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Lee D, Lee H, Shin Y, Park G. Effectiveness of Non-pharmacological Interventions for Adolescents With Type 1 Diabetes in the Last Five Years: A Systematic Review and Meta-analysis. Asian Nurs Res (Korean Soc Nurs Sci) 2024; 18:51-59. [PMID: 38307162 DOI: 10.1016/j.anr.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 01/14/2024] [Accepted: 01/29/2024] [Indexed: 02/04/2024] Open
Abstract
PURPOSE Evidence on non-pharmacological interventions for adolescents with type 1 diabetes is unclear. This review aimed to evaluate the effectiveness of non-pharmacological intervention in adolescents with type 1 diabetes. METHODS We conducted a search on databases from November 11 to 19, 2022, for randomized controlled trials for the effects of non-pharmacological intervention in adolescents with type 1 diabetes. To identify recent research trends, we included studies published from 2017 to November 2022. The risk of bias was assessed using the Cochrane risk-of-bias tool 2.0. To estimate the effect size, a meta-analysis was performed using RevMan 5.4 program and R Studio. RESULTS A total of 45 studies were included in the systematic review. Among those, 30 studies were included in the meta-analysis. Non-pharmacological interventions were significantly effective in improving Glycated hemoglobin (HbA1c) (standardized mean difference [SMD] = -0.26, 95% confidence interval [CI]: -0.42, -0.09), quality of life (SMD = 0.44, 95% CI: 0.13 to 0.76), and anxiety (SMD = -0.91, 95% CI: -1.26, -0.56). Subgroup analysis showed that duration of intervention was not a covariate related to HbA1c levels. CONCLUSIONS Non-pharmacological interventions have shown effectiveness in improving the HbA1c, quality of life, and anxiety in adolescents with type 1 diabetes. Future studies with more rigorous methodology are needed to confirm and strengthen the validity of these findings. Additionally, attention to changes in the lipid profile and self-care motivation among adolescents with type 1 diabetes is warranted. TRIAL REGISTRATION NUMBER Prospective Register of Systematic Reviews (CRD42022382190).
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Affiliation(s)
- DaeEun Lee
- College of Nursing, Pusan National University, South Korea
| | - Haejung Lee
- College of Nursing/Research Institute of Nursing Science, Pusan National University, South Korea.
| | - YoonYoung Shin
- College of Nursing, Pusan National University, South Korea
| | - Gaeun Park
- College of Nursing/Research Institute of Nursing Science, Pusan National University, South Korea
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Nóvoa-Medina Y, Pérez-Lemes A, Suárez-Ramírez N, Barreiro-Bautista M, Fabelo H, López-López S, Quinteiro S, Domínguez A, León M, González MA, Caballero E, Wägner AM. Impact of a Mediterranean diet, physical activity, body composition, and insulin delivery methods on metabolic control in children with type 1 diabetes. Front Nutr 2024; 10:1338601. [PMID: 38249596 PMCID: PMC10799333 DOI: 10.3389/fnut.2023.1338601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 12/14/2023] [Indexed: 01/23/2024] Open
Abstract
Aims To evaluate the synergistic impact of diet, lifestyle and technology on glycemic control in children with type 1 diabetes (T1D). Methods This cross-sectional study included 112 randomly selected patients with T1D from Gran Canaria (median age 12 years; 51.8% female). The study collected data on height, weight, body composition (bioimpedance), age, disease duration, and method of insulin delivery. Physical activity was evaluated using the Krece questionnaire and an accelerometer (GENEActiv). Adherence to the Mediterranean diet was assessed using the KIDMED Quick Nutrition Test. Glycemic control was evaluated using HbA1c and the percentage of time in range. SPSS version 21 and RStudio were used for statistical analysis of the data. Stepwise linear regression analysis (backwards) was used to identify factors independently associated with metabolic control. Results Insulin pump use, age and adherence to the Mediterranean diet were found to be significantly and independently associated with better glycemic control, whereas years with T1D was associated with worse HbA1c values. No relationship was found between body composition and physical activity measured by accelerometry or questionnaire. Conclusion Adherence to the Mediterranean diet, insulin delivery methods, age, and number of years with T1D are important factors to consider in the management of T1D in children.
