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Whyte M, Daeninck F, Linton J, Fowler-Woods M, Fowler-Woods A, Shingoose G, Vergis A, He W, Hardy K. Experiences and Outcomes of Indigenous Patients Undergoing Bariatric Surgery: a Mixed-Method Scoping Review. Obes Surg 2024; 34:1343-1357. [PMID: 38400946 DOI: 10.1007/s11695-024-07089-5] [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: 10/19/2023] [Revised: 01/27/2024] [Accepted: 02/02/2024] [Indexed: 02/26/2024]
Abstract
Obesity and type 2 diabetes (T2D) are growing global health concerns. Evidence suggests that Indigenous peoples are at higher lifetime risk of obesity and its associated conditions. Obesity increases the risk of T2D, cardiovascular disease, and all-cause mortality. Bariatric surgery is the most sustained and effective intervention for treating obesity-associated medical problems. This review aims to explore the experiences and outcomes of Indigenous peoples undergoing bariatric surgery in Canada, the USA, Australia, and New Zealand (CANZUS). Analysis of quantitative data revealed that Indigenous patients had fewer bariatric procedures, poorer clinic attendance, similar weight loss outcomes and slightly higher post-operative complication rates. Qualitative data analysis revealed that Indigenous patients living with obesity have a desire to improve their health and quality of life.
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Affiliation(s)
- Marta Whyte
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Felicia Daeninck
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | | | - Melinda Fowler-Woods
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Amanda Fowler-Woods
- Ongomiizwin Indigenous Institute for Health and Healing, University of Manitoba, Winnipeg, MB, Canada
| | - Geraldine Shingoose
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Ashley Vergis
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Wenjing He
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Krista Hardy
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.
- St. Boniface General Hospital, Z3053-409 Taché Avenue, Winnipeg, MB, R2H 2A6, Canada.
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Hale L, Higgs C, Keen D, Smith C. It Is “All About Relationships” in Lifestyle Programmes for Adults Living With Type Two Diabetes Underpinned by a Person/Whānau-Centred Care Approach. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:829542. [PMID: 36189031 PMCID: PMC9397719 DOI: 10.3389/fresc.2022.829542] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 04/08/2022] [Indexed: 01/15/2023]
Abstract
Background Lifestyle programmes are important in the management of type 2 diabetes (T2D). The Diabetes Community Exercise Programme (DCEP) is an exercise and educational programme for adults living with T2D with the aim of enhancing exercise self-efficacy and supporting wellbeing. DCEP is underpinned by a model of person/whānau-centred care and the spirit of Motivational Interviewing. Person-centred care models in the context of rehabilitation and long-term health conditions are still evolving. This paper explores what those involved in DCEP perceived important to its person/whānau-centredness. Method An evaluative qualitative methodological approach was used with data collected by open-ended interviews and a focus-group at completion of the initial 12-week part of DCEP. Interviews were audio-recorded and transcribed verbatim. Participants were 16 DCEP attendees and 13 healthcare professionals (HCPs) involved in DCEP delivering. Data were analysed using the General Inductive Approach. Results The three interconnected themes constructed from the analysis were ‘It's all about relationships’, Balancing the Outside World, and Empowering through Knowledge. Through the experience and motivation of positive person-centred relationships, DCEP addressed attendees' T2D health needs, but they were constantly balancing these needs with those of family, employers, finances, other health needs and life interests. DCEP relationships facilitated ongoing discussions between attendees and between attendees and HCPs. The ability to discuss in a supportive and non-judgmental environment helped attendees to make sense and process the information they gained at DCEP. This empowering through knowledge in turn helped attendees to work out ways of balancing the outside world and thus better address their T2D needs. Conclusion It is “all about relationships” was key to DCEP's person/whānau-centred approach—all other factors related back to the development and maintenance of relationships. These relationships were between all whānau involved: the attendees, their family, the wider community, the healthcare provider organisations, and the HCPs and personnel involved in delivering DCEPs. These relationships created an accepting, understanding and social atmosphere that enabled attendance and facilitated both knowledge exchange and ability to exercise, both considered to be beneficial by attendees. Importantly, these relationships took time to develop, but the benefits were worth the investment.
