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de Oliveira VLP, de Paula TP, Viana LV. Pedometer- and accelerometer- based physical activity interventions in Type 2 diabetes: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2024; 34:548-558. [PMID: 38220510 DOI: 10.1016/j.numecd.2023.11.017] [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: 05/05/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 01/16/2024]
Abstract
AIMS Although accelerometer- and pedometer-based physical activity (PA) interventions can increase PA, there is no solid evidence for their benefits in patients with type 2 diabetes (T2DM). The aim of this systematic review and meta-analysis of randomized controlled clinical trials (RCTs) was to determine the effects of accelerometer- and pedometer-based PA interventions on hemoglobin A1c (HbA1c), fasting glucose, weight, BMI, blood pressure, lipids, and PA in adults with T2DM. DATA SYNTHESIS Records from MEDLINE/PubMed, EMBASE, LILACS, and Scopus were searched from inception through March 28th, 2022. RCTs of at least two weeks of duration evaluated the effectiveness of pedometers or accelerometers as motivating tools for increasing PA in T2DM patients. This study was registered with PROSPERO and followed the PRISMA reporting guide. Of the 7131 non-duplicated articles retrieved, 24 RCTs (1969 patients) were included. The mean baseline HbA1c of the experimental group of included studies varied from 6.3 ± 0.9 % to 9.0 ± 0.01 %. The accelerometer- and pedometer-based PA interventions resulted in a greater improvement in HbA1c (-0.22 %; 95%CI, -0.4 % to -0.05 %; I2 = 77 %) and triglycerides (-13.11 mg/dL; 95%CI, -25.21 to -1.02; I2 = 22 %) versus control participants. Pedometer ambulatory use as a motivating tool significantly increased PA by 2,131 steps/day (95 % CI, 1,348 to 2,914; I2 = 74 %) in T2DM patients. CONCLUSIONS Pedometers and accelerometers are associated with reductions in HbA1c and triglycerides when used as motivating tools. Larger and higher-quality studies are required to determine the full effects of PA as motivated by trackers in T2DM population.
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Affiliation(s)
- Vanessa L P de Oliveira
- Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 2º andar, Porto Alegre, Brazil.
| | - Tatiana P de Paula
- Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 2º andar, Porto Alegre, Brazil
| | - Luciana V Viana
- Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 2º andar, Porto Alegre, Brazil; Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350 sala 401, Porto Alegre, Brazil
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102
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Stylemans D, Vandecruys M, Leunis S, Engelborghs S, Gargioli D, Monbaliu D, Cornelissen V, Van Craenenbroeck AH, De Smet S. Physical Exercise After Solid Organ Transplantation: A Cautionary Tale. Transpl Int 2024; 37:12448. [PMID: 38414660 PMCID: PMC10898592 DOI: 10.3389/ti.2024.12448] [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: 11/20/2023] [Accepted: 02/02/2024] [Indexed: 02/29/2024]
Abstract
An increasing body of randomized controlled trials suggests the safety of engaging in moderate to vigorous intensity exercise training following solid organ transplantation. Fueled by emerging sport events designed for transplant recipients and the ever-growing body of research highlighting the diverse health benefits of physical activity, transplant recipients are now increasingly participating in strenuous and occasionally competitive physical endeavors that largely surpass those evaluated in controlled research settings. This viewpoint article adopts a cautionary stance to counterbalance the prevalent one-sided optimistic perspective regarding posttransplant physical activity. While discussing methodological limitations, we explore plausible adverse impacts on the cardiovascular, immunological, and musculoskeletal systems. We also examine the physiological consequences of exercising in the heat, at high altitude, and in areas with high air pollution. Risks associated with employing performance-enhancing strategies and the conceivable psychological implications regarding physical activity as a tribute to the 'gift of life' are discussed. With a deliberate focus on the potential adverse outcomes of strenuous posttransplant physical activity, this viewpoint aims to restore a balanced dialogue on our comprehension of both beneficial and potentially detrimental outcomes of physical activity that ultimately underscores the imperative of well-informed decision-making and tailored exercise regimens in the realm of posttransplant care.
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Affiliation(s)
- Dimitri Stylemans
- Department of Respiratory Diseases, Pulmonary Rehabilitation, University Hospitals Leuven, Leuven, Belgium
| | - Marieke Vandecruys
- Nephrology and Renal Transplantation Research Group, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Sofie Leunis
- Laboratory of Abdominal Transplantation, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Sofie Engelborghs
- Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Davide Gargioli
- Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Diethard Monbaliu
- Laboratory of Abdominal Transplantation, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- Department of Abdominal Transplant Surgery, University Hospitals Leuven, Leuven, Belgium
- Transplantoux Foundation, Leuven, Belgium
| | - Véronique Cornelissen
- Research Group for Rehabilitation in Internal Disorders, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Amaryllis H. Van Craenenbroeck
- Nephrology and Renal Transplantation Research Group, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- Department of Nephrology and Kidney Transplantation, University Hospitals Leuven, Leuven, Belgium
| | - Stefan De Smet
- Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
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103
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Moser O, Kaser S, Sourij H. Editorial: Lifestyle intervention approaches in prediabetes or diabetes. Front Endocrinol (Lausanne) 2024; 15:1341674. [PMID: 38405146 PMCID: PMC10893781 DOI: 10.3389/fendo.2024.1341674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/31/2024] [Indexed: 02/27/2024] Open
Affiliation(s)
- Othmar Moser
- Exercise Physiology and Metabolism, Institute of Sports Science, University of Bayreuth, Bayreuth, Germany
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, Graz, Austria
| | - Susanne Kaser
- Department of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria
| | - Harald Sourij
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, Graz, Austria