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Affiliation(s)
- Yeray Nóvoa-Medina
- Pediatric Endocrinology Unit, Complejo Hospitalario Universitario Insular Materno Infantil de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
- Asociación Canaria para la Investigación Pediátrica (ACIP Canarias), Las Palmas de Gran Canaria, Canary Islands, Spain
- Instituto Universitario de Investigación Biomédica y Sanitaria (IUIBS), Las Palmas de Gran Canaria University, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Alicia Pérez-Lemes
- Faculty of Medicine, Las Palmas de Gran Canaria University, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Nerea Suárez-Ramírez
- Faculty of Medicine, Las Palmas de Gran Canaria University, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Marta Barreiro-Bautista
- Instituto Universitario de Investigación Biomédica y Sanitaria (IUIBS), Las Palmas de Gran Canaria University, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Himar Fabelo
- Complejo Hospitalario Universitario Insular—Materno Infantil, Fundación Canaria Instituto de Investigación Sanitaria de Canarias, Las Palmas de Gran Canaria, Spain
- Research Institute for Applied Microelectronics, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Sara López-López
- Pediatric Endocrinology Unit, Complejo Hospitalario Universitario Insular Materno Infantil de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Sofia Quinteiro
- Pediatric Endocrinology Unit, Complejo Hospitalario Universitario Insular Materno Infantil de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Angela Domínguez
- Pediatric Endocrinology Unit, Complejo Hospitalario Universitario Insular Materno Infantil de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Marta León
- Pediatric Endocrinology Unit, Complejo Hospitalario Universitario Insular Materno Infantil de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - María A. González
- Pediatric Endocrinology Unit, Complejo Hospitalario Universitario Insular Materno Infantil de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Elisabeth Caballero
- Pediatric Endocrinology Unit, Complejo Hospitalario Universitario Insular Materno Infantil de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Ana M. Wägner
- Instituto Universitario de Investigación Biomédica y Sanitaria (IUIBS), Las Palmas de Gran Canaria University, Las Palmas de Gran Canaria, Canary Islands, Spain
- Endocrinology and Metabolism Unit, Complejo Hospitalario Universitario Insular Materno Infantil de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
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de Souza E, Meneses-Santos D, Santos JC, Aidar FJ, Carvalho CRDO, dos Santos JL, Marçal AC. "Does Physical Exercise Promote Health Benefits for Diabetic Patients during the COVID-19 Pandemic?": A Systematic Review. Sports (Basel) 2023; 11:192. [PMID: 37888519 PMCID: PMC10610946 DOI: 10.3390/sports11100192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 10/28/2023] Open
Abstract
Patients affected by COVID-19 are prone to facing disorders in multiple systems and organs, which can lead to deleterious diseases; in addition, people with pre-existing diseases may be more prone to the worst outcomes, and the most vulnerable are patients with type 1 and type 2 diabetes mellitus. The aim of this systematic review was to evaluate the effects of physical activity and/or physical exercise prescribed to individuals with diabetes on the maintenance of plasma glucose and glycated hemoglobin during the COVID-19 pandemic. Studies were found by searching PubMed, SCOPUS, Embase, Web of Science, SciELO, LILACS, SportDiscus, Bireme/BVS and Google Scholar databases. The inclusion criteria were articles that addressed only patients with type 1 or type 2 diabetes (T1D and T2D) who had evaluated the level of physical activity or physical exercise and described the effects on plasma glucose and/or glycated hemoglobin in cross-sectional, retrospective, and observational studies, meeting the main criteria established by GRADE. The PICO and GRADE strategies were used to select and assess the methodological quality of studies. Two reviewers searched and selected the articles in databases independently and blindly, during which oppositions and disagreements about the inclusion of articles were discussed and resolved by a third reviewer. Evidence corroborates that levels of physical activity were reduced due to the lockdown, leading to increased body weight and worse glycemic control. On the other hand, individuals with diabetes mellitus (DM) (T1D and T2D) who maintained and/or increased levels of physical activity or physical exercise showed reduced plasma glucose and glycated hemoglobin (HbA1c) levels. Adequate levels of physical exercise and physical activity are beneficial for glucose and HbA1c control in diabetic patients (type 1 or type 2). In addition, maintaining adequate levels of physical activity can contribute to reducing health problems when these patients are infected with COVID-19.
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Affiliation(s)
- Erivaldo de Souza
- Postgraduate Program of Physical Education, Universidade Federal de Sergipe, São Cristóvão 49100-000, SE, Brazil; (E.d.S.); (J.C.S.); (F.J.A.); (J.L.d.S.)
| | - Daniela Meneses-Santos
- Department of Morphology, Universidade Federal de Sergipe, São Cristóvão 49100-000, SE, Brazil;
| | - Josué Cruz Santos
- Postgraduate Program of Physical Education, Universidade Federal de Sergipe, São Cristóvão 49100-000, SE, Brazil; (E.d.S.); (J.C.S.); (F.J.A.); (J.L.d.S.)
| | - Felipe J. Aidar
- Postgraduate Program of Physical Education, Universidade Federal de Sergipe, São Cristóvão 49100-000, SE, Brazil; (E.d.S.); (J.C.S.); (F.J.A.); (J.L.d.S.)
- Department of Physical Education, Universidade Federal de Sergipe, São Cristóvão 49100-000, SE, Brazil
| | | | - Jymmys Lopes dos Santos
- Postgraduate Program of Physical Education, Universidade Federal de Sergipe, São Cristóvão 49100-000, SE, Brazil; (E.d.S.); (J.C.S.); (F.J.A.); (J.L.d.S.)
| | - Anderson Carlos Marçal
- Postgraduate Program of Physical Education, Universidade Federal de Sergipe, São Cristóvão 49100-000, SE, Brazil; (E.d.S.); (J.C.S.); (F.J.A.); (J.L.d.S.)
- Department of Morphology, Universidade Federal de Sergipe, São Cristóvão 49100-000, SE, Brazil;
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