Sun-Pui Ng
- School of Professional Education and Executive Development, The Hong Kong Polytechnic University, Hong Kong, China
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Magkos F, Reeds DN, Mittendorfer B. Evolution of the diagnostic value of "the sugar of the blood": hitting the sweet spot to identify alterations in glucose dynamics. Physiol Rev 2023; 103:7-30. [PMID: 35635320 PMCID: PMC9576168 DOI: 10.1152/physrev.00015.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 11/22/2022] Open
Abstract
In this paper, we provide an overview of the evolution of the definition of hyperglycemia during the past century and the alterations in glucose dynamics that cause fasting and postprandial hyperglycemia. We discuss how extensive mechanistic, physiological research into the factors and pathways that regulate the appearance of glucose in the circulation and its uptake and metabolism by tissues and organs has contributed knowledge that has advanced our understanding of different types of hyperglycemia, namely prediabetes and diabetes and their subtypes (impaired fasting plasma glucose, impaired glucose tolerance, combined impaired fasting plasma glucose, impaired glucose tolerance, type 1 diabetes, type 2 diabetes, gestational diabetes mellitus), their relationships with medical complications, and how to prevent and treat hyperglycemia.
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Affiliation(s)
- Faidon Magkos
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Dominic N Reeds
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri
| | - Bettina Mittendorfer
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri
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Boivin K, Laurencelle L, Trudeau F, Fontaine N. Troubles de santé à la marche au long cours et impacts de facteurs associés. Sci Sports 2022. [DOI: 10.1016/j.scispo.2021.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Kawae T, Nomura T, Iwaki D, Nakashima Y, Fudeyasu K, Kataoka H, Ishiguro T, Kimura H. Intraocular Pressure Fluctuation during Aerobic Exercise at Different Exercise Intensities. Healthcare (Basel) 2022; 10:healthcare10071196. [PMID: 35885722 PMCID: PMC9315960 DOI: 10.3390/healthcare10071196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/17/2022] [Accepted: 06/23/2022] [Indexed: 11/16/2022] Open
Abstract
Few studies have examined the effects of different aerobic-exercise intensities on intraocular-pressure (IOP) changes. This may be important for eye diseases that are impacted by IOP or its fluctuation, including glaucoma, and diabetes that is complicated by diabetic retinopathy. We investigated the effects of low-, moderate-, and high-intensity exercise on IOP in healthy subjects. A submaximal cardiopulmonary exercise test was performed in 18 healthy male subjects, and the maximal oxygen uptake was calculated. The subjects then exercised for 20 min at 30%, 50%, and 70% ·VO2 of maximal oxygen uptake, and their IOP was measured at rest and every 5 min during exercise. Oxygen uptake was monitored using an expiratory gas analyzer during exercise to maintain accurate exercise intensity and adjust exercise load. Oxygen uptake during exercise was significantly higher at all intensities from 5 to 20 min than at rest. IOP was significantly lower at 70% exercise intensity from 5 to 20 min than at rest. A negative correlation existed between IOP and ·VO2. IOP remained unchanged during low- and moderate-intensity exercise but significantly declined during high-intensity exercise compared with that at rest. Although various factors, such as β-blockers, are involved in IOP decline at rest, a different mechanism is involved in IOP decline during exercise.
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Affiliation(s)
- Toshihiro Kawae
- Department of Physical Therapy, Makuhari Human Care Faculty, Tohto University, Hibino 1-1, Mihama-ku, Chiba City 261-0021, Chiba, Japan;
- Correspondence: ; Tel.: +81-43-274-1917
| | - Takuo Nomura
- Department of Rehabilitation Sciences, Kansai University of Welfare Sciences, Kashiwara City 582-0026, Osaka, Japan;
| | - Daisuke Iwaki
- Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Kasumi 1-2-3, Minami-ku, Hiroshima City 734-8551, Hiroshima, Japan; (D.I.); (Y.N.); (K.F.)
| | - Yuki Nakashima
- Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Kasumi 1-2-3, Minami-ku, Hiroshima City 734-8551, Hiroshima, Japan; (D.I.); (Y.N.); (K.F.)
| | - Kenichi Fudeyasu
- Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Kasumi 1-2-3, Minami-ku, Hiroshima City 734-8551, Hiroshima, Japan; (D.I.); (Y.N.); (K.F.)
| | - Hiroaki Kataoka
- Department of Physical Therapy, Faculty of Health Sciences, Okayama Healthcare Professional University, Daiku 3-2-18, Kitaku, Okayama City 700-0913, Okayama, Japan;
| | - Tomoyasu Ishiguro
- Department of Physical Therapy, Makuhari Human Care Faculty, Tohto University, Hibino 1-1, Mihama-ku, Chiba City 261-0021, Chiba, Japan;
| | - Hiroaki Kimura
- Department of Rehabilitation, Hiroshima University Hospital, Kasumi 1-2-3, Minami-ku, Hiroshima City 734-8551, Hiroshima, Japan;
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11
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Ducloux D, Courivaud C. Prevention of Post-Transplant Diabetes Mellitus: Towards a Personalized Approach. J Pers Med 2022; 12:116. [PMID: 35055431 PMCID: PMC8778007 DOI: 10.3390/jpm12010116] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/06/2022] [Accepted: 01/13/2022] [Indexed: 02/01/2023] Open
Abstract
Post-transplant diabetes is a frequent complication after transplantation. Moreover, patients suffering from post-transplant diabetes have increased cardiovascular morbidity and reduced survival. Pathogenesis mainly involves beta-cell dysfunction in presence of insulin resistance. Both pre- and post-transplant risk factors are well-described, and some of them may be corrected or prevented. However, the frequency of post-transplant diabetes has not decreased in recent years. We realized a critical appraisal of preventive measures to reduce post-transplant diabetes.
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Affiliation(s)
- Didier Ducloux
- CHU Besançon, Department of Nephrology, Dialysis and Renal Transplantation, Federation Hospitalo-Universitaire INCREASE, 25000 Besançon, France;
- UMR RIGHT 1098, INSERM-EFS-UFC, 1 Bd Fleming, 25000 Besançon, France
| | - Cécile Courivaud
- CHU Besançon, Department of Nephrology, Dialysis and Renal Transplantation, Federation Hospitalo-Universitaire INCREASE, 25000 Besançon, France;
- UMR RIGHT 1098, INSERM-EFS-UFC, 1 Bd Fleming, 25000 Besançon, France
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12
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Matsushita J, Okada H, Okada Y, Sekiyama T, Iida H, Shindo A, Murata H, Fukui M. Effect of Exercise Instructions With Ambulatory Accelerometer in Japanese Patients With Type 2 Diabetes: a Randomized Control Trial. Front Endocrinol (Lausanne) 2022; 13:949762. [PMID: 35903280 PMCID: PMC9315151 DOI: 10.3389/fendo.2022.949762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 06/20/2022] [Indexed: 12/02/2022] Open
Abstract
This study aimed to investigate the effects of physical therapists' exercise instructions in Japanese patients with type 2 diabetes. Thirty-six participants were recruited from the outpatient clinic at Matsushita Memorial Hospital, Osaka, Japan from June 2020 to September 2020 and were randomly assigned to either the non-intervention or intervention group. The intervention group received exercise instructions from physical therapists for 30 min at baseline (week 0) and at week 4 by referring to ambulatory accelerometer records. Laboratory parameters, physical activity, body composition, motor skill, and transtheoretical model were assessed in both the groups at baseline (week 0) and week 8. In week 8, patients in the intervention group had a statistically significant reduction in HbA1c levels compared with those in the non-intervention group (7.3% [6.8-%-7.9%] vs. 7.4% [7.3%-7.7%], P = 0.04). The number of steps per day (P = 0.001), energy expenditure (P = 0.01), lower extremity muscle strength (P = 0.002), and 6-min walk test results (P = 0.04) were significantly increased in the intervention group compared with those in the non-intervention group in week 8. The transtheoretical model varied between baseline (week 0) and week 8 only in the intervention group (P < 0.001). Thus, outpatient exercise instructions from physical therapists could improve glycemic control owing to physical activity by improving motor skills and changing the transtheoretical model in Japanese patients with type 2 diabetes.
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Affiliation(s)
- Jin Matsushita
- Department of Rehabilitation, Matsushita Memorial Hospital, Moriguchi, Japan
| | - Hiroshi Okada
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, Moriguchi, Japan
- *Correspondence: Hiroshi Okada,
| | - Yuki Okada
- Department of Diabetes, Ikeda Hospital, Amagasaki, Japan
| | - Takashi Sekiyama
- Department of Rehabilitation, Matsushita Memorial Hospital, Moriguchi, Japan
| | - Hideto Iida
- Department of Rehabilitation, Matsushita Memorial Hospital, Moriguchi, Japan
| | - Atsushi Shindo
- Department of Rehabilitation, Matsushita Memorial Hospital, Moriguchi, Japan
| | - Hiroaki Murata
- Department of Orthopedic Surgery, Matsushita Memorial Hospital, Moriguchi, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Ndahimana D, Kim YJ, Wang CS, Kim EK. Energy cost of walking in older adults: accuracy of the ActiGraph accelerometer predictive equations. Nutr Res Pract 2022; 16:565-576. [PMID: 36238379 PMCID: PMC9523204 DOI: 10.4162/nrp.2022.16.5.565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 07/12/2021] [Accepted: 11/05/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND/OBJECTIVES Various accelerometer equations are used to predict energy expenditure (EE). On the other hand, the development of these equations and their validation studies have been conducted primarily without including older adults. This study assessed the accuracy of 8 ActiGraph accelerometer equations to predict the energy cost of walking in older adults. SUBJECTS/METHODS Thirty-one participants with a mean age of 74.3 ± 3.3 yrs were enrolled in this study (20 men and 11 women). The participants completed 8 walking activities, including 5 treadmill and 3 self-paced walking activities. The EE was measured using a portable indirect calorimeter, with each participant simultaneously wearing the ActiGraph accelerometer. Eight ActiGraph equations were assessed for accuracy by comparing the predicted EE with indirect calorimetry results. RESULTS All equations resulted in an overall underestimation of the EE across the activities (bias −1 to −1.8 kcal·min−1 and −0.7 to −1.8 metabolic equivalents [METs]), as well as during treadmill-based (bias −1.5 to −2.9 kcal·min−1 and −0.9 to −2.1 METs) and self-paced (bias −1.2 to −1.7 kcal·min−1 and −0.2 to −1.3 METs) walking. In addition, there were higher rates of activity intensity misclassifications, particularly among vigorous physical activities. CONCLUSIONS The ActiGraph equations underestimated the EE for walking activities in older adults. In addition, these equations inaccurately classified the activities based on their intensities. The present study suggests a need to develop ActiGraph equations specific to older adults.