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104
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Rijal A, Adhikari TB, Dhakal S, Maagaard M, Piri R, Nielsen EE, Neupane D, Jakobsen JC, Olsen MH. Effect of exercise on functional capacity and body weight for people with hypertension, type 2 diabetes, or cardiovascular disease: a systematic review with meta-analysis and trial sequential analysis. BMC Sports Sci Med Rehabil 2024; 16:38. [PMID: 38321506 PMCID: PMC10848448 DOI: 10.1186/s13102-024-00829-1] [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: 08/22/2023] [Accepted: 01/28/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND Hypertension, type 2 diabetes, and cardiovascular disease affect the activities of daily living at varying degree. While the effects of aerobic exercise on functional capacity are well-documented, the extent of change for different types of exercise in these chronic conditions remains unexplored. Additionally, there is conflicting evidence regarding the role of exercise in reducing body weight. METHODS We conducted systematic review with meta-analysis and trial sequential analysis and searched various databases from inception to July 2020. We included randomised clinical trials adding any form of trialist defined exercise to usual care versus usual care in people with either hypertension, type 2 diabetes, and/or cardiovascular disease irrespective of setting, publication status, year, and language. The outcomes assessed were i) functional capacity assessed through different scales separately i.e., Maximal Oxygen Uptake (VO2max), 6-min walk test (6MWT), 10-m walk test (10MWT), and ii) body weight. RESULTS We included 950 studies out of which 444 trials randomising 20,098 participants reported on various functional outcomes (355 trials) and body weight (169 trials). The median follow-up was 3 months (Interquartile ranges (IQR): 2.25 to 6). Exercise added to the usual care, improved VO2max (Mean Difference (MD):2.72 ml/kg/min; 95% Confidence Interval (CI) 2.38 to 3.06; p < 0.01; I2 = 96%), 6MWT (MD: 42.5 m; 95%CI 34.95 to 50.06; p < 0.01; I2 = 96%), and 10MWT (MD: 0.06 m/s; 95%CI 0.03 to 0.10; p < 0.01; I2 = 93%). Dynamic aerobic and resistance exercise showed a consistent improvement across various functional outcomes, whereas body-mind therapies (MD: 3.23 ml/kg/min; 95%CI 1.97 to 4.49, p < 0.01) seemed especially beneficial for VO2max and inspiratory muscle training (MD: 59.32 m; 95%CI 33.84 to 84.80; p < 0.01) for 6MWT. Exercise yielded significant reduction in body weight for people with hypertension (MD: -1.45 kg; 95%CI -2.47 to -0.43; p < 0.01), and type 2 diabetes (MD: -1.53 kg; 95%CI -2.19 to -0.87; p < 0.01) but not for cardiovascular disease with most pronounced for combined exercise (MD: -1.73 kg; 95%CI -3.08 to -0.39; p < 0.05). The very low certainty of evidence warrants cautious interpretations of the results. CONCLUSION Exercise seemed to improve functional capacity for people with hypertension, type 2 diabetes, and/or cardiovascular disease but the effectiveness seems to vary with different forms of exercise. The potentially superior improvement in VO2max and 6MWT by body-mind therapies and inspiratory muscle training calls for further exploration. Additionally, prescribing exercise for the sole purpose of losing weight may be a potential strategy for people with hypertension and type 2 diabetes. The extent of improvement in functional capacity and body weight reduction differed with different exercise regimens hence personalised exercise prescriptions tailored to individual needs may be of importance. PROSPERO REGISTRATION: PROSPERO registration number: CRD42019142313.
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Affiliation(s)
- Anupa Rijal
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
- Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark.
| | - Tara Ballav Adhikari
- Department of Public Health, Research Unit for Environment, Occupation & Health, Aarhus University, Aarhus, Denmark
| | - Sarmila Dhakal
- Center for Research on Environment, Health and Population Activities (CREPHA), Kusunti, Lalitpur, Nepal
| | - Mathias Maagaard
- Centre for Anaesthesiological Research, Department of Anaesthesiology, Zealand University Hospital, Koge, Denmark
| | - Reza Piri
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Emil Eik Nielsen
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Dinesh Neupane
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University Baltimore, Maryland, USA
| | - Janus Christian Jakobsen
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Michael Hecht Olsen
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark
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Brunelli DT, Bonfante ILP, Boldrini VO, Scolfaro PG, Duft RG, Mateus K, Fatori RF, Chacon-Mikahil MPT, Farias AS, Teixeira AM, Cavaglieri CR. Combined Training Improves Gene Expression Related to Immunosenescence in Obese Type 2 Diabetic Individuals. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024:1-10. [PMID: 38319611 DOI: 10.1080/02701367.2023.2299716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 12/21/2023] [Indexed: 02/07/2024]
Abstract
Purpose: The aim of this study was to investigate the effects of moderate combined training (CT) on both the gene expression of pro- and anti-inflammatory markers and senescence in the immune system in peripheral blood mononuclear cells (PBMCs) and subcutaneous adipose tissue (SAT) of obese middle-aged individuals with type 2 diabetes (T2D). Methods: Thirty obese individuals (50.2 ± 9.4 years; body mass index: 31.8 ± 2.3 kg/m²) with T2D underwent 16 weeks of a CT group [CT; aerobic (50-60% of VO2max) plus resistance (50-75% of 1RM) training; 3 times/week, 70 min/session; n = 16)] or a control group (CG, n = 14). Nutritional patterns, muscle strength (1RM), cardiorespiratory fitness (VO2max), waist circumference (WC), body composition (Air Displacement Plethysmograph) and blood collections for biochemical (serum leptin, IL-2, IL-4, IL-6, IL-10, TNF-α and anti-CMV) and molecular (gene expression of leptin, IL-2, IL-4, IL-6, IL-10, TNF-α, PD-1, P16ink4a, CCR7, CD28 and CD27 in PBMCs and SAT) analyses were assessed before (Pre) and after (Post) the 16 weeks of the experimental period. Results: Significant decreases were observed in WC and IL4, TNF-α, PD-1 and CD27 expression in PBMCs for CT. Furthermore, significant increases were observed in 1RM and VO2max for CT after the experimental period. Conclusion: Moderate CT contributed to a reduction in the gene expression of markers associated to chronic inflammation and immunosenescence in PBMCs of obese middle-aged individuals with T2D.