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Hale L, Higgs C, Gray A, Mann J, Mani R, Sullivan T, Terry J, Keen D, Stokes T. The diabetes community exercise programme plus usual care versus usual care in patients with type 2 diabetes: A randomised, two-arm, parallel, open-label trial. EClinicalMedicine 2022; 46:101361. [PMID: 35360148 PMCID: PMC8961191 DOI: 10.1016/j.eclinm.2022.101361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 02/15/2022] [Accepted: 03/03/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Exercise is important in type 2 diabetes (T2D) management. Focussing on Māori and Pacific people and those from deprived circumstances, the Diabetes Community Exercise Programme (DCEP) was developed to engage people with T2D in exercise. We report the evaluation of whether being offered DCEP (plus usual care) was more effective than usual care in improving glycaemic control at 1-year. METHODS A randomised, two-arm, parallel, open-label trial with blinding of outcome assessor and data analyst. Adults (age ≥35 years) with T2D recruited from two New Zealand (NZ) communities were randomised, using opaque sealed envelopes and stratified by centre with random block lengths, to DCEP or usual care. DCEP comprises twice-weekly, two-hour sessions of exercise and education over 12-weeks, followed by a twice-weekly maintenance exercise class. The primary outcome was between-group differences in mean changes of glycated haemoglobin (HbA1c) from baseline to 1-year follow-up with intention-to treat analysis. This trial is registered with the Australian NZ Clinical Trials Registry (ANZCTR): ACTRN12617001624370p and is closed to new participants. FINDINGS From 2018 - 2019, of 294 people screened, 165 (mean age 63·8, SD16·2 years, 56% female, 78·5% European, 14% Māori, 6% Pacific, 27% most deprived) were baseline evaluated, randomised, and analysed at study end (DCEP = 83, control = 82). Multimorbidity (≥2) and polypharmacy (>5 medications) were high (82%, 69%). We found no statistically significant between-groups differences in HbA1c (mmol/mol) change at 15 months (mean 3% higher in DCEP, 95% CI 2% lower to 8% higher, p = 0·23). Twelve-week intervention adherence was good (41% attended >80% available sessions). No adverse events were reported. INTERPRETATION DCEP was not effective in improving glycaemic control, possibly due to insufficient exercise intensity. Our attendance demonstrated DCEP's cultural accessibility. DCEP might be good to engage in exercise marginalised people with high Hb1Ac levels, multimorbidity, and high polypharmacy. FUNDING Health Research Council of New Zealand.
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Affiliation(s)
- L. Hale
- Centre of Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, 325 Great King Street, Dunedin 9016, PO Box 56, Dunedin 9054, New Zealand
- Corresponding author.
| | - C. Higgs
- Centre of Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, 325 Great King Street, Dunedin 9016, PO Box 56, Dunedin 9054, New Zealand
| | - A.R. Gray
- Biostatistics Centre, University of Otago, Dunedin, Otago, New Zealand
| | - J. Mann
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - R. Mani
- Centre of Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, 325 Great King Street, Dunedin 9016, PO Box 56, Dunedin 9054, New Zealand
| | - T. Sullivan
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - J. Terry
- Centre of Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, 325 Great King Street, Dunedin 9016, PO Box 56, Dunedin 9054, New Zealand
| | - D. Keen
- Centre of Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, 325 Great King Street, Dunedin 9016, PO Box 56, Dunedin 9054, New Zealand
| | - T. Stokes
- Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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Li J, Jiang R, Cheng W, Ma H. A Study Using Power Cycling on the Affective Responses of a Low-Volume High-Intensity Interval Training to Male Subjects with Type 2 Diabetes in Different Physical Activity Status. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:1255943. [PMID: 34876964 PMCID: PMC8645398 DOI: 10.1155/2021/1255943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/02/2021] [Accepted: 11/06/2021] [Indexed: 11/18/2022]
Abstract
High-intensity interval training (HIIT) has been shown in studies to enhance glucose management and cardiovascular well-being in patients with type 2 diabetes. In this study, we used power cycling to assess the physical activity levels of men with type 2 diabetes during a single low-volume HIIT session. First, fifty-six men with type 2 diabetes volunteered to take part in the study, and they were split into two groups based on the International Physical Activity Scale Short Form (IPA). To the first 1-4 labor bouts, both the sufficiently physically active and insufficiently physically active groups exhibited equal positive emotional reactions (p > 0.05). However, over time (about 5-10 times), both of them showed reduced emotional reactions, with a significant difference (p < 0.01). The insufficiently physically active group had lower mean emotional response, lowest effective response, and maximum effective response values than the sufficiently physically active group (p < 0.001), while the difference in RPE between the two groups was not statistically significant (p > 0.05). From the standpoint of emotional response, the proposed model shows that HIIT or reduced volume HIIT exercise prescriptions should be utilized with caution in physical activity programs for novices and less active and chronically sick persons. The frequency, intensity, and effects of low-volume HIIT on individuals' emotional reactions and health conditions in the T2DM group are also investigated. Furthermore, this low-volume HIIT program can be successfully applied in the real-world setting of people who are not physically active enough or who are chronically unwell.