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Affiliation(s)
- Didace Ndahimana
- Department of Food and Nutrition, Gangneung-Wonju National University, Gangneung 25457, Korea
| | - Ye-Jin Kim
- Department of Food and Nutrition, Gangneung-Wonju National University, Gangneung 25457, Korea
| | - Cui-Sang Wang
- Department of Food and Nutrition, Gangneung-Wonju National University, Gangneung 25457, Korea
| | - Eun-Kyung Kim
- Department of Food and Nutrition, Gangneung-Wonju National University, Gangneung 25457, Korea
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14
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Xiang M, Sun X, Wei J, Cao ZB. Combined effects of vitamin D supplementation and endurance exercise training on insulin resistance in newly diagnosed type 2 diabetes mellitus patients with vitamin D deficiency: study protocol for a randomized controlled trial. Trials 2021; 22:888. [PMID: 34872610 PMCID: PMC8647429 DOI: 10.1186/s13063-021-05861-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 11/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although approximately 50% of Chinese with type 2 diabetes mellitus (T2DM) patients have vitamin D deficiency, studies regarding vitamin D supplementation on insulin resistance (IR) have mainly focused on non-Asians. Endurance exercise training (ET) enhances insulin-mediated glucose metabolism, which plays a critical role in T2DM prevention and control. However, the combined effects of vitamin D supplementation and ET on IR in T2DM patients are unclear. The objectives of this study is to investigate the synergistic effect of vitamin D supplementation combined with exercise training intervention on IR in T2DM patients. METHODS AND ANALYSIS We propose a 3-month randomized controlled trial among 60 T2DM patients aged 40-65, newly diagnosed with T2DM ≤ 1 year, and with stable HbA1c level (≤ 8.0%) in the past 3 months. The participants will be randomly allocated to the vitamin D group, vitamin D combined with exercise training group, exercise training group, and control group (CG) using a computer-generated random number sequence. At baseline, participants will undergo a medical review, anthropometric measurements, dual X-ray absorptiometry, a 75-g oral glucose tolerance test (OGTT), ankle-brachial index measurements, and physical fitness measurements and will complete related lifestyle questionnaires. Fasting blood lipid and glucose levels were also measured. In a 3-month intervention period, vitamin D intervention group will receive a dose of 1000 IU daily; exercise group will perform a 1-h endurance exercise 3 times per week (maximal heart rate, 60-80%), and the control group will receive apparently identical tablets. Additionally, all participants will be advised to maintain their normal diet and physical activities during the intervention. All measurements will be repeated at 3-month follow-up after the intervention with the primary outcome measure expressed as a change from baseline in insulin sensitivity and secretion. Secondary outcome measures will compare the changes in anthropometry, ankle-brachial index, and physical fitness factors (e.g., peak oxygen uptake, hand grip strength). Data will be managed and analyzed using the Statistical Package for the Social Sciences. DISCUSSION This is the first study to conduct a randomized trial to clearly determine the independent and combined effects of vitamin D supplementation and endurance exercise trial on IR in Chinese T2DM patients as measured by OGTT. The findings from the proposed study will not only provide new evidences that vitamin D supplementation plays an important role in IR management but also develop a simple and efficient method to improve IR-associated metabolic diseases for T2DM patients. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1800015383 , Registered on 28 March 2018.
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Affiliation(s)
- Mi Xiang
- School of Public Health, Xinhua Hospital, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Xiaomin Sun
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, 76 Yanta West Road, Xi'an, Shaanxi, 710061, China.
| | - Junxiang Wei
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, 76 Yanta West Road, Xi'an, Shaanxi, 710061, China
| | - Zhen-Bo Cao
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, School of Kinesiology, Shanghai University of Sport, 399 Chang Hai Road, Shanghai, 200438, China.
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15
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Igarashi Y, Akazawa N, Maeda S. The relationship between the level of exercise and hemoglobin A 1c in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Endocrine 2021; 74:546-558. [PMID: 34296390 DOI: 10.1007/s12020-021-02817-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/25/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of the study was to evaluate the relationship between changes in hemoglobin A1c (HbA1c) and exercise levels in type 2 diabetes mellitus (T2DM) patients when performing various types of exercise. METHODS The inclusion criteria were randomized controlled trials involving adults with T2DM, intervention involving exercise alone, the overall duration of intervention ≥12 weeks, and reporting HbA1c. Weighted mean difference (WMD) was defined as the mean difference between the intervention group and the control group weighted by the inverse of the squared standard error for each study, and all WMDs were pooled as overall effects. A meta-regression analysis was performed to evaluate the relationship between the exercise level and the WMD in HbA1c. RESULTS Forty-eight studies (2395 subjects) were analyzed. The pooled WMD in HbA1c decreased significantly (-0.5% [95% confidence intervals: -0.6 to -0.4]) but contained significant heterogeneity (Q = 103.8, P < 0.01; I2 = 36.6%). A meta-regression analysis showed that the intensity (metabolic equivalents [METs]), time (min/session), or frequency (sessions/week) of the exercise was not associated with the HbA1c. However, the overall duration of exercise (weeks) was significantly associated with the WMD in HbA1c (meta-regression coefficient: 0.01 [95% confidence intervals: 0.002-0.016]; R2 = 70.0%), and that result did not contain significant heterogeneity (P > 0.05; I2 = 14.7%). CONCLUSIONS The exercise intervention decreases HbA1c in T2DM patients. In addition, exercise for an extended duration was associated with an increase in HbA1c, so the effects of exercise may be evident early on, but results suggested that exercise for a prolonged period alone may increase HbA1c.
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Affiliation(s)
| | - Nobuhiko Akazawa
- Japan Institute of Sports Sciences, Tokyo, 115-0056, Japan
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, 305-8574, Japan
| | - Seiji Maeda
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, 305-8574, Japan
- Faculty of Sport Sciences, Waseda University, Saitama, 359-1192, Japan
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16
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Enguita-Germán M, Tamayo I, Galbete A, Librero J, Cambra K, Ibáñez-Beroiz B. Effect of Physical Activity on Cardiovascular Event Risk in a Population-Based Cohort of Patients with Type 2 Diabetes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312370. [PMID: 34886096 PMCID: PMC8657417 DOI: 10.3390/ijerph182312370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 12/01/2022]
Abstract
Cardiovascular disease (CVD) is the most common cause of morbidity and mortality among patients with type 2 diabetes (T2D). Physical activity (PA) is one of the few modifiable factors that can reduce this risk. The aim of this study was to estimate to what extent PA can contribute to reducing CVD risk and all-cause mortality in patients with T2D. Information from a population-based cohort including 26,587 patients with T2D from the Navarre Health System who were followed for five years was gathered from electronic clinical records. Multivariate Cox regression models were fitted to estimate the effect of PA on CVD risk and all-cause mortality, and the approach was complemented using conditional logistic regression models within a matched nested case–control design. A total of 5111 (19.2%) patients died during follow-up, which corresponds to 37.8% of the inactive group, 23.9% of the partially active group and 12.4% of the active group. CVD events occurred in 2362 (8.9%) patients, which corresponds to 11.6%, 10.1% and 7.6% of these groups. Compared with patients in the inactive group, and after matching and adjusting for confounders, the OR of having a CVD event was 0.84 (95% CI: 0.66–1.07) for the partially active group and 0.71 (95% CI: 0.56–0.91) for the active group. A slightly more pronounced gradient was obtained when focused on all-cause mortality, with ORs equal to 0.72 (95% CI: 0.61–0.85) and 0.50 (95% CI: 0.42–0.59), respectively. This study provides further evidence that physically active patients with T2D may have a reduced risk of CVD-related complications and all-cause mortality.
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Affiliation(s)
- Mónica Enguita-Germán
- Unidad de Metodología, Navarrabiomed-HUN-UPNA, 31008 Pamplona, Spain; (M.E.-G.); (I.T.); (A.G.); (J.L.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), 48902 Bilbao, Spain;
| | - Ibai Tamayo
- Unidad de Metodología, Navarrabiomed-HUN-UPNA, 31008 Pamplona, Spain; (M.E.-G.); (I.T.); (A.G.); (J.L.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), 48902 Bilbao, Spain;
| | - Arkaitz Galbete
- Unidad de Metodología, Navarrabiomed-HUN-UPNA, 31008 Pamplona, Spain; (M.E.-G.); (I.T.); (A.G.); (J.L.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), 48902 Bilbao, Spain;
- Departamento de Estadística, Universidad Pública de Navarra (UPNA), 31008 Pamplona, Spain
| | - Julián Librero
- Unidad de Metodología, Navarrabiomed-HUN-UPNA, 31008 Pamplona, Spain; (M.E.-G.); (I.T.); (A.G.); (J.L.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), 48902 Bilbao, Spain;
| | - Koldo Cambra
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), 48902 Bilbao, Spain;
- Departamento de Salud, Gobierno Vasco, 01006 Vitoria-Gasteiz, Spain
| | - Berta Ibáñez-Beroiz
- Unidad de Metodología, Navarrabiomed-HUN-UPNA, 31008 Pamplona, Spain; (M.E.-G.); (I.T.); (A.G.); (J.L.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), 48902 Bilbao, Spain;
- Correspondence:
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Boivin K, Laurencelle L, Trudeau F, Fontaine N. La marche au long cours : comment influence-t-elle l’anthropométrie ? Sci Sports 2021. [DOI: 10.1016/j.scispo.2020.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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18
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Classification of Diabetic Walking for Senior Citizens and Personal Home Training System Using Single RGB Camera through Machine Learning. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11199029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Senior citizens have increased plasma glucose and a higher risk of diabetes-related complications than young people. However, it is difficult to diagnose and manage elderly diabetics because there is no clear symptom according to current diagnostic criteria. They also dislike the invasive blood sample test. This study aimed to classify a difference in gait and physical fitness characteristics between senior citizens with and without diabetes for a non-invasive method and propose a machine-learning-based personal home-training system for training abnormal gait motions by oneself. We used a dataset for classification with 200 over 65-year-old elders who walked a flat and straight 15 m route in 3 different walking speed conditions using an inertial measurement unit and physical fitness test. Then, questionnaires for participants were included to identify life patterns. Through results, it was found that there were abnormalities in gait and physical fitness characteristics related to balance ability and walking speed. Using a single RGB camera, the developed training system for improving abnormalities enabled us to correct the exercise posture and speed in real-time. It was discussed that there are risks and errors in the training system based on human pose estimation for future works.
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19
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Wood G, Taylor E, Ng V, Murrell A, Patil A, van der Touw T, Sigal R, Wolden M, Smart N. Determining the effect size of aerobic exercise training on the standard lipid profile in sedentary adults with three or more metabolic syndrome factors: a systematic review and meta-analysis of randomised controlled trials. Br J Sports Med 2021; 56:bjsports-2021-103999. [PMID: 34193471 DOI: 10.1136/bjsports-2021-103999] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To estimate the change in the standard lipid profile (SLP) of adults diagnosed with ≥3 metabolic syndrome (MetS) factors following aerobic exercise training (AET); and to investigate whether study/intervention covariates are associated with this change. DESIGN Systematic review with univariate meta-analysis and meta-regression. DATA SOURCES English language searches of online databases from inception until July 2020. ELIGIBILITY CRITERIA: (1) Published randomised controlled human trials with study population ≥10 per group; (2) sedentary adults with ≥3 MetS factors but otherwise free of chronic disease, not pregnant/lactating; (3) AET-only intervention with duration ≥12 weeks; and (4) reporting pre-post intervention SLP outcomes. RESULTS Various univariate meta-analyses pooled 48 data sets of 2990 participants. Aerobic exercise training significantly (P<.001) improved all lipids (mmol/L mean difference ranges, 95% CIs): total cholesterol, -0.19 (-0.26 to -0.12) to -0.29 (-0.36 to -0.21); triglycerides, -0.17 (-0.19 to -0.14) to -0.18 (-0.24 to -0.13); high-density lipoprotein-cholesterol (HDL-C), 0.05 (0.03 to 0.07) to 0.10 (0.05 to 0.15); and low-density lipoprotein-cholesterol (LDL-C), -0.12 (-0.16 to -0.9) to -0.20 (-0.25 to -0.14). Meta-regression showed that intensity may explain change in triglycerides and volume may explain change in HDL-C and LDL-C. CONCLUSION Aerobic exercise training positively changes the SLP of sedentary and otherwise healthy adults with ≥3 MetS factors. Adjusting AET intervention training variables may increase the effects of AET on triglycerides and HDL-C. PROSPERO REGISTRATION NUMBER CRD42020151925.