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106
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Steiman De Visser H, Fast I, Brunton N, Arevalo E, Askin N, Rabbani R, Abou-Setta AM, McGavock J. Cardiorespiratory Fitness and Physical Activity in Pediatric Diabetes: A Systemic Review and Meta-Analysis. JAMA Netw Open 2024; 7:e240235. [PMID: 38393727 PMCID: PMC10891480 DOI: 10.1001/jamanetworkopen.2024.0235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/22/2023] [Indexed: 02/25/2024] Open
Abstract
Importance It is unclear whether cardiorespiratory fitness (CRF) and physical activity are lower among youths with type 1 diabetes (T1D) and type 2 diabetes (T2D) compared with youths without diabetes. Objective To describe the magnitude, precision, and constancy of the differences in CRF and physical activity among youths with and without diabetes. Data Sources MEDLINE, Embase, CINAHL, and SPORTDiscus were searched from January 1, 2000, to May 1, 2022, for eligible studies. Study Selection Observational studies with measures of CRF and physical activity in children and adolescents aged 18 years or younger with T1D or T2D and a control group were included. Data Extraction and Synthesis Data extraction was completed by 2 independent reviewers. A random-effects meta-analysis model was used to estimate differences in main outcomes. The pooled effect estimate was measured as standardized mean differences (SMDs) with 95% CIs. The Preferred Reporting Items for Systematic Review and Meta-Analyses guideline was followed. Main Outcomes and Measures The main outcomes were objectively measured CRF obtained from a graded maximal exercise test and subjective or objective measures of physical activity. Subgroup analyses were performed for weight status and measurement type for outcome measures. Results Of 7857 unique citations retrieved, 9 studies (755 participants) with measures of CRF and 9 studies (1233 participants) with measures of physical activity for youths with T2D were included; for youths with T1D, 23 studies with measures of CRF (2082 participants) and 36 studies with measures of PA (12 196 participants) were included. Random-effects models revealed that directly measured CRF was lower in youths with T2D (SMD, -1.06; 95% CI, -1.57 to -0.56; I2 = 84%; 9 studies; 755 participants) and in youths with T1D (SMD, -0.39; 95% CI, -0.70 to -0.09; I2 = 89%; 22 studies; 2082 participants) compared with controls. Random-effects models revealed that daily physical activity was marginally lower in youths with T1D (SMD, -0.29; 95% CI, -0.46 to -0.11; I2 = 89%; 31 studies; 12 196 participants) but not different among youths with T2D (SMD, -0.56; 95% CI, -1.28 to 0.16; I2 = 91%; 9 studies; 1233 participants) compared with controls. When analyses were restricted to studies with objective measures, physical activity was significantly lower in youths with T2D (SMD, -0.71; 95% CI, -1.36 to -0.05; I2 = 23%; 3 studies; 332 participants) and T1D (SMD, -0.67; 95% CI, -1.17 to -0.17; I2 = 93%; 12 studies; 1357 participants) compared with controls. Conclusions and Relevance These findings suggest that deficits in CRF may be larger and more consistent in youths with T2D compared with youths with T1D, suggesting an increased risk for cardiovascular disease-related morbidity in adolescents with diabetes, particularly among those with T2D. The findings reinforce calls for novel interventions to empower youths living with diabetes to engage in regular physical activity and increase their CRF.
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Affiliation(s)
| | - Isaak Fast
- Children’s Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Nicole Brunton
- Children’s Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Edward Arevalo
- Children’s Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Nicole Askin
- Neil John MacLean Library, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Rasheda Rabbani
- George & Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ahmed M. Abou-Setta
- George & Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jonathan McGavock
- Children’s Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme, Winnipeg, Manitoba, Canada
- Diabetes Action Canada, Toronto, Ontario, Canada
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107
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Wollesen B, Herden M, Lamberti N, Giannaki CD. Defining and reporting exercise intensity in interventions for older adults: a modified Delphi process. Eur Rev Aging Phys Act 2024; 21:3. [PMID: 38302886 PMCID: PMC10835929 DOI: 10.1186/s11556-024-00337-8] [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: 08/28/2023] [Accepted: 01/14/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Many exercise studies, including older adults, do not report all relevant exercise characteristics. Especially the description of exercise intensity is missing and mostly not controlled. This leads to difficulties in interpreting study results and summarizing the evidence in systematic reviews or meta-analyses. Therefore, the aim of the present Delphi study was to gain recommendations about the categorization of exercise intensity and for the conducting and reporting of characteristics in future intervention studies with older adults by experts in exercise science and physiology. METHODS Two hundred ninety-seven international interdisciplinary participants from an EU COST action were invited to participate in three rounds of online questionnaires in April/May 2023. Up to N = 93 experts participated in each round. Round 1 included open-ended questions to solicit possible recommendations and categorizations for light, moderate, vigorous, and high intensity. In round 2, the experts rated their agreement using Likert scales (1-10) on the revealed categories and recommendations. Clusters with a higher average rating of M = 8.0 were summarized into round 3. In the final round, the results were presented for a final rating of agreement (based on a simple majority > 50%). RESULTS In round 1 a total of 416 qualitative statements were provided from thirteen questions. From round 1 to round 3, a total of 38 items were excluded, with 205 items retained for the final consensus. In round three 37 participants completed the whole questionnaire. The experts showed overall agreement on the final categorizations with 6.7 to 8.8 out of 10 points on the Likert scale. They also showed broad consensus on the relevance of reporting exercise intensity and the recommendations for future conducting and reporting of study results. However, exercise types such as yoga, balance, and coordination training led to conflicting results for categorization into light or moderate. DISCUSSION AND IMPLICATIONS The results of the current survey can be used to classify the intensity of exercise and suggest a practical approach that can be adopted by the scientific community and applied when conducting systematic reviews and meta-analysis articles when vital and objective information regarding exercise intensity is lacking from the original article.