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Affiliation(s)
- Jun Li
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China
| | - Ruichen Jiang
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China
| | - Wei Cheng
- Department of Endocrinology, Yangpu Hospital, Tongji University, Shanghai 200090, China
| | - Haifeng Ma
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China
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Chepulis L, Morison B, Cassim S, Norman K, Keenan R, Paul R, Lawrenson R. Barriers to Diabetes Self-Management in a Subset of New Zealand Adults with Type 2 Diabetes and Poor Glycaemic Control. J Diabetes Res 2021; 2021:5531146. [PMID: 34136579 PMCID: PMC8177985 DOI: 10.1155/2021/5531146] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 05/02/2021] [Accepted: 05/21/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Despite the fact that there is an increasingly effective armoury of medications to treat diabetes, many people continue to have substantially elevated blood glucose levels. The purpose of this study was to explore what the barriers to diabetes management are in a cohort of people with diabetes and poor glycaemic control. METHODS Qualitative semistructured interviews were carried out with 10 people with diabetes who had known diabetes and a recent HbA1c of >11.3% (100 mmol/mol) to explore their experiences of barriers to diabetes self-management and glycaemic control. RESULTS Barriers to diabetes management were based around two key themes: biopsychosocial factors and knowledge about diabetes. Specifically, financial concerns, social stigma, medication side effects, and cognitive impairment due to hyperglycaemia were commonly reported as barriers to medication use. Other barriers included a lack of knowledge about their own condition, poor relationships with healthcare professionals, and a lack of relevant resources to support diet and weight loss. CONCLUSION People with diabetes with poor glycaemic control experience many of the same barriers as those reported elsewhere, but also experience issues specifically related to their severe hyperglycaemia. Management of diabetes could be improved via the increased use of patient education and availability of locally relevant resources.
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Affiliation(s)
- Lynne Chepulis
- Medical Research Centre, University of Waikato, Hamilton, New Zealand
| | - Brittany Morison
- Medical Research Centre, University of Waikato, Hamilton, New Zealand
| | - Shemana Cassim
- Medical Research Centre, University of Waikato, Hamilton, New Zealand
| | - Kimberley Norman
- Medical Research Centre, University of Waikato, Hamilton, New Zealand
| | - Rawiri Keenan
- Medical Research Centre, University of Waikato, Hamilton, New Zealand
| | - Ryan Paul
- Medical Research Centre, University of Waikato, Hamilton, New Zealand
- Waikato District Health Board, Waikato, Hamilton, New Zealand
| | - Ross Lawrenson
- Medical Research Centre, University of Waikato, Hamilton, New Zealand
- Waikato District Health Board, Waikato, Hamilton, New Zealand
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Nazari M, Shabani R, Dalili S. The effect of concurrent resistance-aerobic training on serum cortisol level, anxiety, and quality of life in pediatric type 1 diabetes. J Pediatr Endocrinol Metab 2020; 33:599-604. [PMID: 32284450 DOI: 10.1515/jpem-2019-0526] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/24/2020] [Indexed: 02/01/2023]
Abstract
Background Given the importance of anxiety and quality of life for the mental health of children with type 1 diabetes (T1D), exercise prescription can be of crucial significance. The present study aims to explore the effect of concurrent resistance-aerobic training on serum cortisol level, anxiety, and quality of life among pediatric T1D. Methods Forty children (aged 8-14 years) were randomly assigned to experimental (n = 20) and control groups (n = 20) for 16 weeks. The exercise training program was composed of 16 weeks of interval concurrent resistance-aerobic training with a duration of 60 min performed three times a week. The subjects first performed the resistance training (20 min of Pilates exercises and 20 min of body weight-bearing exercises). Then, the aerobic exercises were performed with an intensity of 50-75% of maximum heart rate. Before and after the training, blood tests including cortisol were carried out on the subjects by RIA kit. Anxiety and quality of life were measured by the Revised Children's Manifest Anxiety Scale (RCMAS) and Pediatric Quality of Life (PedsQL), respectively. Body composition was measured by InBody. Data were analyzed by paired and independent t-test at p < 0.05 significance level. Results Sixteen weeks of concurrent resistance-aerobic exercise significantly reduced the anxiety index (p = 0.001) and increased the quality of life (p = 0.003). Although the cortisol index was increased, it did not reveal any significant differences between the experimental and control groups (p = 0.781). No significant differences were observed in the indices of quality of life, anxiety, and cortisol in the control group. Conclusions A 16-week program of concurrent resistance-aerobic training can improve the quality of life and anxiety among children suffering from T1D, but it may not influence the cortisol level (p > 0.05).