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Affiliation(s)
- Gina Wood
- School of Physiotherapy and Exercise Science, Curtin University Faculty of Health Sciences, Perth, Western Australia, Australia
- School of Science and Technology, University of New England School of Science and Technology, Armidale, New South Wales, Australia
| | - Emily Taylor
- School of Science and Technology, University of New England School of Science and Technology, Armidale, New South Wales, Australia
| | - Vanessa Ng
- School of Rural Medicine, Faculty of Medicine and Health, University of New England, Armidale, New South Wales, Australia
| | - Anna Murrell
- School of Rural Medicine, University of New England, Armidale, New South Wales, Australia
| | - Aditya Patil
- School of Science and Technology, University of New England School of Science and Technology, Armidale, New South Wales, Australia
| | - Tom van der Touw
- School of Science and Technology, University of New England School of Science and Technology, Armidale, New South Wales, Australia
| | - Ronald Sigal
- Division of Endocrinology and Metabolism, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Mitch Wolden
- Physical Therapy, University of Jamestown, Jamestown, North Dakota, USA
| | - Neil Smart
- School of Science and Technology, University of New England School of Science and Technology, Armidale, New South Wales, Australia
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20
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Sgrò P, Emerenziani GP, Antinozzi C, Sacchetti M, Di Luigi L. Exercise as a drug for glucose management and prevention in type 2 diabetes mellitus. Curr Opin Pharmacol 2021; 59:95-102. [PMID: 34182427 DOI: 10.1016/j.coph.2021.05.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/19/2021] [Accepted: 05/25/2021] [Indexed: 02/06/2023]
Abstract
Physical inactivity and sedentary behavior are risk factors for type 2 diabetes mellitus (T2DM). Therefore, physical exercise (PE) together with medical treatment might be considered as a key strategy to counteract T2DM. Glycemic control is a central objective in the prevention and management of T2DM, and PE might be able to substantially affect the processes that determine it. Just like a drug, exercise can be dosed based on the characteristics of the individual to increase its benefits and reduce side effects. In this brief review, the mechanisms underlying the effects of PE on glucose metabolism in muscle are illustrated, and the effects of modulation of the parameters characterizing this atypical "drug" on glucose homeostasis are described.
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Affiliation(s)
- Paolo Sgrò
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Gian Pietro Emerenziani
- Department of Experimental and Clinical Medicine, University of Catanzaro "Magna Græcia", Catanzaro, Italy
| | - Cristina Antinozzi
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Massimo Sacchetti
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Luigi Di Luigi
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.
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21
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De Bruijn GJ, Dallinga JM, Deutekom M. Predictors of Walking App Users With Comparison of Current Users, Previous Users, and Informed Nonusers in a Sample of Dutch Adults: Questionnaire Study. JMIR Mhealth Uhealth 2021; 9:e13391. [PMID: 33978595 PMCID: PMC8156117 DOI: 10.2196/13391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 05/19/2019] [Accepted: 06/19/2019] [Indexed: 01/03/2023] Open
Abstract
Background The last decade has seen a substantial increase in the use of mobile health apps and research into the effects of those apps on health and health behaviors. In parallel, research has aimed at identifying population subgroups that are more likely to use those health apps. Current evidence is limited by two issues. First, research has focused on broad health apps, and little is known about app usage for a specific health behavior. Second, research has focused on comparing current users and current nonusers, without considering subgroups of nonusers. Objective We aimed to provide profile distributions of current users, previous users, and informed nonusers, and to identify predictor variables relevant for profile classification. Methods Data were available from 1683 people who participated in a Dutch walking event in Amsterdam that was held in September 2017. They provided information on demographics, self-reported walking behavior, and walking app usage, as well as items from User Acceptance of Information Technology, in an online survey. Data were analyzed using discriminant function analysis and multinomial logistic regression analysis. Results Most participants were current walking app users (899/1683, 53.4%), while fewer participants were informed nonusers (663/1683, 39.4%) and very few were previous walking app users (121/1683, 7.2%). Current walking app users were more likely to report walking at least 5 days per week and for at least 30 minutes per bout (odds ratio [OR] 1.44, 95% CI 1.11-1.85; P=.005) and more likely to be overweight (OR 1.72, 95% CI 1.24-2.37; P=.001) or obese (OR 1.49, 95% CI 1.08-2.08; P=.005) as compared with informed nonusers. Further, current walking app users perceived their walking apps to be less boring, easy to use and retrieve information, and more helpful to achieve their goals. Effect sizes ranged from 0.10 (95% CI 0.08-0.30) to 1.58 (95% CI 1.47-1.70). Conclusions The distributions for walking app usage appeared different from the distributions for more general health app usage. Further, the inclusion of two specific subgroups of nonusers (previous users and informed nonusers) provides important information for health practitioners and app developers to stimulate continued walking app usage, including making information in those apps easy to understand and making it easy to obtain information from the apps, as well as preventing apps from becoming boring and difficult to use for goal attainment.
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Affiliation(s)
- Gert-Jan De Bruijn
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, Netherlands
| | - Joan Martine Dallinga
- Department of Physiotherapy, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Marije Deutekom
- Department of Physiotherapy, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
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22
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Wernicke K, Grischke J, Stiesch M, Zeissler S, Krüger K, Bauer P, Hillebrecht A, Eberhard J. Influence of physical activity on periodontal health in patients with type 2 diabetes mellitus. A blinded, randomized, controlled trial. Clin Oral Investig 2021; 25:6101-6107. [PMID: 33796948 PMCID: PMC8531088 DOI: 10.1007/s00784-021-03908-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 03/23/2021] [Indexed: 11/30/2022]
Abstract
Objectives The aim was to investigate the effect of physical activity on periodontal health and HbA1c levels in patients with type 2 diabetes mellitus (T2DM) over a period of 6 months. Materials and methods Thirty-seven patients with non-insulin-dependent T2DM were included in the study. The intervention group (n=20) performed physical activity over a period of 6 months. The control group (n=17) did not receive any intervention. Baseline and final examinations included dental parameters and concentrations of glycosylated hemoglobin (HbA1c) and high-sensitivity C-reactive protein (hsCRP). Results Physical activity showed a positive effect on periodontal health. Both the BOP (p= 0.005) and the severity of periodontitis (p= 0.001) were significantly reduced in the intervention group compared to the control group. Furthermore, HbA1c levels were reduced (p= 0.010) significantly in the intervention group while hsCRP levels significantly increased in the control group (p= 0.04). Conclusions Within the limitations of this randomized, controlled trial, physical activity over a period of 6 months is a health-promoting measure for patients with T2DM and improves both periodontal health and HbA1c concentrations.
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Affiliation(s)
- K Wernicke
- Hannover Medical School, Hanover, Germany
| | - J Grischke
- Hannover Medical School, Hanover, Germany. .,Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany.
| | - M Stiesch
- Hannover Medical School, Hanover, Germany
| | | | - K Krüger
- Justus-Liebig-Universität Gießen, Gießen, Germany
| | - P Bauer
- Justus-Liebig-Universität Gießen, Gießen, Germany
| | | | - J Eberhard
- The University of Sydney School of Dentistry and the Charles Perkins Centre, Faculty of Health and Medicine, The University of Sydney, Sydney, Australia
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Moghetti P, Balducci S, Guidetti L, Mazzuca P, Rossi E, Schena F, Moghetti P, Balducci S, Guidetti L, Schena F, Mazzuca P, Rossi E. Walking for subjects with type 2 diabetes: a systematic review and joint AMD/SID/SISMES evidence-based practical guideline. SPORT SCIENCES FOR HEALTH 2021. [DOI: 10.1007/s11332-020-00690-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Abstract
Aims
Regular exercise is considered a cornerstone in the management of type 2 diabetes mellitus (T2DM). It improves glucose control and cardiovascular risk factors, contributes to weight loss, and also improves general well-being, likely playing a role in the prevention of chronic complications of diabetes. However, compliance to exercise recommendations is generally inadequate in subjects with T2DM. Walking is the most ancestral form of physical activity in humans, easily applicable in daily life. It may represent, in many patients, a first simple step towards lifestyle changes. Nevertheless, while most diabetic patients do not engage in any weekly walking, exercise guidelines do not generally detail how to improve its use. The aims of this document are to conduct a systematic review of available literature on walking as a therapeutic tool for people with T2DM, and to provide practical, evidence-based clinical recommendations regarding its utilization in these subjects.
Data synthesis
Analysis of available RCTs proved that regular walking training, especially when supervised, improves glucose control in subjects with T2DM, with favorable effects also on cardiorespiratory fitness, body weight, and blood pressure. Moreover, some recent studies have shown that even short bouts of walking, used for breaking prolonged sitting, can ameliorate glucose profiles in diabetic patients with sedentary behavior.
Conclusions
There is sufficient evidence to recognize that walking is a useful therapeutic tool for people with T2DM. This document discusses theoretical and practical issues for improving its use.