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Affiliation(s)
- Bettina Wollesen
- Institute of Human Movement Science, University of Hamburg, Hamburg, Germany.
| | - Mona Herden
- Institute of Human Movement Science, University of Hamburg, Hamburg, Germany
| | - Nicola Lamberti
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Christoforos D Giannaki
- Department of Life Sciences, School of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
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108
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Riahy S. The effects of 12 weeks of high-intensity interval training and moderate-intensity continuous training on FGF21, irisin, and myostatin in men with type 2 diabetes mellitus. Growth Factors 2024; 42:24-35. [PMID: 37945531 DOI: 10.1080/08977194.2023.2279163] [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: 05/22/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023]
Abstract
This study investigated the influence of a 12-week high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on irisin, fibroblast growth factor 21 (FGF21), and myostatin (MSTN) among men with type 2 diabetes mellitus (T2DM). Forty-five adult men with T2DM were randomly selected and assigned to receive and perform HIIT (4 × 4 min at 85-95% HRmax with three min of active rest at 50-60% HRmax in between) and MICT (walking/running continuously for 47 min at 60-70% HRmax) three sessions per week for 12 weeks, or to act as a non-exercise control (CON) group. The subjects' blood samples were collected at baseline and 48 hours after the last intervention session. Our research revealed that both interventions resulted in similar decreases in FGF21 and MSTN when compared to the CON (p < .01). However, only the HIIT group showed a significant increase in irisin (p < .01) compared to the CON. Further, improvements in insulin resistance, body composition, and VO2 peak were noted in both intervention groups compared with those of the CON group (p < .01). It seems that while either aerobic exercise strategy could be seen as a therapy for men with T2DM, HIIT had a more advantageous effect on the irisin response.
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Affiliation(s)
- Simin Riahy
- Clinical Biomechanics and Ergonomics Research Center, AJA University of Medical Sciences, Tehran, Iran
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109
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Doyenart R, Boeira D, Milhomens YP, Oliveira Silva da Silva V, Zilli Réus G, Silveira PCL, da Silva LA. Effects of aquatic high intensity interval training on parameters of functional autonomy, mental health, and oxidative dysfunction in elderly subjects with type 2 diabetes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:826-838. [PMID: 36780534 DOI: 10.1080/09603123.2023.2175797] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
The present study investigated the effects of aquatic exercise on parameters of functional autonomy, mental health, and oxidative dysfunction in elderly patients with DM2. A total of 130 elderly were included in the longitudinal clinical study and were attributed to the non-diabetic group (n = 27) and diabetes the group (n = 22). Both groups participated in 24 sessions of Hydro-HIIT, 48 h before and after Hydro-HIIT, the GDLAM index, depression, and anxiety scores and markers of oxidative dysfunction were quantified. After intervention, GI decreased in both groups (non-diabetes group = -24%; diabetes group = -22%) (p < 0.05), markers of depression (-46%), anxiety (-60%), DCFH-DA (-55%), SOD (+59%), TNF-α (-37%) and IL-1 (-48%) in diabetes group (p < 0.05). The intervention with Hydro-HIIT improves aspects related to functional autonomy, mental health, and exerts consequently, a modulating effect on oxidative stress and inflammatory response in elderly people diagnosed with DM2.
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Affiliation(s)
- Ramiro Doyenart
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Daniel Boeira
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Yuri Pinheiro Milhomens
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Vitória Oliveira Silva da Silva
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Gislaine Zilli Réus
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Paulo Cesar Lock Silveira
- Laboratory of Exercise Biochemistry and Physiology, Graduate Programme in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
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Zhang C, Yang J. Personalizing Physical Activity for Glucose Control Among Individuals With Type 2 Diabetes: Are We There Yet? Diabetes Care 2024; 47:196-198. [PMID: 38241495 PMCID: PMC10834384 DOI: 10.2337/dci23-0063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 10/25/2023] [Indexed: 01/21/2024]
Affiliation(s)
- Cuilin Zhang
- Global Centre for Asian Women’s Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Bia-Echo Asia Centre for Reproductive Longevity & Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Jiaxi Yang
- Global Centre for Asian Women’s Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Bia-Echo Asia Centre for Reproductive Longevity & Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Chang KT, Goh KK, Latthirun K, Yang CT. The effect of exercise on cognition and clinical symptoms of patients with schizophrenia: A systematic review of randomized controlled trial. PROGRESS IN BRAIN RESEARCH 2024; 283:255-304. [PMID: 38538191 DOI: 10.1016/bs.pbr.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
Physical activity has been viewed as a potential non-pharmacological therapeutic strategy to improve the clinical symptoms and neurocognitive deficits in patients with schizophrenia. However, there are various types of physical activities, and different exercise prescriptions might produce inconsistent benefits. Thus, this study aimed to conduct a systematic review of exercise interventions for patients with schizophrenia, clarifying the benefits of these interventions on cognitive function and clinical symptoms. This review encompasses six electronic databases, with inclusion criteria including randomized controlled trial designs, participants with schizophrenia, and a comprehensive exercise intervention program. Twenty-seven studies met the inclusion criteria, incorporating data from 1549 patients with schizophrenia. The results highlight that when comparing the exercise intervention group to the non-intervention control group, patients with schizophrenia showed significant improvement in negative symptoms. Structured exercise interventions can help improve the negative symptoms of schizophrenia, filling the gaps where medication falls short. Regarding functional outcomes, exercise interventions aid in enhancing the overall functionality (psychological, social, occupational) of individuals with schizophrenia. The improvement is largely tied to the boost in physical fitness that exercise provides. Based on current findings, exercise interventions assist in enhancing cognitive function in patients with schizophrenia. Notably, significant improvements are observed in higher-order cognitive functions, including processing speed, attention, and working memory. It is recommended to engage in moderate-intensity exercises at least three times a week, with each session lasting a minimum of 30min. Well-structured exercise interventions contribute to enhancing the negative symptoms and cognitive functions in patients with schizophrenia.
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Affiliation(s)
- Kun-Tang Chang
- International Doctoral Program in Principles and Implications of Mind Science, National Cheng Kung University, Tainan, Taiwan
| | - Kah Kheng Goh
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan; The Innovative and Translational Research Center for Brain Consciousness, Taipei Medical University, Taipei, Taiwan
| | - Kanthika Latthirun
- International Doctoral Program in Principles and Implications of Mind Science, National Cheng Kung University, Tainan, Taiwan
| | - Cheng-Ta Yang
- Department of Psychology, National Cheng Kung University, Tainan, Taiwan; Graduate Institute of Health and Biotechnology Law, Taipei Medical University, Taipei, Taiwan.