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Affiliation(s)
- Marzieh Nazari
- PhD Candidate of Exercise Physiology, Faculty of Humanities, Rasht Brunch, Islamic Azad University, Rasht, Iran.,Young Researchers and Elite Club, Rasht Brunch, Islamic Azad University, Rasht, Iran
| | - Ramin Shabani
- Associate Professor, Department of Exercise, Physiology, Faculty of Humanities, Rasht Brunch, Islamic Azad University, Rasht 147654919, Iran, Phone: (+98) 9112324796, 1333424309
| | - Setila Dalili
- Department of Pediatric Endocrinology, Pediatric Growth Disorders Research Center, 17 Shahrivar Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, IR Iran
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Dearie C, Dubois S, Simmons D, MacMillan F, McBride KA. A Qualitative Exploration of Fijian Perceptions of Diabetes: Identifying Opportunities for Prevention and Management. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071100. [PMID: 30934779 PMCID: PMC6480118 DOI: 10.3390/ijerph16071100] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 03/22/2019] [Accepted: 03/25/2019] [Indexed: 11/16/2022]
Abstract
Rates of diabetes are high in many communities of Pacific Island peoples, including people from Fiji. This qualitative study explores knowledge and attitudes towards diabetes among i-Taukei Fijians to facilitate the cultural tailoring of diabetes prevention and management programs for this community. Fijians aged 26 to 71 years (n = 15), residing in Australia, participated in semi-structured interviews; 53% (n = 8) were male. Interviews were audio-recorded, transcribed verbatim, then thematically analyzed. Diabetes is recognized as an important and increasing health problem requiring action in the i-Taukei Fijian community. Widespread support for culturally appropriate lifestyle interventions utilizing existing societal structures, like family networks and church groups, was apparent. These structures were also seen as a crucial motivator for health action. Intervention content suggestions included diabetes risk awareness and education, as well as skills development to improve lifestyle behaviors. Leveraging existing social structures and both faith and family experiences of diabetes within the Fijian community may help convert increased awareness and understanding into lifestyle change. Ongoing in-community support to prevent and manage diabetes was also regarded as important. We recommend building upon experience from prior community-based interventions in other high-risk populations, alongside our findings, to assist in developing tailored diabetes programs for Fijians.
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Affiliation(s)
- Catherine Dearie
- School of Public Health and Community Medicine, University of New South Wales Kensington Campus, Randwick, NSW 2052, Australia.
- School of Science and Health, Western Sydney University, Penrith, NSW 2750, Australia.
| | - Shamieka Dubois
- School of Science and Health, Western Sydney University, Penrith, NSW 2750, Australia.
| | - David Simmons
- School of Medicine, Western Sydney University, Penrith, NSW, 2750, Australia.
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW 2750, Australia.
| | - Freya MacMillan
- School of Science and Health, Western Sydney University, Penrith, NSW 2750, Australia.
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW 2750, Australia.
| | - Kate A McBride
- School of Medicine, Western Sydney University, Penrith, NSW, 2750, Australia.
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW 2750, Australia.
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Ndwiga DW, MacMillan F, McBride KA, Simmons D. Lifestyle Interventions for People with, and at Risk of Type 2 Diabetes in Polynesian Communities: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15050882. [PMID: 29710788 PMCID: PMC5981921 DOI: 10.3390/ijerph15050882] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 04/25/2018] [Accepted: 04/26/2018] [Indexed: 01/14/2023]
Abstract
There is evidence that lifestyle intervention among Polynesian people can reduce diabetes incidence and complications, but this evidence has not been systematically reviewed. The aim of this study was to systematically review the efficacy of lifestyle interventions, targeting the prevention and management of type 2 diabetes among Polynesian people. MEDLINE, Web of Science, Cochrane Library, and Embase were searched to find randomised controlled trials (RCTs) and pre-post studies. Eight studies (four RCTs and four pre-post studies) with 1590 participants met the inclusion criteria. The data on health outcomes that was reported in these studies included blood pressure, body mass index, waist circumference, weight, and glycated haemoglobin (HbA1c). The meta-analyses showed that the interventions had resulted in statistically significant reductions in systolic blood pressure (SBP) across four of the studies (WMD, −9.93 mmHg; 95% Cl, −10.77 to −9.09; and p < 0.00001). However, the effects on weight across five of the studies (WMD, −1.15 kg; 95% Cl, −2.80 to 0.51; p = 0.18) and the HbA1c levels across two of the studies (WMD, −0.38%; 95% Cl, −1.15 to 0.39; and p = 0.33) were not statistically significant. This review provides evidence that lifestyle interventions may be effective in achieving modest reductions in SBP in Polynesian people. Further research is needed to fully assess the effectiveness of these interventions in this population long-term.
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Affiliation(s)
- Dorothy W Ndwiga
- School of Science and Health, Western Sydney University, Penrith 2751, Australia.
| | - Freya MacMillan
- School of Science and Health, Western Sydney University, Penrith 2751, Australia.
| | - Kate A McBride
- School of Medicine, Western Sydney University, Penrith 2751, Australia.
- Translational Health Research Institute, Western Sydney University, Penrith 2751, Australia.
| | - David Simmons
- School of Medicine, Western Sydney University, Penrith 2751, Australia.