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Abstract
BACKGROUND Increased physical activity has been recommended as an important lifestyle modification for the prevention and control of hypertension. Walking is a low-cost form of physical activity and one which most people can do. Studies testing the effect of walking on blood pressure have revealed inconsistent findings. OBJECTIVES To determine the effect of walking as a physical activity intervention on blood pressure and heart rate. SEARCH METHODS We searched the following databases up to March 2020: the Cochrane Hypertension Specialised Register, CENTRAL (2020, Issue 2), Ovid MEDLINE, Ovid Embase, CINAHL, PsycINFO, SPORTDiscus, PEDro, the WHO International Clinical Trials Registry Platform, and ClinicalTrials.gov. We also searched the following Chinese databases up to May 2020: Index to Taiwan Periodical Literature System; National Digital Library of Theses and Dissertation in Taiwan; China National Knowledge Infrastructure (CNKI) Journals, Theses & Dissertations; and Wanfang Medical Online. We contacted authors of relevant papers regarding further published and unpublished work. The searches had no language restrictions. SELECTION CRITERIA Randomised controlled trials of participants, aged 16 years and over, which evaluated the effects of a walking intervention compared to non-intervention control on blood pressure and heart rate were included. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. Where data were not available in the published reports, we contacted authors. Pooled results for blood pressure and heart rate were presented as mean differences (MDs) between groups with 95% confidence intervals (CIs). We undertook subgroup analyses for age and sex. We undertook sensitivity analyses to assess the effect of sample size on our findings. MAIN RESULTS A total of 73 trials met our inclusion criteria. These 73 trials included 5763 participants and were undertaken in 22 countries. Participants were aged from 16 to 84 years and there were approximately 1.5 times as many females as males. The characteristics of walking interventions in the included studies were as follows: the majority of walking interventions was at home/community (n = 50) but supervised (n = 36 out of 47 reported the information of supervision); the average intervention length was 15 weeks, average walking time per week was 153 minutes and the majority of walking intensity was moderate. Many studies were at risk of selection bias and performance bias. Primary outcome We found moderate-certainty evidence suggesting that walking reduces systolic blood pressure (SBP) (MD -4.11 mmHg, 95% CI -5.22 to -3.01; 73 studies, n = 5060). We found moderate-certainty evidence suggesting that walking reduces SBP in participants aged 40 years and under (MD -4.41 mmHg, 95% CI -6.17 to -2.65; 14 studies, n = 491), and low-certainty evidence that walking reduces SBP in participants aged 41 to 60 years (MD -3.79 mmHg, 95% CI -5.64 to -1.94, P < 0.001; 35 studies, n = 1959), and those aged 60 years of over (MD -4.30 mmHg, 95% CI -6.17 to -2.44, 24 studies, n = 2610). We also found low certainty-evidence suggesting that walking reduces SBP in both females (MD -5.65 mmHg, 95% CI -7.89 to -3.41; 22 studies, n = 1149) and males (MD -4.64 mmHg, 95% CI -8.69 to -0.59; 6 studies, n = 203). Secondary outcomes We found low-certainty evidence suggesting that walking reduces diastolic blood pressure (DBP) (MD -1.79 mmHg, 95% CI -2.51 to -1.07; 69 studies, n = 4711) and heart rate (MD -2.76 beats per minute (bpm), 95% CI -4.57 to -0.95; 26 studies, n = 1747). We found moderate-certainty evidence suggesting that walking reduces DBP for participants aged 40 years and under (MD -3.01 mmHg, 95% CI -4.44 to -1.58; 14 studies, n = 491) and low-certainty evidence suggesting that walking reduces DBP for participants aged 41 to 60 years (MD -1.74 mmHg, 95% CI -2.95 to -0.52; 32 studies, n = 1730) and those aged 60 years and over (MD -1.33 mmHg, 95% CI -2.40 to -0.26; 23 studies, n = 2490). We found moderate-certainty evidence that suggests walking reduces DBP for males (MD -2.54 mmHg, 95% CI -4.84 to -0.24; 6 studies, n = 203) and low-certainty evidence that walking reduces DBP for females (MD -2.69 mmHg, 95% CI -4.16 to -1.23; 20 studies, n = 1000). Only 21 included studies reported adverse events. Of these 21 studies, 16 reported no adverse events, the remaining five studies reported eight adverse events, with knee injury being reported five times. AUTHORS' CONCLUSIONS Moderate-certainty evidence suggests that walking probably reduces SBP. Moderate- or low-certainty evidence suggests that walking may reduce SBP for all ages and both sexes. Low-certainty evidence suggests that walking may reduce DBP and heart rate. Moderate- and low-certainty evidence suggests walking may reduce DBP and heart rate for all ages and both sexes.
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Affiliation(s)
- Ling-Ling Lee
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien City, Hualien County, Taiwan
| | | | | | | | - Michael C Watson
- School of Health Sciences, The University of Nottingham, Nottingham, UK
| | - Hui-Hsin Lin
- Medical Affairs Division, Hualien Armed Forces General Hospital, Hualien, Taiwan
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Masuda H, Ishiyama D, Yamada M, Iwashima F, Kimura Y, Otobe Y, Tani N, Suzuki M, Nakajima H. Relationship Between Long-Term Objectively Measured Physical Activity and Glycemic Control in Type 2 Diabetes Mellitus Patients: A Prospective Cohort Study. Diabetes Metab Syndr Obes 2021; 14:2057-2063. [PMID: 33994800 PMCID: PMC8112872 DOI: 10.2147/dmso.s307070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/10/2021] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Increasing physical activity (PA) improves glycemic control in patients with type 2 diabetes mellitus (T2DM). However, whether long-term objectively measured PA is related to glycemic control remains unclear. The aim of this study was to investigate the relationship between long-term objectively measured PA and glycemic control in T2DM patients. RESEARCH DESIGN AND METHODS This prospective cohort study recruited T2DM patients admitted to a hospital-based diabetes management and education program. The primary outcome was glycemic control by hemoglobin A1c at 6 months after discharge. We defined poor glycemic control according to the Japanese Clinical Practice Guidelines. The PA was objectively measured using a three-axis accelerometer during 6 months' period after discharge. The representative value of PA was the average daily steps during the measurement period and was divided into quartiles. To determine the relationship between the daily steps and poor glycemic control, we performed a multivariate logistic regression analysis. RESULTS Ninety-four participants were enrolled in the study. Their median age was 59 years, and 38 (40.0%) of them showed poor glycemic control. Multivariate logistic regression analysis showed that the first (Q1, ≤ 6106 steps/day) and second quartiles (Q2, 6107-8258 steps/day) had significantly elevated risks of poor glycemic control compared to Q4 (≥ 10,542 steps/day), with odds ratios of 8.55 [95% confidence intervals (CI) =1.43-51.23] and 15.62 (95% CI 2.63-92.87), respectively. CONCLUSION We found that lesser PA was significantly associated with poor glycemic control in T2DM patients. This finding may be beneficial for clinicians while providing long-term advice to diabetic patients.
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Affiliation(s)
- Hiroaki Masuda
- Department of Rehabilitation, Toshima Hospital, Tokyo Metropolitan Health and Hospitals Corporation, Tokyo, Japan
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
- Correspondence: Hiroaki Masuda Department of Rehabilitation, Toshima Hospital, Tokyo Metropolitan Health and Hospitals Corporation, 33-1 Sakaecho, Itabashi-ku, Tokyo, 173-0015, JapanTel +81-3-5375-1234Fax +81-3-5944-3534 Email
| | - Daisuke Ishiyama
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Fumiko Iwashima
- Department of Endocrinology and Metabolism, Toshima Hospital, Tokyo Metropolitan Health and Hospitals Corporation, Tokyo, Japan
| | - Yosuke Kimura
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Yuhei Otobe
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Naoki Tani
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Mizue Suzuki
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Hideki Nakajima
- Department of Rehabilitation, Toshima Hospital, Tokyo Metropolitan Health and Hospitals Corporation, Tokyo, Japan
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Araki E, Tanaka A, Inagaki N, Ito H, Ueki K, Murohara T, Imai K, Sata M, Sugiyama T, Ishii H, Yamane S, Kadowaki T, Komuro I, Node K. Diagnosis, prevention, and treatment of cardiovascular diseases in people with type 2 diabetes and prediabetes: a consensus statement jointly from the Japanese Circulation Society and the Japan Diabetes Society. Diabetol Int 2021; 12:1-51. [PMID: 33479578 PMCID: PMC7790968 DOI: 10.1007/s13340-020-00471-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Eiichi Araki
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501 Japan
| | - Nobuya Inagaki
- Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kohjiro Ueki
- Diabetes Research Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenjiro Imai
- Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School, Tokushima, Japan
| | - Takehiro Sugiyama
- Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hideki Ishii
- Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Shunsuke Yamane
- Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501 Japan
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Idowu OA, Adeniyi AF. Efficacy of Graded Activity with and without Daily-Monitored-Walking on Pain and Back Endurance among Patients with Concomitant Low-Back Pain and Type-2 Diabetes: A Randomized Trial. Ethiop J Health Sci 2020; 30:233-242. [PMID: 32165813 PMCID: PMC7060385 DOI: 10.4314/ejhs.v30i2.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background There is evidence supporting the efficacy of Graded Activity (GA) in managing clinical attributes of patients with Low-Back Pain (LBP) in the general population. However, it is unknown whether GA alone is efficacious in managing these clinical attributes in patients with concomitant LBP and Type-2 Diabetes (T2D) or additional daily-monitored walking will be required. Methods A single-blind controlled trial involving 58 patients (mean age: 48.3±9.4 years, 64.7% females) with concomitant LBP and T2D who received treatment twice weekly for twelve weeks was conducted. Participants were randomized into GA or GA with daily-monitored-walking (GAMW) groups. Pain Intensity (PI), Static Back Extensors Endurance (SBEE), Static Abdominal Muscular Endurance (SAME) and Glycaemic Control (GC) were assessed using Visual Analogue Scale, Biering-Sorensen test, flexor endurance test, and in2itTM device respectively at baseline, 4th, 8th and 12th week. Data were analysed using repeated measures ANOVA and Unpaired t-tests at α = 0.05. Results There were significant differences in PI, SAME and SBEE among participants in each of GA and GAMW groups respectively (p<0.05). Within-group difference on GC was significant for GAMW (6.3±0.9%, 5.7±0.7%) but not GA (6.3±0.9%, 6.3±0.9%). There was significant difference (p<0.05) between GA and GAMW group participants for SBEE (7.2±0.1 sec, 7.3±0.1 sec) at week 8 of the study and GC (-0.5±0.2%, -0.6±0.5%) at the end of the study. No differences were found between GA and GAMW groups for PI and SAME. Conclusion Graded activity with daily-monitored-walking produced positive effects on GC and yielded a better improvement on SAME and SBEE.
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Affiliation(s)
- Opeyemi Ayodiipo Idowu
- Department of Physiotherapy, School of Basic Medical Sciences, College of Medical Sciences, University of Benin, Benin-City, Nigeria
| | - Ade Fatai Adeniyi
- Department of Physiotherapy, College of Medicine, College of Medicine, University of Ibadan, Nigeria
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28
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Araki E, Tanaka A, Inagaki N, Ito H, Ueki K, Murohara T, Imai K, Sata M, Sugiyama T, Ishii H, Yamane S, Kadowaki T, Komuro I, Node K. Diagnosis, Prevention, and Treatment of Cardiovascular Diseases in People With Type 2 Diabetes and Prediabetes - A Consensus Statement Jointly From the Japanese Circulation Society and the Japan Diabetes Society. Circ J 2020; 85:82-125. [PMID: 33250455 DOI: 10.1253/circj.cj-20-0865] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Eiichi Araki
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University
| | | | - Nobuya Inagaki
- Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Kohjiro Ueki
- Diabetes Research Center, Research Institute, National Center for Global Health and Medicine
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Kenjiro Imai
- Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School
| | - Takehiro Sugiyama
- Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine
| | - Hideki Ishii
- Department of Cardiology, Fujita Health University Bantane Hospital
| | - Shunsuke Yamane
- Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine
| | | | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
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29
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Hu H, Lei Y, Yin L, Luo X. Evaluation of walking exercise on glycemic control in patients with type 2 diabetes mellitus: A protocol for systematic review and meta-analysis of randomized cross-over controlled trials. Medicine (Baltimore) 2020; 99:e22735. [PMID: 33217794 PMCID: PMC7676596 DOI: 10.1097/md.0000000000022735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 09/15/2020] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Hyperglycemia is closely associated with the occurrence of diabetic complications, especially for patients with type 2 diabetes mellitus. Clinical trials indicated that walking exercise could improve glycemic control in patients with type 2 diabetes mellitus, but it is difficult to draw definitive and reliable conclusions due to the small sample size and possible exaggerated efficacy of various individual clinical trials. Therefore, we will conduct systematic review and meta-analysis to assess the current evidence for the efficacy of walking on glycemic control. METHODS AND ANALYSIS The databases of PubMed, EMBASE, Web of Science and Cochrane Library will be searched for this review. Cochrane risk-of-bias assessment tool will be applied to assess the risk of bias of included studies. A meta-analysis will be performed according to the Cochrane Handbook for Systematic Reviews of Interventions by using RevMan 5.3 and STATA/SE 14.0 software. Subgroup analysis will be conducted to investigate the sources of heterogeneity. Sensitivity analysis will be performed to assess the reliability and stability of the meta-analysis. Publication bias and small-study effects will be evaluated by a funnel plot and Eggers test if there are at least 10 studies. Additionally, the quality of evidence for this review will be assessed by Grades of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS This systematic review and meta-analysis will be to assess the efficacy of walking exercise on glycemic control. CONCLUSION We will provide strong evidence to determine whether walking can improve glycemic control in patients with type 2 diabetes mellitus. This study is supposed to provide references for clinical trials and patients with type 2 diabetes mellitus. ETHICS AND DISSEMINATION This study does not require ethical approval. The results of this review will be published in a peer reviewed journal. INPLASY REGISTRATION NUMBER INPLASY202090046.