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Bruckner F, Gruber JR, Ruf A, Edwin Thanarajah S, Reif A, Matura S. Exploring the Link between Lifestyle, Inflammation, and Insulin Resistance through an Improved Healthy Living Index. Nutrients 2024; 16:388. [PMID: 38337673 PMCID: PMC10857191 DOI: 10.3390/nu16030388] [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: 12/20/2023] [Revised: 01/18/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Lifestyle factors-such as diet, physical activity (PA), smoking, and alcohol consumption-have a significant impact on mortality as well as healthcare costs. Moreover, they play a crucial role in the development of type 2 diabetes mellitus (DM2). There also seems to be a link between lifestyle behaviours and insulin resistance, which is often a precursor of DM2. This study uses an enhanced Healthy Living Index (HLI) integrating accelerometric data and an Ecological Momentary Assessment (EMA) to explore differences in lifestyle between insulin-sensitive (IS) and insulin-resistant (IR) individuals. Moreover, it explores the association between lifestyle behaviours and inflammation. Analysing data from 99 participants of the mPRIME study (57 women and 42 men; mean age 49.8 years), we calculated HLI scores-ranging from 0 to 4- based on adherence to specific low-risk lifestyle behaviours, including non-smoking, adhering to a healthy diet, maximally moderate alcohol consumption, and meeting World Health Organization (WHO) PA guidelines. Insulin sensitivity was assessed using a Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and C-reactive protein (CRP) levels were used as a proxy for inflammation. Lifestyle behaviours, represented by HLI scores, were significantly different between IS and IR individuals (U = 1529.0; p = 0.023). The difference in the HLI score between IR and IS individuals was mainly driven by lower adherence to PA recommendations in the IR group. Moreover, reduced PA was linked to increased CRP levels in the IR group (r = -0.368, p = 0.014). Our findings suggest that enhancing PA, especially among individuals with impaired insulin resistance, holds significant promise as a preventive strategy.
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Affiliation(s)
- Franz Bruckner
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt am Main, Germany; (F.B.); (J.R.G.); (A.R.); (S.E.T.); (A.R.)
| | - Judith R. Gruber
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt am Main, Germany; (F.B.); (J.R.G.); (A.R.); (S.E.T.); (A.R.)
| | - Alea Ruf
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt am Main, Germany; (F.B.); (J.R.G.); (A.R.); (S.E.T.); (A.R.)
| | - Sharmili Edwin Thanarajah
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt am Main, Germany; (F.B.); (J.R.G.); (A.R.); (S.E.T.); (A.R.)
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt am Main, Germany; (F.B.); (J.R.G.); (A.R.); (S.E.T.); (A.R.)
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Silke Matura
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt am Main, Germany; (F.B.); (J.R.G.); (A.R.); (S.E.T.); (A.R.)
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Paluch AE, Boyer WR, Franklin BA, Laddu D, Lobelo F, Lee DC, McDermott MM, Swift DL, Webel AR, Lane A. Resistance Exercise Training in Individuals With and Without Cardiovascular Disease: 2023 Update: A Scientific Statement From the American Heart Association. Circulation 2024; 149:e217-e231. [PMID: 38059362 PMCID: PMC11209834 DOI: 10.1161/cir.0000000000001189] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
Resistance training not only can improve or maintain muscle mass and strength, but also has favorable physiological and clinical effects on cardiovascular disease and risk factors. This scientific statement is an update of the previous (2007) American Heart Association scientific statement regarding resistance training and cardiovascular disease. Since 2007, accumulating evidence suggests resistance training is a safe and effective approach for improving cardiovascular health in adults with and without cardiovascular disease. This scientific statement summarizes the benefits of resistance training alone or in combination with aerobic training for improving traditional and nontraditional cardiovascular disease risk factors. We also address the utility of resistance training for promoting cardiovascular health in varied healthy and clinical populations. Because less than one-third of US adults report participating in the recommended 2 days per week of resistance training activities, this scientific statement provides practical strategies for the promotion and prescription of resistance training.
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Chireshe R, Manyangadze T, Naidoo K. Diabetes mellitus and associated factors among HIV-positive patients at primary health care facilities in Harare, Zimbabwe: a descriptive cross-sectional study. BMC PRIMARY CARE 2024; 25:28. [PMID: 38221613 PMCID: PMC10789024 DOI: 10.1186/s12875-024-02261-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 01/01/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Highly active antiretroviral therapy (HAART) has improved the life expectancy of people living with HIV (PLWH) and has increased the risk of chronic non-communicable diseases. Comorbid HIV and diabetes mellitus (DM) significantly increase cardiovascular disease and mortality risk. This study aimed to determine the prevalence of type 2 diabetes mellitus among HIV-positive patients receiving HAART in Zimbabwe and its associated risk factors. METHODS This cross-sectional study was conducted at eight primary healthcare facilities in Harare, Zimbabwe, between January 2022 and March 2023. Non-probability convenience sampling was used to recruit adult HIV-positive patients undergoing HAART attending the facilities. Data were captured on clinical history and socio-demographic and behavioral characteristics, and analyzed using descriptive statistics to determine DM prevalence rates. Additionally, bivariate and multivariate logistic regression models were employed to examine factors associated with HIV and DM comorbidities. RESULTS A total of 450 participants were included in this study, of which 57.6% (n = 259) were female. The majority were married (73.8%) and older than 35 years (80.2%). Most participants had completed high school (87.6%) and 68.9% were employed either formally or self-employed. The prevalence of diabetes mellitus (DM) was 14.9%. HIV/DM comorbidity was more prevalent in patients who were female, self-employed, and smoked (p < 0.05). Multivariate logistic regression analysis revealed that the factors associated with DM-HIV comorbidity were gender, age, education, marital status, employment status, smoking, physical activities, duration of HAART, and diet. Age, level of education, marital status, and occupation were not associated with HIV-DM comorbidity. Obesity (body mass index > 30 kg/m2), smoking, and alcohol consumption were associated with an increased risk of DM. Regular physical activity is associated with a reduced risk of DM. CONCLUSION A substantial burden of DM was found in PLWH. The intersectoral integration approach is advocated, and active screening for DM is recommended. Gender-specific interventions are necessary to target diseases and health behaviors that differ between men and women. These interventions should be customized to the specific diseases and behaviors of each group.