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Glover M, Kira A, Kira G, McRobbie H, Breier BH, Kruger R, Stephen J, Funaki-Tahifote M. An innovative team-based weightloss competition to reduce cardiovascular and diabetes risk among Māori and Pacific people: rationale and method for the study and its evaluation. BMC Nutr 2017; 3:78. [PMID: 32153855 PMCID: PMC7050897 DOI: 10.1186/s40795-017-0199-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 10/03/2017] [Indexed: 11/18/2022] Open
Abstract
Background Obesity rates for New Zealand (NZ) Pacific and Māori (NZ indigenous people) are among the highest in the world. Long-term results of weight management programmes for adults have been modest but primarily focused on individuals. This paper describes the rationale and methodology for a trial of a culturally tailored team-based weightloss competition conducted online with community level support. Methods/Design A quasi-experimental design was used to compare an intervention and control group. Three six-month competitions with seven teams of seven Māori or Pacific people (N = 147) were run. Eligible participants were: Māori or Pacific, 16 years of age and above, obese (BMI ≥30 kg/m2) and either at risk of or already diagnosed with type 2 diabetes (HbA1c >50 mmol/mol) or cardiovascular disease. The intervention facilitated group use of an internet-based competition offering financial incentives, education and support. The primary outcome was percentage of individual weight lost at 12-months. Secondary outcomes were percentage reduced total cholesterol and glycated haemoglobin (HbA1c). Data collected at baseline, 6-months and 12-months included: height, body weight, blood lipids and HbA1c, eating and dieting habits, family support, food access, alcohol use, nutrition literacy, activity levels, perceptions of weight, stress and sleep, and, perceived contagion effect. Process evaluation tasks will inform acceptability. Discussion An attractive, easy to understand weight change programme that effectively reduces disease risk among Māori and Pacific is desperately needed. Web-based delivered support and information to largely self-directed teams could also ease exponential rises in costs to the health system. Trial registration Trial Id: ACTRN12617000871347.
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Affiliation(s)
- Marewa Glover
- 1School of Health Sciences, College of Health, Massey University, Albany Highway, Albany, Auckland, 0632 New Zealand
| | | | - Geoff Kira
- 1School of Health Sciences, College of Health, Massey University, Albany Highway, Albany, Auckland, 0632 New Zealand
| | | | - Bernhard H Breier
- 4School of Sport, Exercise and Nutrition, College of Health, Massey University, Private Bag 102904, North Shore, Auckland, 0745 New Zealand
| | - Rozanne Kruger
- 4School of Sport, Exercise and Nutrition, College of Health, Massey University, Private Bag 102904, North Shore, Auckland, 0745 New Zealand
| | - Jane Stephen
- 1School of Health Sciences, College of Health, Massey University, Albany Highway, Albany, Auckland, 0632 New Zealand
| | - Mafi Funaki-Tahifote
- Pacific Heartbeat, Heart Foundation, PO Box 17-160, Greenlane, Auckland, 1546 New Zealand
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Wormgoor SG, Dalleck LC, Zinn C, Harris NK. Effects of High-Intensity Interval Training on People Living with Type 2 Diabetes: A Narrative Review. Can J Diabetes 2017; 41:536-547. [PMID: 28366674 DOI: 10.1016/j.jcjd.2016.12.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 10/16/2016] [Accepted: 12/05/2016] [Indexed: 12/17/2022]
Abstract
People with type 2 diabetes typically present with comorbidities, such as elevated blood pressure, high cholesterol, high blood glucose, obesity and decreased fitness, all contributive to increased risk for cardiovascular complications. Determination of effective exercise modalities for the management of such complications is important. One such modality is high-intensity interval training (HIIT). To conduct the review, PubMed and EBSCOHost databases were searched through June 1, 2016, for all HIIT intervention studies conducted in people living with type 2 diabetes. Thereafter, the central characteristics of HIIT were analyzed to obtain a broader understanding of the cardiometabolic benefits achievable by HIIT. Fourteen studies were included for review, but the heterogeneity of the participants with type 2 diabetes, the training equipment and HIIT parameters, accompanied by variations in supervision, dietary advice and medications, prevented direct comparisons. However HIIT, regardless of the specific parameters employed, was a suitable option in pursuing improved glycemic control, body composition, aerobic fitness, blood pressure and lipidemia measures in individuals with type 2 diabetes. HIIT is a therapy with at least equivalent benefit to moderate-intensity continuous training; hence, HIIT should be considered when prescribing exercise interventions for people living with type 2 diabetes.
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Affiliation(s)
- Shohn G Wormgoor
- U-Kinetics Exercise and Wellness Clinic, Faculty of Health and Sciences, Universal College of Learning, Masterton, New Zealand; AUT Millennium Campus, Human Potential Centre, Auckland University of Technology, Rosedale, Auckland, New Zealand
| | - Lance C Dalleck
- High Altitude Exercise Physiology Program, Western State Colorado University, Gunnison, Colorado, United States
| | - Caryn Zinn
- AUT Millennium Campus, Human Potential Centre, Auckland University of Technology, Rosedale, Auckland, New Zealand
| | - Nigel K Harris
- AUT Millennium Campus, Human Potential Centre, Auckland University of Technology, Rosedale, Auckland, New Zealand.