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Affiliation(s)
- Hengchang Hu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province
| | - Yuanhong Lei
- Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Liping Yin
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province
| | - Xiaoqiong Luo
- Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
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30
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Moghetti P, Balducci S, Guidetti L, Mazzuca P, Rossi E, Schena F. Walking for subjects with type 2 diabetes: A systematic review and joint AMD/SID/SISMES evidence-based practical guideline. Nutr Metab Cardiovasc Dis 2020; 30:1882-1898. [PMID: 32998820 DOI: 10.1016/j.numecd.2020.08.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 12/19/2022]
Abstract
AIMS Regular exercise is considered a cornerstone in the management of type 2 diabetes mellitus (T2DM). It improves glucose control and cardiovascular risk factors, contributes to weight loss, and also improves general well-being, likely playing a role in the prevention of chronic complications of diabetes. However, compliance to exercise recommendations is generally inadequate in subjects with T2DM. Walking is the most ancestral form of physical activity in humans, easily applicable in daily life. It may represent, in many patients, a first simple step towards lifestyle changes. Nevertheless, while most diabetic patients do not engage in any weekly walking, exercise guidelines do not generally detail how to improve its use. The aims of this document are to conduct a systematic review of available literature on walking as a therapeutic tool for people with T2DM, and to provide practical, evidence-based clinical recommendations regarding its utilization in these subjects. DATA SYNTHESIS Analysis of available RCTs proved that regular walking training, especially when supervised, improves glucose control in subjects with T2DM, with favorable effects also on cardiorespiratory fitness, body weight and blood pressure. Moreover, some recent studies have shown that even short bouts of walking, used for breaking prolonged sitting, can ameliorate glucose profiles in diabetic patients with sedentary behavior. CONCLUSIONS There is sufficient evidence to recognize that walking is a useful therapeutic tool for people with T2DM. This document discusses theoretical and practical issues for improving its use. This article is co-published in the journals Sport Sciences for Health and Nutrition, Metabolism and Cardiovascular Diseases.
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Affiliation(s)
- P Moghetti
- Unit of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Verona, Italy; Hospital Trust of Verona, Verona, Italy.
| | - S Balducci
- Department of Clinical and Molecular Medicine, La Sapienza University, Rome, Italy; Diabetes Unit, Sant'Andrea University Hospital, Rome, Italy; Metabolic Fitness Association, Monterotondo, Rome, Italy
| | - L Guidetti
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - P Mazzuca
- Unit of Internal Medicine, Diabetes and Metabolic Disease Center, Romagna Health District, Rimini, Italy; Department for Life Quality Studies, University of Bologna, Rimini, Italy
| | - E Rossi
- Diabetes Unit, ASL of Benevento, Benevento, Italy
| | - F Schena
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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31
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Regeer H, Huisman SD, Empelen P, Flim J, Bilo HJG. Improving physical activity within diabetes care: Preliminary effects and feasibility of a national low‐intensity group‐based walking intervention among people with type 2 diabetes mellitus. LIFESTYLE MEDICINE 2020. [DOI: 10.1002/lim2.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Hannah Regeer
- Department of Internal Medicine Leiden University Medical Centre Leiden The Netherlands
- National Diabetes Challenge Bas Van De Goor Foundation Arnhem The Netherlands
| | - Sasja D. Huisman
- Department of Internal Medicine Leiden University Medical Centre Leiden The Netherlands
| | | | - Jeroen Flim
- National Diabetes Challenge Bas Van De Goor Foundation Arnhem The Netherlands
| | - Henk J. G. Bilo
- Diabetes Knowledge Centre Isala Hospitals Zwolle The Netherlands
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Cigarroa I, Espinoza-Sanhueza MJ, Lasserre-Laso N, Diaz-Martinez X, Garrido-Mendez A, Matus-Castillo C, Martinez-Sanguinetti MA, Leiva AM, Petermann-Rocha F, Parra-Soto S, Concha-Cisternas Y, Troncoso-Pantoja C, Martorell M, Ulloa N, Waddell H, Celis-Morales C. Association between Walking Pace and Diabetes: Findings from the Chilean National Health Survey 2016-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5341. [PMID: 32722215 PMCID: PMC7432405 DOI: 10.3390/ijerph17155341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 04/26/2020] [Accepted: 04/27/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Walking pace is a well-known indicator of physical capability, but it is also a strong predictor of type 2 diabetes (T2D). However, there is a lack of evidence on the association between walking pace and T2D, specifically, within developing countries such as Chile. AIM To investigate the association between self-reported walking pace and T2D in the Chilean adult population. METHODS 5520 Chilean participants (aged 15 to 90 years, 52.1% women) from the Chilean National Health Survey 2016-2017 were included in this cross-sectional study. Both walking pace (slow, average, and brisk) and diabetes data were collected through self-reported methods. Fasting blood glucose (reported in mg/dl) and glycosylated haemoglobin A (HbA1c) scores were determined via blood exams. RESULTS In the unadjusted model, and compared to people who reported a slow walking pace, those with average and brisk walking pace had lower blood glucose levels (β = -7.74 mg/dL (95% CI: -11.08 to -4.40) and β = -11.05 mg/dL (95% CI: -14.36 to -7.75), respectively) and lower HbA1c (β = -0.34% (95% CI: -0.57 to -0.11) and β= -0.72% (95% CI: -0.94 to -0.49)), respectively. After adjusting for sociodemographic, Body Mass Index and lifestyle factors, the association between glycaemia and HbA1c remained only for brisk walkers. Both the average and brisk walker categories had lower odds of T2D (OR: 0.59 (95% CI: 0.41 to 0.84) and (OR 0.48 (95% CI: 0.30 to 0.79), respectively). CONCLUSION Brisk walkers were associated with lower blood glucose and HbA1c levels. Moreover, average to brisk walking pace also showed a lower risk for T2D.
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Affiliation(s)
- Igor Cigarroa
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Santiago 1015, Chile;
| | | | - Nicole Lasserre-Laso
- Escuela de Nutrición y Dietética, Facultad de Salud, Universidad Santo Tomás, Santiago 1015, Chile;
| | - Ximena Diaz-Martinez
- Grupo de Investigación en Calidad de Vida, Departamento de Ciencias de la Educación, Facultad de Educación y Humanidades, Universidad del Biobío, Chillán 1180, Chile;
| | - Alex Garrido-Mendez
- Departamento de Ciencias del Deporte y Acondicionamiento Físico, Universidad Católica de la Santísima Concepción, Concepción 2850, Chile; (A.G.-M.); (C.M.-C.)
| | - Carlos Matus-Castillo
- Departamento de Ciencias del Deporte y Acondicionamiento Físico, Universidad Católica de la Santísima Concepción, Concepción 2850, Chile; (A.G.-M.); (C.M.-C.)
| | | | - Ana Maria Leiva
- Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia 1954, Chile;
| | - Fanny Petermann-Rocha
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8QQ, UK; (F.P.-R.); (S.P.-S.); (H.W.); (C.C.-M.)
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Solange Parra-Soto
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8QQ, UK; (F.P.-R.); (S.P.-S.); (H.W.); (C.C.-M.)
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Yeny Concha-Cisternas
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Santiago 1015, Chile;
- Pedagogía en Educación Física, Facultad de Educación, Universidad Autónoma de Chile, Talca 2203, Chile
| | - Claudia Troncoso-Pantoja
- CIEDE-UCSC, Departamentos de Salud Pública, Facultad de Medicina, Universidad Católica de la Santísima, Concepción 2850, Chile;
| | - Miquel Martorell
- Departamento de Nutrición y Dietética, Facultad de Farmacia, Universidad de Concepción, Concepción 1290, Chile;
| | - Natalia Ulloa
- Centro de Vida Saludable, Universidad de Concepción, Concepción 1290, Chile;
- Depto. de Bioquímica Clínica e Inmunología, Facultad de Farmacia, Universidad de Concepción, Concepción 1290, Chile
| | - Heather Waddell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8QQ, UK; (F.P.-R.); (S.P.-S.); (H.W.); (C.C.-M.)
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Carlos Celis-Morales
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8QQ, UK; (F.P.-R.); (S.P.-S.); (H.W.); (C.C.-M.)