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Affiliation(s)
- Rumbidzai Chireshe
- Discipline of Public Health Medicine, College of Health Sciences, University of KwaZulu-Natal, Howard Campus, Mazisi Kunene Road, Glenwood, Durban, 4041, South Africa.
| | - Tawanda Manyangadze
- Discipline of Public Health Medicine, College of Health Sciences, University of KwaZulu-Natal, Howard Campus, Mazisi Kunene Road, Glenwood, Durban, 4041, South Africa
- 2Department of Geosciences, School of Geosciences, Disasters, and Development, Faculty of Sciences and Engineering, Bindura University of Science Education, Bindura, Zimbabwe
| | - Keshena Naidoo
- Department of Family Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
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Brummer J, Glasbrenner C, Hechenbichler Figueroa S, Koehler K, Höchsmann C. Continuous glucose monitoring for automatic real-time assessment of eating events and nutrition: a scoping review. Front Nutr 2024; 10:1308348. [PMID: 38264192 PMCID: PMC10804456 DOI: 10.3389/fnut.2023.1308348] [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: 10/10/2023] [Accepted: 12/13/2023] [Indexed: 01/25/2024] Open
Abstract
Background Accurate dietary assessment remains a challenge, particularly in free-living settings. Continuous glucose monitoring (CGM) shows promise in optimizing the assessment and monitoring of ingestive activity (IA, i.e., consumption of calorie-containing foods/beverages), and it might enable administering dietary Just-In-Time Adaptive Interventions (JITAIs). Objective In a scoping review, we aimed to answer the following questions: (1) Which CGM approaches to automatically detect IA in (near-)real-time have been investigated? (2) How accurate are these approaches? (3) Can they be used in the context of JITAIs? Methods We systematically searched four databases until October 2023 and included publications in English or German that used CGM-based approaches for human (all ages) IA detection. Eligible publications included a ground-truth method as a comparator. We synthesized the evidence qualitatively and critically appraised publication quality. Results Of 1,561 potentially relevant publications identified, 19 publications (17 studies, total N = 311; for 2 studies, 2 publications each were relevant) were included. Most publications included individuals with diabetes, often using meal announcements and/or insulin boluses accompanying meals. Inpatient and free-living settings were used. CGM-only approaches and CGM combined with additional inputs were deployed. A broad range of algorithms was tested. Performance varied among the reviewed methods, ranging from unsatisfactory to excellent (e.g., 21% vs. 100% sensitivity). Detection times ranged from 9.0 to 45.0 min. Conclusion Several CGM-based approaches are promising for automatically detecting IA. However, response times need to be faster to enable JITAIs aimed at impacting acute IA. Methodological issues and overall heterogeneity among articles prevent recommending one single approach; specific cases will dictate the most suitable approach.
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Kerr D, Abbasi M, Bevier W, Glantz N, Larez A, Sabharwal A. Patterns of Timing and Intensity of Physical Activity and HbA1c Levels in Hispanic/Latino Adults With or at Risk of Type 2 Diabetes. J Diabetes Sci Technol 2024; 18:106-112. [PMID: 35771029 PMCID: PMC10899824 DOI: 10.1177/19322968221105531] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Despite the clear benefits of increased physical activity (PA) on glycemic control, little is known about the importance of the timing of exercise among people with diabetes. Our objective was to compare the time of day of PA with concurrent HbA1c levels and body mass index (BMI) among Hispanic/Latino adults with or at risk of type 2 diabetes (T2D). METHODS Monitored activity data obtained from Hispanic/Latino adults were summarized as number of steps per day, moderate-to vigorous-intensity physical activity (MVPA), and energy expenditure (kcals/day). We next examined the association between PA measures and participants' HbA1c. K-means clustering analysis was applied to identify daily PA patterns by time of day and intensity. RESULTS Three dominant clusters were identified: low-intensity PA, and early and late PA by time of day. The step counts were correlated with HbA1c in the late-active group (P = .01). Furthermore, independently in younger adults (age ≤ 50 years) and in overweight adults 25 ≤ BMI < 30 kg/m2), there was an association between HbA1c and step counts (P < .01 and P < .005, respectively) as well as HbA1c and MVPA (P < .05 and P < .035, respectively). CONCLUSIONS For Hispanic/Latino adults with or at risk of T2D, there appears to be clustering of PA by intensity and time of day which, in turn, may influence achieved HbA1c and BMI. Our findings demonstrate that the amount of activity is more efficacious on HbA1c in participants who are more active later during the day and separately in overweight and younger individuals. This finding may help design more personalized PA recommendations in this population. CLINICALTRIALS.GOV IDENTIFIERS NCT03830840 and NCT03736468.