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Pilates-Based Mat Exercises and Parameters of Quality of Life in Women With Type 2 Diabetes. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016. [DOI: 10.5812/ircmj.21919] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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12
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Dietary habits of Samoan adults in an urban Australian setting: a cross-sectional study. Public Health Nutr 2015; 19:788-95. [DOI: 10.1017/s1368980015001998] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveTo describe key characteristics of the dietary habits of Samoans residing in Logan, Queensland and to compare these characteristics with comparable populations.DesignDietary intake was measured using a self-administered structured questionnaire between December 2012 and March 2013. Demographic characteristics included age and sex. Questionnaire results were compared with data from samples of Brisbane residents of similar social and economic characteristics and Pacific Islanders in New Zealand. The association between demographic characteristics and diet was investigated.SettingLogan, Queensland, Australia.SubjectsSamoans aged 16 years and older.ResultsA total of 207 Samoans participated, ninety-six (46 %) of whom were male. Of the participants, seventy-nine (38 %) were aged 16–29 years, sixty-three (30 %) were aged 30–49 years and sixty-five (31 %) were aged ≥50 years. Younger adults were significantly more likely to eat hamburgers, pizza, cakes, savoury pastries, potato crisps, sweets and soft drinks (all variablesP<0·001). Among Samoans, 44·7 % consumed two or more pieces of fruit daily, compared with 43·8 % of comparable Brisbane residents (relative risk=1·0; 95 % CI 0·8, 1·2). Three or more servings of vegetables each day were consumed by 9·2 % of Samoans compared with 36·6 % of comparable Brisbane residents (relative risk=3·8; 95 % CI 2·5, 6·0).ConclusionsSamoans are consuming significantly fewer vegetables and more discretionary foods than other populations. Socio-economic factors, length of stay in Australia and cultural practices may impact upon Samoans’ diets. Further comprehensive studies on Samoans’ dietary habits in Australia are recommended.
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Tan J, Manley P, Gamble G, Collins J, Bagg W, Hotu C, Braatvedt G. Long-term effectiveness of a community-based model of care in Māori and Pacific patients with type 2 diabetes and chronic kidney disease: a 4-year follow up of the DElay Future End Stage Nephropathy due to Diabetes (DEFEND) study. Intern Med J 2015; 45:843-9. [PMID: 25872126 DOI: 10.1111/imj.12788] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 04/04/2015] [Indexed: 01/13/2023]
Abstract
BACKGROUND/AIM The Delay Future End Stage Nephropathy due to Diabetes study was a randomised controlled trial of Māori and Pacific patients with advanced diabetic nephropathy, comparing a community-based model of care with usual care. The intervention group achieved lower blood pressure (BP), proteinuria and less end-organ damage. After the intervention ended, all patients reverted to usual care, and were followed to review the sustainability of the intervention. METHODS A retrospective observation of 65 patients (aged 47-75 years) with type 2 diabetes, hypertension, chronic kidney disease 3/4 and proteinuria (>0.5 g/day) previously randomised to intervention/community care or usual care for 11-21 months. Follow up thereafter was until death, end-stage renal disease (ESRD) (estimated glomerular filtration rate (eGFR) ≤ 10 mL/min/1.73 m(2) )/dialysis or 1 February 2014. Primary end-points were death and ESRD/dialysis. Secondary outcomes were annualised glomerular filtration rate decline, non-fatal vascular events and hospitalisations. RESULTS Median (interquartile ranges (IQR)) post-trial follow up was 49 (21-81) months and similar in both groups. The median (IQR) eGFR decline was -3.1 (-5.5, -2.3) and -5.5 (-7.1, -3.0) mL/min/year in the intervention and usual care groups respectively (P = 0.11). Similar number of deaths, renal and vascular events were observed in both groups. At the end of follow up, the number of prescribed antihypertensive medications was similar (3.4 ± 1.0 vs 3.3 ± 1.4; P = 0.78). There were fewer median (IQR) hospital days (8 (3, 18) vs 15.5 (6, 49) days, P = 0.03) in the intervention group. CONCLUSIONS Short-term intensive BP control followed by usual care did not translate into reduction in long-term mortality or ESRD rates, but was associated with reduced hospitalisations.