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ, UK
- Centro de Investigación en Fisiología del Ejercicio (CIFE), Universidad Mayor, Santiago 2422, Chile
- Laboratorio de Rendimiento Humano, Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca 2203, Chile
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Araki E, Goto A, Kondo T, Noda M, Noto H, Origasa H, Osawa H, Taguchi A, Tanizawa Y, Tobe K, Yoshioka N. Japanese Clinical Practice Guideline for Diabetes 2019. Diabetol Int 2020; 11:165-223. [PMID: 32802702 PMCID: PMC7387396 DOI: 10.1007/s13340-020-00439-5] [Citation(s) in RCA: 213] [Impact Index Per Article: 53.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Indexed: 01/09/2023]
Affiliation(s)
- Eiichi Araki
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Atsushi Goto
- Department of Health Data Science, Graduate School of Data Science, Yokohama City University, Yokohama, Japan
| | - Tatsuya Kondo
- Department of Diabetes, Metabolism and Endocrinology, Kumamoto University Hospital, Kumamoto, Japan
| | - Mitsuhiko Noda
- Department of Diabetes, Metabolism and Endocrinology, Ichikawa Hospital, International University of Health and Welfare, Ichikawa, Japan
| | - Hiroshi Noto
- Division of Endocrinology and Metabolism, St. Luke’s International Hospital, Tokyo, Japan
| | - Hideki Origasa
- Department of Biostatistics and Clinical Epidemiology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Haruhiko Osawa
- Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine, Toon, Japan
| | - Akihiko Taguchi
- Department of Endocrinology, Metabolism, Hematological Science and Therapeutics, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Yukio Tanizawa
- Department of Endocrinology, Metabolism, Hematological Science and Therapeutics, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Kazuyuki Tobe
- First Department of Internal Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
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Araki E, Goto A, Kondo T, Noda M, Noto H, Origasa H, Osawa H, Taguchi A, Tanizawa Y, Tobe K, Yoshioka N. Japanese Clinical Practice Guideline for Diabetes 2019. J Diabetes Investig 2020; 11:1020-1076. [PMID: 33021749 PMCID: PMC7378414 DOI: 10.1111/jdi.13306] [Citation(s) in RCA: 140] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 05/24/2020] [Indexed: 01/09/2023] Open
Affiliation(s)
- Eiichi Araki
- Department of Metabolic MedicineFaculty of Life SciencesKumamoto UniversityKumamotoJapan
| | - Atsushi Goto
- Department of Health Data ScienceGraduate School of Data ScienceYokohama City UniversityYokohamaJapan
| | - Tatsuya Kondo
- Department of Diabetes, Metabolism and EndocrinologyKumamoto University HospitalKumamotoJapan
| | - Mitsuhiko Noda
- Department of Diabetes, Metabolism and EndocrinologyIchikawa HospitalInternational University of Health and WelfareIchikawaJapan
| | - Hiroshi Noto
- Division of Endocrinology and MetabolismSt. Luke's International HospitalTokyoJapan
| | - Hideki Origasa
- Department of Biostatistics and Clinical EpidemiologyGraduate School of Medicine and Pharmaceutical SciencesUniversity of ToyamaToyamaJapan
| | - Haruhiko Osawa
- Department of Diabetes and Molecular GeneticsEhime University Graduate School of MedicineToonJapan
| | - Akihiko Taguchi
- Department of Endocrinology, Metabolism, Hematological Science and TherapeuticsGraduate School of MedicineYamaguchi UniversityUbeJapan
| | - Yukio Tanizawa
- Department of Endocrinology, Metabolism, Hematological Science and TherapeuticsGraduate School of MedicineYamaguchi UniversityUbeJapan
| | - Kazuyuki Tobe
- First Department of Internal MedicineGraduate School of Medicine and Pharmaceutical SciencesUniversity of ToyamaToyamaJapan
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Soheili S, Pirdehghan Y, Hosseini SR. Effect of Lifestyle Educational Intervention on Blood Pressure in Diabetic Patients with Hypertension. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2020. [DOI: 10.29252/jech.7.1.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Kim JM, Kim MK, Joung KH, Lee JH, Kim HJ, Ku BJ. Association between glycemic state and pulmonary function and effect of walking as a protective factor in subjects with diabetes mellitus. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:530. [PMID: 31807512 DOI: 10.21037/atm.2019.09.139] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background Several population-based studies have shown that individuals with type 2 diabetes mellitus (T2DM) have decreased pulmonary function. Moreover, impaired pulmonary function is associated with all-cause mortality in T2DM. We investigated the association between glycemic state and pulmonary function and evaluated the role of walking as protective factor in subjects with diabetes using a nationwide, population-based, cross-sectional survey. Methods The study included 17,542 subjects: 2,195 with diabetes, 4,042 with prediabetes, and 11,305 with normal glucose tolerance. Furthermore, 1,770 subjects with available data on walking exercise were divided into three groups according to weekly exercise time: <150, 150-300, and ≥ 300 min/week. Results The diabetes group had reduced pulmonary function, particularly forced vital capacity (FVC) (P<0.001), and a decrease in pulmonary function was observed in the subjects with prediabetes (P<0.001). The walking exercise analysis revealed that the percentage of predicted FVC (P=0.001) and percentage of predicted forced expiratory volume in 1 s (P=0.021) were highest in the subjects with diabetes who walked ≥300 min/week after adjustment for age, sex, body mass index, and waist circumference (WC) measurements. Conclusions Pulmonary function was significantly associated with walking exercise in diabetic patients, and walking ≥300 min/week may have a preventive effect against pulmonary dysfunction in subjects with diabetes.
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Affiliation(s)
- Ji Min Kim
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Min Kyeong Kim
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Kyong Hye Joung
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Ju Hee Lee
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Hyun Jin Kim
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Bon Jeong Ku
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea.,Department of Medical Science, Chungnam National University College of Medicine, Daejeon, Republic of Korea
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Akinci B, Yeldan I, Celik S, Satman I. Physical Activity Indicators, Metabolic Biomarkers, and Comorbidity in Type 2 Diabetes. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2019; 90:690-698. [PMID: 31479402 DOI: 10.1080/02701367.2019.1645269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 07/15/2019] [Indexed: 06/10/2023]
Abstract
Purpose: This study aimed (1) to compare physical activity (PA) indicators, metabolic biomarkers, and comorbidity, (2) to investigate the relationship between PA indicators and metabolic biomarkers, comorbidity and (3) to identify barriers to PA in patients with type 2 diabetes (T2DM) who are using oral hypoglycaemic agent (OHA) or combined OHA and insulin (OHAiN). Methods: Sixty-one patients were classified as patients using only OHA or combined OHAiN. Metabolic biomarkers (waist-to-hip ratio, body mass index (BMI), lipid profile, glycosylated haemoglobin (HbA1c), fasting blood glucose, comorbidity and PA indicators (self-reported PA, number of steps (NOS), 6-minute walking distance (6MWD)) were assessed. PA perceptions and reasons for inactivity were questioned. Results: The comorbidity (p = .013), low-density lipoprotein-cholesterol (p = .026), total cholesterol (p = .008) and HbA1c (p = .020) were higher and PA level was lower (p = .007) in the OHAiN group. NOS was positively correlated with high-density lipoprotein-cholesterol (p = .037) and negatively correlated with BMI (p = .007). 6MWD was negatively correlated with BMI (p = .014) and comorbidity (p = .004) in the OHA group. BMI was a significant predictor of NOS (adjusted R2 = 0.242) and comorbidity for 6MWD (adjusted R2 = 0.250) in the OHA group. The majority of the patients (OHA = 34.3%, OHAiN = 42.3%) reported "lack of time" as the most common barrier to PA. Conclusions: This study showed that patients on OHAiN have lower PA levels, poorer metabolic profiles, and higher comorbidity rates than OHA users. PA indicators were related with some metabolic biomarkers and comorbidity in only OHA users. The most common reason for inactivity was "the lack of time" in both groups.
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Affiliation(s)
| | | | | | - Ilhan Satman
- Istanbul University-Istanbul Medical Faculty
- Health Institutes of Turkey
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Effect of Exercise on Risk Factors of Diabetic Foot Ulcers: A Systematic Review and Meta-Analysis. Am J Phys Med Rehabil 2019; 98:103-116. [PMID: 30020090 DOI: 10.1097/phm.0000000000001002] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The objectives of this study were to examine the effectiveness of different types of exercise on risk factors of diabetic foot ulcers, including glycated hemoglobin, peripheral arterial disease, and diabetic peripheral neuropathy, in people with type 2 diabetes mellitus. PubMed, Web of Science, Cochrane Library, Scopus, and CINAHL were searched from inception to January 2018 for relevant articles. Eligible studies were randomized controlled trials that examined effects of exercise on the selected risk factors. Twenty randomized controlled trials with 1357 participants were included in the meta-analyses. The differences in postintervention values of glycated hemoglobin and ankle brachial index between exercise and control groups were synthesized, yielding mean differences of -0.45% (P < 0.00001) and 0.03 (P = 0.002), respectively; the differences in within-group changes in glycated hemoglobin were synthesized, yielding mean differences of -0.19% (P = 0.1), -0.25% (P = 0.0006), and -0.64% (P = 0.006) for aerobic versus resistance, combined versus aerobic, and combined versus resistance exercise, respectively. Exercise has a significant effect on reducing glycated hemoglobin, whereas combined exercise is more effective compared with aerobic or resistance exercise alone. Exercise also improves ankle brachial index. However, evidence regarding the association between exercise and peripheral neuropathy and risks of diabetic foot ulcers in people with type 2 diabetes mellitus remains insufficient.
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Han SJ, Bae KH, Lee HJ, Kim SJ, Cho HJ. Association between regular walking and periodontitis according to socioeconomic status: a cross-sectional study. Sci Rep 2019; 9:12969. [PMID: 31506568 PMCID: PMC6736985 DOI: 10.1038/s41598-019-49505-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 08/22/2019] [Indexed: 02/08/2023] Open
Abstract
Physical activity reduces the risk and mortality risk of inflammatory diseases. This study aimed to examine the relationship between regular walking and periodontitis in a Korean representative sample of adults according to socioeconomic status. Data acquired by the Sixth Korea National Health and Nutrition Examination Survey in 2014 and 2015 were used. The survey was completed by 11,921 (5,175 males; 6,746 females) participants (≥19 years). Individuals without values on periodontitis were excluded, and 9,728 participants remained. Multivariable logistic regression analysis was done using socio-demographic characteristics (age, gender, income, education), oral health-related variables (flossing, interdental brushing, community periodontal index), oral and general health status and behaviour (smoking, diabetes mellitus), and regular walking. In all models, subjects who walked regularly had significantly lower risks of periodontitis. After adjusting for age, gender, income, education, smoking, diabetes mellitus, flossing, and interdental brushing, the odds ratio for periodontitis in subjects who walked regularly was 0.793 (95% Confidence interval: 0.700-0.898). Non-regular walking groups showed similar social gradients. Risk of low socioeconomic status was not significant in the regular walking group after adjusting for age, gender, income, and education. This study found that regular walking is associated to lower prevalence of periodontitis and can attenuate the relationship between periodontitis and low socioeconomic status.
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Affiliation(s)
- Su-Jin Han
- Department of Dental Hygiene, College of Health Science, Gachon University, Incheon, Korea
| | - Kwang-Hak Bae
- Oral Health Science Research Centre, Apple tree Dental Hospital, Goyang-si, Gyounggi-do, Korea, Seoul, Korea
| | - Hyo-Jin Lee
- Department of Dental Hygiene, College of Dentistry and Research Institute of Oral Science, Gangneung-Wonju National University, Gangeung, Korea
| | - Seon-Jip Kim
- Department of Preventive Dentistry & Public Oral Health, School of Dentistry, Seoul National University, Seoul, Korea.,Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Hyun-Jae Cho
- Department of Preventive Dentistry & Public Oral Health, School of Dentistry, Seoul National University, Seoul, Korea. .,Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.