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Affiliation(s)
- David Kerr
- Sansum Diabetes Research Institute, Santa Barbara, CA, USA
| | - Mahsan Abbasi
- Electrical and Computer Engineering, Rice University, Houston, TX, USA
| | - Wendy Bevier
- Sansum Diabetes Research Institute, Santa Barbara, CA, USA
| | - Namino Glantz
- Sansum Diabetes Research Institute, Santa Barbara, CA, USA
| | - Arianna Larez
- Sansum Diabetes Research Institute, Santa Barbara, CA, USA
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Rijal A, Adhikari TB, Dhakal S, Maagaard M, Piri R, Nielsen EE, Neupane D, Jakobsen JC, Olsen MH. Effects of adding exercise to usual care on blood pressure in patients with hypertension, type 2 diabetes, or cardiovascular disease: a systematic review with meta-analysis and trial sequential analysis. J Hypertens 2024; 42:10-22. [PMID: 37796224 DOI: 10.1097/hjh.0000000000003589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
INTRODUCTION Exercise is the most recommended lifestyle intervention in managing hypertension, type 2 diabetes, and/or cardiovascular disease; however, evidence in lowering blood pressure is still inconsistent and often underpowered. METHOD We conducted a systematic review with meta-analysis and trial sequential analysis of randomized clinical trials adding any form of trialist defined exercise to usual care versus usual care and its effect on systolic blood pressure (SBP) or diastolic blood pressure (DBP) in participants with hypertension, type 2 diabetes, or cardiovascular disease searched in different databases from inception to July 2020. Our methodology was based on PRISMA and Cochrane Risk of Bias-version1. Five independent reviewers extracted data and assessed risk of bias in pairs. RESULTS Two hundred sixty-nine trials randomizing 15 023 participants reported our predefined outcomes. The majority of exercise reported in the review was dynamic aerobic exercise (61%), dynamic resistance (11%), and combined aerobic and resistance exercise (15%). The trials included participants with hypertension (33%), type 2 diabetes (28%), or cardiovascular disease (37%). Meta-analyses and trial sequential analyses reported that adding exercise to usual care reduced SBP [mean difference (MD) MD: -4.1 mmHg; 95% confidence interval (95% CI) -4.99 to -3.14; P < 0.01; I2 = 95.3%] and DBP (MD: -2.6 mmHg; 95% CI -3.22 to -2.07, P < 0.01; I2 = 94%). Test of interaction showed that the reduction of SBP and DBP was almost two times higher among trials from low-and middle-income countries (LMICs) as compared to high-income countries (HICs). The exercise induced SBP reduction was also higher among participants with hypertension and type 2 diabetes compared to participants with cardiovascular disease. The very low certainty of evidence warrants a cautious interpretation of the present results. CONCLUSION Adding any type of exercise to usual care may be a potential complementary strategy for optimal management of blood pressure for patients with hypertension, type 2 diabetes, or cardiovascular disease, especially, in LMICs.PROSPERO registration number CRD42019142313.
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Affiliation(s)
- Anupa Rijal
- Department of Internal Medicine, Holbaek Hospital, Holbaek
- Department of Regional Health Research, University of Southern Denmark
| | - Tara Ballav Adhikari
- Department of Public Health, Research Unit for Environment, Occupation and Health, Aarhus University, Aarhus, Denmark
| | - Sarmila Dhakal
- Center for Research on Environment, Health and Population Activities (CREPHA), Kusunti, Lalitpur, Nepal
| | - Mathias Maagaard
- Centre for Anaesthesiological Research, Department of Anaesthesiology, Zealand University Hospital, Koge
| | - Reza Piri
- Department of Clinical Research, University of Southern Denmark
- Department of Nuclear Medicine, Odense University Hospital
- Department of Cardiology, Odense University Hospital, Odense Denmark
| | - Emil Eik Nielsen
- Department of Regional Health Research, University of Southern Denmark
- Department of Cardiology, Odense University Hospital, Odense Denmark
| | - Dinesh Neupane
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University Baltimore, Mayland, USA
| | - Janus Christian Jakobsen
- Department of Regional Health Research, University of Southern Denmark
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital- Rigshospitalet, Copenhagen, Denmark
| | - Michael Hecht Olsen
- Department of Internal Medicine, Holbaek Hospital, Holbaek
- Department of Regional Health Research, University of Southern Denmark
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Masuda H, Iwashima F, Ishiyama D, Nakajima H, Kimura Y, Otobe Y, Suzuki M, Koyama S, Tanaka S, Kojima I, Yamada M. Effect of Exercise Therapy on Incident Admission in Patients with Type 2Diabetes Mellitus Undergoing Inpatient Diabetes Self-manageme ntEducation and Support. Curr Diabetes Rev 2024; 20:e211123223677. [PMID: 37990899 DOI: 10.2174/0115733998269490231106190128] [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: 07/24/2023] [Revised: 09/27/2023] [Accepted: 10/04/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Exercise therapy is the key to preventing admission of patients with type 2 diabetes mellitus (T2DM). However, a few studies have examined the effects of exercise therapy on patients with T2DM undergoing inpatient diabetes self-management education and support (IDSMES). OBJECTIVE This study investigated whether exercise therapy influenced the incidence of admission after discharge in patients with T2DM undergoing IDSMES. METHODS This retrospective cohort study included patients with T2DM who underwent IDSMES between June 2011 and May 2015. Overall, 258 patients were included in this study. The exercise therapy program was implemented in June 2013. Accordingly, patients diagnosed between June 2011 and May 2013 were categorized as the non-exercise therapy program group, while those diagnosed between June 2013 and May 2015 were categorized as the exercise therapy program group. Outcomes were incident diabetes-related and all-cause admissions within 1 year of discharge. Multiple logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of the exercise therapy program's impact on the outcomes. RESULTS Within 1 year of discharge, 27 (10.5%) patients underwent diabetes-related admissions and 62 (24.0%) underwent all-cause admissions. Multiple logistic regression analyses showed a significant association of the exercise therapy program with incident diabetes-related and allcause admissions [OR: 0.22 (95% CI: 0.08-0.59) and 0.44 (95% CI: 0.22-0.86), respectively]. CONCLUSION Exercise therapy programs significantly lowered the incidences of diabetes-related and all-cause admissions. This indicates that implementing exercise therapy during hospitalization may be important for preventing admissions of patients with T2DM receiving IDSMES.