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Affiliation(s)
- J Tan
- Auckland Diabetes Centre, Auckland District Health Board, Auckland, New Zealand.,Department of Renal Medicine, Auckland District Health Board, Auckland, New Zealand
| | - P Manley
- Department of Renal Medicine, Auckland District Health Board, Auckland, New Zealand
| | - G Gamble
- Auckland Diabetes Centre, Auckland District Health Board, Auckland, New Zealand
| | - J Collins
- Department of Renal Medicine, Auckland District Health Board, Auckland, New Zealand
| | - W Bagg
- Auckland Diabetes Centre, Auckland District Health Board, Auckland, New Zealand.,Department of Medicine, University of Auckland, Auckland, New Zealand
| | - C Hotu
- Department of Renal Medicine, Auckland District Health Board, Auckland, New Zealand.,Department of Medicine, University of Auckland, Auckland, New Zealand
| | - G Braatvedt
- Department of Medicine, University of Auckland, Auckland, New Zealand
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Maharaj SS, Nuhu JM. The effect of rebound exercise and treadmill walking on the quality of life for patients with non-insulin-dependent type 2 diabetes. Int J Diabetes Dev Ctries 2015. [DOI: 10.1007/s13410-015-0350-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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Rowlands DS, Page RA, Sukala WR, Giri M, Ghimbovschi SD, Hayat I, Cheema BS, Lys I, Leikis M, Sheard PW, Wakefield SJ, Breier B, Hathout Y, Brown K, Marathi R, Orkunoglu-Suer FE, Devaney JM, Leiken B, Many G, Krebs J, Hopkins WG, Hoffman EP. Multi-omic integrated networks connect DNA methylation and miRNA with skeletal muscle plasticity to chronic exercise in Type 2 diabetic obesity. Physiol Genomics 2014; 46:747-65. [PMID: 25138607 PMCID: PMC4200377 DOI: 10.1152/physiolgenomics.00024.2014] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 08/08/2014] [Indexed: 01/19/2023] Open
Abstract
Epigenomic regulation of the transcriptome by DNA methylation and posttranscriptional gene silencing by miRNAs are potential environmental modulators of skeletal muscle plasticity to chronic exercise in healthy and diseased populations. We utilized transcriptome networks to connect exercise-induced differential methylation and miRNA with functional skeletal muscle plasticity. Biopsies of the vastus lateralis were collected from middle-aged Polynesian men and women with morbid obesity (44 kg/m(2) ± 10) and Type 2 diabetes before and following 16 wk of resistance (n = 9) or endurance training (n = 8). Longitudinal transcriptome, methylome, and microRNA (miRNA) responses were obtained via microarray, filtered by novel effect-size based false discovery rate probe selection preceding bioinformatic interrogation. Metabolic and microvascular transcriptome topology dominated the network landscape following endurance exercise. Lipid and glucose metabolism modules were connected to: microRNA (miR)-29a; promoter region hypomethylation of nuclear receptor factor (NRF1) and fatty acid transporter (SLC27A4), and hypermethylation of fatty acid synthase, and to exon hypomethylation of 6-phosphofructo-2-kinase and Ser/Thr protein kinase. Directional change in the endurance networks was validated by lower intramyocellular lipid, increased capillarity, GLUT4, hexokinase, and mitochondrial enzyme activity and proteome. Resistance training also lowered lipid and increased enzyme activity and caused GLUT4 promoter hypomethylation; however, training was inconsequential to GLUT4, capillarity, and metabolic transcriptome. miR-195 connected to negative regulation of vascular development. To conclude, integrated molecular network modelling revealed differential DNA methylation and miRNA expression changes occur in skeletal muscle in response to chronic exercise training that are most pronounced with endurance training and topographically associated with functional metabolic and microvascular plasticity relevant to diabetes rehabilitation.
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Affiliation(s)
- David S Rowlands
- School of Sport and Exercise, Massey University, Wellington, New Zealand;
| | - Rachel A Page
- Institute of Food, Nutrition & Human Health, Massey University, New Zealand
| | - William R Sukala
- Institute of Food, Nutrition & Human Health, Massey University, New Zealand
| | - Mamta Giri
- Children's National Medical Center, Center for Genetic Medicine Research (CGMR), Washington, District of Columbia
| | - Svetlana D Ghimbovschi
- Children's National Medical Center, Center for Genetic Medicine Research (CGMR), Washington, District of Columbia
| | - Irum Hayat
- Institute of Food, Nutrition & Human Health, Massey University, New Zealand
| | - Birinder S Cheema
- School of Science and Health, University of Western Sydney, Campbelltown, Australia
| | - Isabelle Lys
- Faculty of Engineering, Health, Science and the Environment, Charles Darwin University, Australia
| | - Murray Leikis
- Wellington Hospital, Capital and Coast District Health Board, Wellington, New Zealand
| | - Phillip W Sheard
- Department of Physiology, University of Otago, Dunedin, New Zealand
| | - St John Wakefield
- Department of Pathology, University of Otago, Wellington, New Zealand; and
| | - Bernhard Breier
- Institute of Food, Nutrition & Human Health, Massey University, New Zealand
| | - Yetrib Hathout
- Children's National Medical Center, Center for Genetic Medicine Research (CGMR), Washington, District of Columbia
| | - Kristy Brown
- Children's National Medical Center, Center for Genetic Medicine Research (CGMR), Washington, District of Columbia
| | - Ramya Marathi
- Children's National Medical Center, Center for Genetic Medicine Research (CGMR), Washington, District of Columbia
| | - Funda E Orkunoglu-Suer
- Children's National Medical Center, Center for Genetic Medicine Research (CGMR), Washington, District of Columbia