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Ughreja RA, Ughreja RA. Type 2 diabetes mellitus, physical activity, yoga and telomere length: A literature review. JOURNAL OF INSULIN RESISTANCE 2019. [DOI: 10.4102/jir.v4i1.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: Type 2 diabetes mellitus (DM), a chronic metabolic disease prevalent in adults, is also prevalent amongst children, adolescents and young adults. On understanding the molecular basis of diabetes, a significant association is found between telomere length (TL) and type 2 DM.Aim: The aim of the study was to review the available evidence on effect of physical activity and yoga on DM including their effect on TL.Setting: The study was conducted in Bangalore.Method: A number of databases such as Google Scholar, PubMed and Cochrane Review were searched for relevant articles using keywords such as ’diabetes’, ‘type 2 DM’, ‘physical activity’, ‘yoga’, ‘TL’ and ‘telomerase activity’. All types of articles were included for the study, such as randomised controlled trial, systematic reviews, literature review and pilot study. Non-English articles were excluded from the study.Results: Studies have demonstrated the effectiveness of yoga and physical exercise in type 2 DM in various ways, such as reducing fasting blood glucose and glycosylated haemoglobin; improving lipid profile, blood pressure and waist-to-hip ratio; reducing inflammatory, oxidative and psychological stress markers; and improving the quality of life of patients. However, limited information is available on the effect of these interventions on TL in type 2 DM and mechanisms involved.Conclusion: Recent studies have shown positive effects of yoga and physical activity on TL. However, there is a dearth of good-quality studies evaluating the effects of yoga on TL in type 2 DM. Future studies need to be conducted with standard treatment protocols, long-term follow-up, appropriate control groups and large sample size.
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Höchsmann C, Müller O, Ambühl M, Klenk C, Königstein K, Infanger D, Walz SP, Schmidt-Trucksäss A. Novel Smartphone Game Improves Physical Activity Behavior in Type 2 Diabetes. Am J Prev Med 2019; 57:41-50. [PMID: 31128953 PMCID: PMC7719398 DOI: 10.1016/j.amepre.2019.02.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 02/20/2019] [Accepted: 02/21/2019] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Many type 2 diabetes patients show insufficient levels of physical activity and are often unmotivated to change physical activity behaviors. This study investigated whether a newly developed smartphone game delivering individualized exercise and physical activity promotion through an elaborate storyline can generate sustained improvements in daily physical activity (steps/day). STUDY DESIGN Thirty-six participants were enrolled in this 24-week RCT between August 2016 and April 2018. After baseline assessment, participants were randomized in equal numbers to the intervention or control condition. Data analysis was performed in May-June 2018. SETTING/PARTICIPANTS Inactive, overweight type 2 diabetes patients, aged 45-70 years, were recruited through advertising and from hospitals and diabetes care centers in the Basel, Switzerland, metropolitan area. INTERVENTION Participants were instructed to play the innovative smartphone game (intervention group) or to implement the recommendations from the baseline lifestyle counseling (control group) autonomously during the 24-week intervention period. MAIN OUTCOME MEASURES Primary outcomes were changes in daily physical activity (steps/day); changes in aerobic capacity, measured as oxygen uptake at the first ventilatory threshold; and changes in glycemic control, measured as HbA1c. RESULTS Daily physical activity increased by an average of 3,998 (SD=1,293) steps/day in the intervention group and by an average of 939 (SD=1,156) steps/day in the control group. The adjusted difference between the two groups was 3,128 steps/day (95% CI=2,313, 3,943, p<0.001). The increase in daily physical activity was accompanied by an improved aerobic capacity (adjusted difference of oxygen uptake at the first ventilatory threshold of 1.9 mL/(kg·min), 95% CI=0.9, 2.9, p<0.001). Glycemic control (HbA1c) did not change over the course of the intervention. CONCLUSIONS A novel, self-developed smartphone game, delivering multidimensional home-based exercise and physical activity promotion, significantly increases daily physical activity (steps/day) and aerobic capacity in inactive type 2 diabetes patients after 24 weeks. The ability of the game to elicit a sustained physical activity motivation may be relevant for other inactive target groups with chronic diseases. TRIAL REGISTRATION This study is registered at www.clinicaltrials.gov NCT02657018.
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Affiliation(s)
- Christoph Höchsmann
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland; Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Olivia Müller
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Muriel Ambühl
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Christopher Klenk
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Karsten Königstein
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Denis Infanger
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Steffen P Walz
- Centre for Design Innovation, Swinburne University of Technology, Melbourne, Australia
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Delevatti RS, Bracht CG, Lisboa SDC, Costa RR, Marson EC, Netto N, Kruel LFM. The Role of Aerobic Training Variables Progression on Glycemic Control of Patients with Type 2 Diabetes: a Systematic Review with Meta-analysis. SPORTS MEDICINE - OPEN 2019; 5:22. [PMID: 31175522 PMCID: PMC6555839 DOI: 10.1186/s40798-019-0194-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 05/20/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND Aerobic training (AT) improves glycemic control in patients with type 2 diabetes. However, the role of the progression of training variables remains unclear. The objective of this review was to analyze the effects of progressive AT (PAT) and non-progressive AT (NPAT) on glycated hemoglobin (HbA1c) in patients with type 2 diabetes. METHODS Data sources used were PubMed, Cochrane Central, Embase, SPORTDiscus, and LILACS. Studies that evaluated the effect of at least 12 weeks of PAT and NPAT compared to a control condition on HbA1c levels in type 2 diabetes patients were eligible for analysis. Two independent reviewers screened the search results, extracted the data, and assessed the risk of bias. Effect sizes (ESs) were calculated using the standardized mean difference in HbA1c levels between the intervention and control groups using a random-effect model. RESULTS Of 5848 articles retrieved, 24 randomized clinical trials (825 participants) were included. Among the included studies, 92% reported to have performed a randomization process, 8% presented allocation concealment, 21% reported blinding of outcome assessment, and 38% reported complete outcome data. AT reduced HbA1c levels by 0.65% (ES: - 1.037; 95% confidence interval [CI]: - 1.386, - 0.688; p < 0.001). The reduction in HbA1c induced by PAT was 0.84% (ES: - 1.478; 95% CI - 2.197, - 0.759; p < 0.001), and NPAT was 0.45% (ES: - 0.920; 95% CI - 1.329, - 0.512; p < 0.001). Subgroup analysis of the different forms of progression showed a reduction in HbA1c levels of 0.94% (ES: - 1.967; 95% CI - 3.783, - 0.151; p = 0.034) with progression in volume, 0.41% (ES: - 1.277; 95% CI - 2.499, - 0.056; p = 0.040) with progression in intensity, and 1.27% (ES: - 1.422; 95% CI - 2.544, - 0.300; p = 0.013) with progression in both volume and intensity. Subgroup analysis of the different modalities of AT showed a reduction of 0.69% (ES: - 1.078; 95% CI - 1.817, - 0.340; p = 0.004) with walking and/or running and of 1.12% (ES: - 2.614; 95% CI - 4.206, - 1.022; p = 0.001) with mixed protocols while progressive training was adopted. In non-progressive protocols, a significant HbA1c reduction was only found with walking and/or running (- 0.43%; ES: - 1.292; 95% CI - 1.856, - 0.72; p < 0.001). CONCLUSION The effect of PAT on glycemic control was greater than that of NPAT, especially when volume and intensity were progressively incremented throughout the interventions.
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Affiliation(s)
- Rodrigo Sudatti Delevatti
- Universidade Federal de Santa Catarina, Office 215, Deputado Edu Antônio Vieira St., Administrative Center, Sports Center, Pantanal District, Florianópolis, 88036-120 Brazil
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | | | | | - Nathalie Netto
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Ndahimana D, Go NY, Ishikawa-Takata K, Park J, Kim EK. Validity of the dietary reference intakes for determining energy requirements in older adults. Nutr Res Pract 2019; 13:256-262. [PMID: 31214294 PMCID: PMC6548704 DOI: 10.4162/nrp.2019.13.3.256] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 05/10/2019] [Accepted: 05/23/2019] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND/OBJECTIVES The objectives of this study were to evaluate the accuracy of the Dietary Reference Intakes (DRI) for estimating the energy requirements of older adults, and to develop and validate new equations for predicting the energy requirements of this population group. MATERIALS/METHODS The study subjects were 25 men and 23 women with a mean age of 72.2 ± 3.9 years and 70.0 ± 3.3 years, and mean BMI of 24.0 ± 2.1 and 23.9 ± 2.7, respectively. The total energy expenditure (TEE) was measured by using the doubly labeled water (DLW) method, and used to validate the DRI predictive equations for estimated energy requirements (EER) and to develop new EER predictive equations. These developed equations were cross-validated by using the leave-one-out technique. RESULTS In men, the DRI equation had a -7.2% bias and accurately predicted the EER (meaning EER values within ±10% of the measured TEE) for 64% of the subjects, whereas our developed equation had a bias of -0.1% and an accuracy rate of 84%. In women, the bias was -6.6% for the DRI equation and 0.2% for our developed equation, and the accuracy rate was 74% and 83%, respectively. The predicted EER was strongly correlated with the measured TEE, for both the DRI equations and our developed equations (Pearson's r = 0.915 and 0.908, respectively). CONCLUSIONS The DRI equations provided an acceptable prediction of EER in older adults and these study results therefore support the use of these equations in this population group. Our developed equations had a better predictive accuracy than the DRI equations, but more studies need to be performed to assess the performance of these new equations when applied to an independent sample of older adults.
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Affiliation(s)
- Didace Ndahimana
- Department of Food and Nutrition, Gangneung-Wonju National University, 7 Jukheon-gil, Gangneung 25457, Korea
| | - Na-Young Go
- Department of Food and Nutrition, Gangneung-Wonju National University, 7 Jukheon-gil, Gangneung 25457, Korea
| | - Kazuko Ishikawa-Takata
- Department of Nutrition and Metabolism, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan
| | - Jonghoon Park
- Department of Physical Education, Korea University, 145 Anam-Ro, Seongbuk-Gu, Seoul 02841, Korea
| | - Eun-Kyung Kim
- Department of Food and Nutrition, Gangneung-Wonju National University, 7 Jukheon-gil, Gangneung 25457, Korea
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Abstract
PURPOSE OF REVIEW Robust epidemiological evidence exists that lifelong regular exercise contributes to longevity. The aim of this review is to discuss recent findings regarding, which dose and type of physical activity promotes a long healthy life, free of disease. RECENT FINDINGS Meeting the currently recommended amounts of leisure time physical aerobic activity of moderate intensity of at least 150 min/week provides most of the longevity benefit. However, a higher duration and intensity augments the beneficial effect on cardiovascular health and metabolism. Performing three to five times the recommended physical activity minimum reaches the maximal longevity benefit, that can be achieved. Although it is not dangerous to perform even higher amounts of exercise, the benefit may decrease. A high maximal oxygen uptake in mid-life is a strong marker of longevity, whereas muscle mass is a critical prognostic factor in aging and cancer. SUMMARY Exercise training above the public health recommendations provides additional benefits regarding disease protection and longevity. Endurance exercise, including high-intensity training to improve cardiorespiratory fitness promotes longevity and slows down aging. Strength training should be added to slow down loss of muscle mass, associated with aging and disease.
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Affiliation(s)
- Bente Klarlund Pedersen
- Centre of Inflammation and Metabolism (CIM)/Centre for Physical Activity Research (CFAS), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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45
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Abstract
Physical inactivity is one of the leading health problems in the world. Strong epidemiological and clinical evidence demonstrates that exercise decreases the risk of more than 35 different disorders and that exercise should be prescribed as medicine for many chronic diseases. The physiology and molecular biology of exercise suggests that exercise activates multiple signaling pathways of major health importance. An anti-inflammatory environment is produced with each bout of exercise, and long-term anti-inflammatory effects are mediated via an effect on abdominal adiposity. There is, however, a need to close the gap between knowledge and practice and assure that basic research is translated, implemented, and anchored in society, leading to change of praxis and political statements. In order to make more people move, we need a true translational perspective on exercise as medicine, from molecular and physiological events to infrastructure and architecture, with direct implications for clinical practice and public health.