| | - Joseph M Devaney
- Children's National Medical Center, Center for Genetic Medicine Research (CGMR), Washington, District of Columbia
| | - Benjamin Leiken
- Children's National Medical Center, Center for Genetic Medicine Research (CGMR), Washington, District of Columbia
| | - Gina Many
- Children's National Medical Center, Center for Genetic Medicine Research (CGMR), Washington, District of Columbia
| | - Jeremy Krebs
- Endocrine and Diabetes Unit, Capital and Coast District Health Board, Wellington, New Zealand
| | - Will G Hopkins
- Health Science/Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
| | - Eric P Hoffman
- Children's National Medical Center, Center for Genetic Medicine Research (CGMR), Washington, District of Columbia
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Kaveeshwar SA, Cornwall J. The current state of diabetes mellitus in India. Australas Med J 2014; 7:45-8. [PMID: 24567766 DOI: 10.4066/amj.2013.1979] [Citation(s) in RCA: 121] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Role of exercise in the management of diabetes mellitus: the global scenario. PLoS One 2013; 8:e80436. [PMID: 24236181 PMCID: PMC3827454 DOI: 10.1371/journal.pone.0080436] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 10/02/2013] [Indexed: 01/28/2023] Open
Abstract
Background Exercise training programs have emerged as a useful therapeutic regimen for the management of type 2 diabetes mellitus (T2DM). Majority of the Western studies highlighted the effective role of exercise in T2DM. Therefore, the main aim was to focus on the extent, type of exercise and its clinical significance in T2DM in order to educate the clinicians from developing countries, especially in Asians. Methods Pubmed, Science Direct, Scopus, ISI Web of Knowledge and Google scholar were searched using the terms “type 2 diabetes mellitus,” “type 2 DM,” “exercise,” and/or “physical activity,” and “type 2 diabetes mellitus with exercise.” Only clinical or human studies published in English language between 2000 and 2012 were included. Certain criteria were assigned to achieve appropriate results. Results Twenty five studies met the selected criteria. The majority of the studies were randomized controlled trial study design (65%). Most of the aerobic exercise based studies showed a beneficial effect in T2DM. Resistance exercise also proved to have positive effect on T2DM patients. Minimal studies related to other types of exercises such as yoga classes, joba riding and endurance-type exercise were found. On the other hand, United States of America (USA) showed strong interest of exercise management towards T2DM. Conclusion Aerobic exercise is more common in clinical practice compared to resistance exercise in managing T2DM. Treatment of T2DM with exercise training showed promising role in USA. A large number of researches are mandatory in the developing countries for incorporating exercise in the effective management of T2DM.
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Farran B, Channanath AM, Behbehani K, Thanaraj TA. Predictive models to assess risk of type 2 diabetes, hypertension and comorbidity: machine-learning algorithms and validation using national health data from Kuwait--a cohort study. BMJ Open 2013; 3:bmjopen-2012-002457. [PMID: 23676796 PMCID: PMC3657675 DOI: 10.1136/bmjopen-2012-002457] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE We build classification models and risk assessment tools for diabetes, hypertension and comorbidity using machine-learning algorithms on data from Kuwait. We model the increased proneness in diabetic patients to develop hypertension and vice versa. We ascertain the importance of ethnicity (and natives vs expatriate migrants) and of using regional data in risk assessment. DESIGN Retrospective cohort study. Four machine-learning techniques were used: logistic regression, k-nearest neighbours (k-NN), multifactor dimensionality reduction and support vector machines. The study uses fivefold cross validation to obtain generalisation accuracies and errors. SETTING Kuwait Health Network (KHN) that integrates data from primary health centres and hospitals in Kuwait. PARTICIPANTS 270 172 hospital visitors (of which, 89 858 are diabetic, 58 745 hypertensive and 30 522 comorbid) comprising Kuwaiti natives, Asian and Arab expatriates. OUTCOME MEASURES Incident type 2 diabetes, hypertension and comorbidity. RESULTS Classification accuracies of >85% (for diabetes) and >90% (for hypertension) are achieved using only simple non-laboratory-based parameters. Risk assessment tools based on k-NN classification models are able to assign 'high' risk to 75% of diabetic patients and to 94% of hypertensive patients. Only 5% of diabetic patients are seen assigned 'low' risk. Asian-specific models and assessments perform even better. Pathological conditions of diabetes in the general population or in hypertensive population and those of hypertension are modelled. Two-stage aggregate classification models and risk assessment tools, built combining both the component models on diabetes (or on hypertension), perform better than individual models. CONCLUSIONS Data on diabetes, hypertension and comorbidity from the cosmopolitan State of Kuwait are available for the first time. This enabled us to apply four different case-control models to assess risks. These tools aid in the preliminary non-intrusive assessment of the population. Ethnicity is seen significant to the predictive models. Risk assessments need to be developed using regional data as we demonstrate the applicability of the American Diabetes Association online calculator on data from Kuwait.
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Affiliation(s)
- Bassam Farran
- Integrative Informatics, Dasman Diabetes Institute, Dasman, Kuwait
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