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Affiliation(s)
- Bente Klarlund Pedersen
- Centre of Inflammation and Metabolism/Centre for Physical Activity Research (CIM/CFAS), Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark
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Hoogendoorn SW, Rutten GE, Hart HE, de Wolf C, Vos RC. A simple to implement and low-cost supervised walking programme in highly motivated individuals with or at risk for type 2 diabetes: An observational study with a pre-post design. Prev Med Rep 2018; 13:30-36. [PMID: 30510891 PMCID: PMC6260274 DOI: 10.1016/j.pmedr.2018.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 09/05/2018] [Accepted: 11/05/2018] [Indexed: 12/30/2022] Open
Abstract
This observational study with a pre-post design, conducted in two Dutch primary healthcare centres, aimed to evaluate the effect of a supervised walking programme in highly motivated individuals with or at risk for type 2 diabetes mellitus (T2DM). Those able and willing to walk at least 6 km, were invited for a 28-week walking programme (February to August 2017), in which participants walked in groups, once weekly under supervision of volunteer healthcare professionals. Changes in bodyweight, BMI, waist circumference, HbA1c, blood pressure, well-being, health status and patient activation were analysed using paired t-tests and the Wilcoxon signed-rank test. Fifty-six people were included (30 T2DM; 26 at risk), of whom 60.7% were female. Mean age was 60.6 years, median BMI 30.8 kg/m2 and mean systolic blood pressure 146.9 mm Hg. Participants with T2DM had median HbA1c of 50.0 mmol/mol. Post-challenge, BMI had decreased to 29.7 kg/m2, and waist circumference decreased 3.4 cm (95% CI 2.1-4.8), both p < 0.01. Systolic and diastolic blood pressure decreased significantly (mean difference 6.5 mm Hg (95% CI 1.6-11.3, p = 0.01) and 3.5 mm Hg (95% CI 1.0-6.0, p < 0.01), respectively). Participants with HbA1c >53 mmol/mol at baseline (n = 8), had median decrease in HbA1c of 6.5 mmol/mol (p = 0.03). Well-being, but not health status and patient activation, improved significantly. In conclusion, in highly motivated individuals with or at risk for T2DM, this simple to implement and low-cost, but intensive, volunteer-based supervised walking programme is favourable, and therefore, can be seen as an option for clinical programs to implement to support highly motivated patients.
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Key Words
- BMI, body mass index
- DBP, diastolic blood pressure
- EMR, electronic medical record
- EQ-VAS, EuroQol-visual analogue scale
- HbA1c, glycosylated haemoglobin A1c
- Lifestyle intervention
- NC, Nijkerk Challenge
- PAM-13, 13-item patient activation measure
- Physical activity
- Prevention
- RCTs, randomised controlled trials
- Real-life setting
- SBP, systolic blood pressure
- T2DM, type 2 diabetes mellitus
- Type 2 diabetes mellitus
- WHO-5, World Health Organization five well-being index
- Walking
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Affiliation(s)
- Sonja W. Hoogendoorn
- Julius Center of Health Sciences and Primary Care, Department of General Practice, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Guy E.H.M. Rutten
- Julius Center of Health Sciences and Primary Care, Department of General Practice, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Huberta E. Hart
- Julius Center of Health Sciences and Primary Care, Department of General Practice, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Cees de Wolf
- Collaborating Health Centers Nijkerk, Nijkerk, the Netherlands
| | - Rimke C. Vos
- Julius Center of Health Sciences and Primary Care, Department of General Practice, University Medical Center Utrecht, Utrecht University, the Netherlands
- Leiden University Medical Center, Dept Public Health and Primary Care/LUMC-Campus The Hague, the Netherlands
- Corresponding author at: UMC Utrecht, div. Julius Centrum, Huispost Str. 6.131, PO Box 85500, 3508, GA, Utrecht, the Netherlands.
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47
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Davies MJ, D'Alessio DA, Fradkin J, Kernan WN, Mathieu C, Mingrone G, Rossing P, Tsapas A, Wexler DJ, Buse JB. Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia 2018; 61:2461-2498. [PMID: 30288571 DOI: 10.1007/s00125-018-4729-5] [Citation(s) in RCA: 739] [Impact Index Per Article: 123.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The American Diabetes Association and the European Association for the Study of Diabetes convened a panel to update the prior position statements, published in 2012 and 2015, on the management of type 2 diabetes in adults. A systematic evaluation of the literature since 2014 informed new recommendations. These include additional focus on lifestyle management and diabetes self-management education and support. For those with obesity, efforts targeting weight loss, including lifestyle, medication and surgical interventions, are recommended. With regards to medication management, for patients with clinical cardiovascular disease, a sodium-glucose cotransporter-2 (SGLT2) inhibitor or a glucagon-like peptide-1 (GLP-1) receptor agonist with proven cardiovascular benefit is recommended. For patients with chronic kidney disease or clinical heart failure and atherosclerotic cardiovascular disease, an SGLT2 inhibitor with proven benefit is recommended. GLP-1 receptor agonists are generally recommended as the first injectable medication.
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Affiliation(s)
- Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, UK.
- Leicester Diabetes Centre, Leicester General Hospital, Leicester,, LE5 4PW, UK.
| | - David A D'Alessio
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Judith Fradkin
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Walter N Kernan
- Department of Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Chantal Mathieu
- Clinical and Experimental Endocrinology, UZ Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Geltrude Mingrone
- Department of Internal Medicine, Catholic University, Rome, Italy
- Diabetes and Nutritional Sciences, King's College London, London, UK
| | - Peter Rossing
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- University of Copenhagen, Copenhagen, Denmark
| | - Apostolos Tsapas
- Second Medical Department, Aristotle University Thessaloniki, Thessaloniki, Greece
| | - Deborah J Wexler
- Department of Medicine and Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - John B Buse
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA
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48
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Tai Chi exercise is more effective than brisk walking in reducing cardiovascular disease risk factors among adults with hypertension: A randomised controlled trial. Int J Nurs Stud 2018; 88:44-52. [DOI: 10.1016/j.ijnurstu.2018.08.009] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 06/25/2018] [Accepted: 08/23/2018] [Indexed: 12/21/2022]
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49
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Davies MJ, D'Alessio DA, Fradkin J, Kernan WN, Mathieu C, Mingrone G, Rossing P, Tsapas A, Wexler DJ, Buse JB. Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2018; 41:2669-2701. [PMID: 30291106 PMCID: PMC6245208 DOI: 10.2337/dci18-0033] [Citation(s) in RCA: 1667] [Impact Index Per Article: 277.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The American Diabetes Association and the European Association for the Study of Diabetes convened a panel to update the prior position statements, published in 2012 and 2015, on the management of type 2 diabetes in adults. A systematic evaluation of the literature since 2014 informed new recommendations. These include additional focus on lifestyle management and diabetes self-management education and support. For those with obesity, efforts targeting weight loss, including lifestyle, medication, and surgical interventions, are recommended. With regards to medication management, for patients with clinical cardiovascular disease, a sodium-glucose cotransporter 2 (SGLT2) inhibitor or a glucagon-like peptide 1 (GLP-1) receptor agonist with proven cardiovascular benefit is recommended. For patients with chronic kidney disease or clinical heart failure and atherosclerotic cardiovascular disease, an SGLT2 inhibitor with proven benefit is recommended. GLP-1 receptor agonists are generally recommended as the first injectable medication.
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Affiliation(s)
- Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, U.K.,Leicester Diabetes Centre, Leicester General Hospital, Leicester, U.K
| | - David A D'Alessio
- Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Judith Fradkin
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD
| | - Walter N Kernan
- Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Chantal Mathieu
- Clinical and Experimental Endocrinology, UZ Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Geltrude Mingrone
- Department of Internal Medicine, Catholic University, Rome, Italy.,Diabetes and Nutritional Sciences, King's College London, London, U.K
| | - Peter Rossing
- Steno Diabetes Center Copenhagen, Gentofte, Denmark.,University of Copenhagen, Copenhagen, Denmark
| | - Apostolos Tsapas
- Second Medical Department, Aristotle University Thessaloniki, Thessaloniki, Greece
| | - Deborah J Wexler
- Department of Medicine and Diabetes Unit, Massachusetts General Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | - John B Buse
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
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50
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Delevatti RS, Kanitz AC, Alberton CL, Marson EC, Pantoja PD, Pinho CD, Lisboa SC, Kruel LFM. Glycemic Threshold as an Alternative Method to Identify the Anaerobic Threshold in Patients With Type 2 Diabetes. Front Physiol 2018; 9:1609. [PMID: 30483156 PMCID: PMC6243106 DOI: 10.3389/fphys.2018.01609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 10/25/2018] [Indexed: 11/13/2022] Open
Abstract
Purpose: To analyze the agreement between the velocity, heart rate, and oxygen uptake values corresponding to second ventilatory threshold and glycemic threshold in patients with type 2 diabetes. Methods: Twenty-four untrained patients (55.1 ± 8.9 years) were evaluated. Three different parameters of training intensity corresponding to anaerobic threshold, one mechanical (velocity) and two physiological (heart rate and oxygen uptake) parameters, were identified by a classical method (second ventilatory threshold) and by an alternative method (glycemic threshold). To determine the threshold values, patients performed an incremental treadmill test, with an initial velocity of 3 km.h-1 for 3 min, that was then increased by 1 km.h-1 every 2 min. Comparisons between mean values and the degree of agreement between second ventilatory threshold and glycemic threshold were analyzed using the paired t-test and Bland-Altman test, respectively. Results: All patients performed the tests appropriately, and no adverse effects were recorded. Patients demonstrated similar mean velocity (p = 0.25), heart rate (p = 0.97) and oxygen uptake (p = 0.71) between the ventilatory threshold (6.4 ± 0.6 km.h-1, 130.1 ± 18.7 bpm, 15.2 ± 3.5 ml.kg.min-1) and the glycemic threshold (6.2 ± 0.9 km.h-1, 130.2 ± 12.8 bpm, 15.0 ± 3.8 ml.kg.min-1). Conclusion: The present study indicates an agreement between the glycemic and second ventilatory methods in determination of the anaerobic threshold of patients with type 2 diabetes; and thus, either method may be used for these patients.
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Affiliation(s)
- Rodrigo S. Delevatti
- Sports Center, Department of Physical Education, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Ana Carolina Kanitz
- Department of Physical Education, Universidade Federal de Uberlândia, Uberlândia, Brazil
| | - Cristine L. Alberton
- Department of Physical Education, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Elisa Corrêa Marson
- Exercise Research Laboratory, Department of Physical Education, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Patricia Dias Pantoja
- Exercise Research Laboratory, Department of Physical Education, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Carolina DertzbocherFeil Pinho
- Exercise Research Laboratory, Department of Physical Education, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Salime Chedid Lisboa
- Exercise Research Laboratory, Department of Physical Education, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Luiz Fernando M. Kruel
- Exercise Research Laboratory, Department of Physical Education, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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