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Affiliation(s)
- Hiroaki Masuda
- Department of Rehabilitation, Tokyo Metropolitan Toshima Hospital, Tokyo Metropolitan Hospital Organization, 33-1 Sakaecho, Itabashi-ku, Tokyo, 173-0015, Japan
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo, 112-0012, Japan
| | - Fumiko Iwashima
- Department of Endocrinology and Metabolism, Tokyo Metropolitan Toshima Hospital, Tokyo Metropolitan Hospital Organization, 33-1 Sakaecho, Itabashi-ku, Tokyo, 173- 0015, Japan
| | - Daisuke Ishiyama
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo, 112-0012, Japan
| | - Hideki Nakajima
- Department of Rehabilitation, Tokyo Metropolitan Toshima Hospital, Tokyo Metropolitan Hospital Organization, 33-1 Sakaecho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Yosuke Kimura
- Health and Sports Technology Course, College of Science and Engineering, Kanto Gakuin University, 1- 50-1 Mutsuura, Kanazawa-ku, Yokohama, 236-8501, Japan
| | - Yuhei Otobe
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, 3-7-30 Habikino, Habikino-city, Osaka, 583-8555, Japan
| | - Mizue Suzuki
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo, 112-0012, Japan
| | - Shingo Koyama
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo, 112-0012, Japan
| | - Shu Tanaka
- Major of Physical Therapy, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, 5-23-22 Nishikamata, Ota-ku, Tokyo, 144-8535, Japan
| | - Iwao Kojima
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo, 112-0012, Japan
| | - Minoru Yamada
- Faculty of Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo, 112-0012, Japan
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de Assis RC, Celedonio RF, Valentim AB, Monteiro GR, da Silva AMH, Dantas ACP, Maia CSC. Influence of Anaerobic Exercise in Type 1 Diabetes Mellitus Biomarkers: ASystematic Review. Curr Diabetes Rev 2024; 20:e230124226018. [PMID: 38275039 DOI: 10.2174/0115733998274125231126111321] [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: 08/28/2023] [Revised: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 01/27/2024]
Abstract
AIM Physical exercise is part of the type 1 diabetes mellitus (T1DM) treatment. However, this practice is still neglected due to the wide variety of glycemic responses under the influence of anaerobic exercise. Therefore, this study aimed to investigate the influence of anaerobic exercise on biomarkers of T1DM. METHODS The systematic review was conducted on PubMed, Lilacs, and Embase, according to PRISMA. For this purpose, three groups of descriptors were used: Adults with T1DM, anaerobic physical exercise, and glycemic control. The search filter was set to human beings older than 18 years of age, longitudinal and cross-sectional studies, with studies published from 2000 to 2023 in English, Spanish, or Portuguese. Titles and abstracts were read independently by two reviewers, and then the articles were selected for this review. The Kappa coefficient was measured to evaluate the selection. RESULTS A total of 738 articles were identified, and five were selected to be part of the review after applying the steps of the procedure. Some benefits were observed in fatigue reduction, absence of diabetic ketoacidosis requiring hospitalization, and enhancement of glucose monitoring during exercise. In the anaerobic workouts of the groups with T1DM, glycemic mean values ranged from 124.5-185.0 mg/dl, and glycated hemoglobin records ranged from 6.7-8.1%. CONCLUSION Anaerobic exercise improved the biomarkers of T1DM, especially glycemic control, and the reduction of symptomatic hypoglycemic episodes. Anaerobic exercise can be performed by individuals with T1DM, suggesting an individualized training prescription and encouraging its practice associated with aerobic exercise.
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Cho E. Loneliness and Other Factors Associated with Physical Activity in Older Adults with Diabetes: A Cross-Sectional Study. Gerontol Geriatr Med 2024; 10:23337214241253365. [PMID: 38737719 PMCID: PMC11084991 DOI: 10.1177/23337214241253365] [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: 02/14/2024] [Revised: 04/16/2024] [Accepted: 04/19/2024] [Indexed: 05/14/2024] Open
Abstract
The purpose of this study was to examine the association of physical activity with socioeconomic conditions, demographic factors, depression, and loneliness among older adults with diabetes in the United States. Using data from Wave 3 of the National Social Life, Health, and Aging Project (NSHAP), we found that male respondents, those with incomes greater than $100,000, and those with less depression were more likely to be physically active among older adults with diabetes. Education level and loneliness were not significant factors influencing physical activity among older adults with diabetes. This suggests that changing gender-based social norms and increasing awareness of the need for physical activity should be considered when designing physical activity interventions for older adults with diabetes and highlights the need for programs to reduce disparities in physical activity opportunities among low-income populations. It also suggests the need to further integrate programs to promote mental health, such as depression, into physical activity interventions.
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Affiliation(s)
- Emma Cho
- The University of Pennsylvania School of Nursing, Philadelphia, USA
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121
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ElSayed NA, Aleppo G, Bannuru RR, Beverly EA, Bruemmer D, Collins BS, Darville A, Ekhlaspour L, Hassanein M, Hilliard ME, Johnson EL, Khunti K, Lingvay I, Matfin G, McCoy RG, Perry ML, Pilla SJ, Polsky S, Prahalad P, Pratley RE, Segal AR, Seley JJ, Stanton RC, Gabbay RA. 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2024. Diabetes Care 2024; 47:S77-S110. [PMID: 38078584 PMCID: PMC10725816 DOI: 10.2337/dc24-s005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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ElSayed NA, Aleppo G, Bannuru RR, Bruemmer D, Collins BS, Ekhlaspour L, Hilliard ME, Johnson EL, Khunti K, Lingvay I, Matfin G, McCoy RG, Perry ML, Pilla SJ, Polsky S, Prahalad P, Pratley RE, Segal AR, Seley JJ, Stanton RC, Gabbay RA. 14. Children and Adolescents: Standards of Care in Diabetes-2024. Diabetes Care 2024; 47:S258-S281. [PMID: 38078582 PMCID: PMC10725814 DOI: 10.2337/dc24-s014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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Jakicic JM. Comment on: Role of the exercise professional in metabolic and bariatric surgery. Surg Obes Relat Dis 2024; 20:109-110. [PMID: 37989624 DOI: 10.1016/j.soard.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 10/29/2023] [Indexed: 11/23/2023]
Affiliation(s)
- John M Jakicic
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
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Tanenbaum ML, Addala A, Hanes S, Ritter V, Bishop FK, Cortes AL, Pang E, Hood KK, Maahs DM, Zaharieva DP. "It changed everything we do": A mixed methods study of youth and parent experiences with a pilot exercise education intervention following new diagnosis of type 1 diabetes. J Diabetes Complications 2024; 38:108651. [PMID: 38043358 PMCID: PMC10843536 DOI: 10.1016/j.jdiacomp.2023.108651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/06/2023] [Accepted: 11/19/2023] [Indexed: 12/05/2023]
Abstract
AIMS This pilot study delivered a comprehensive exercise education intervention to youth with new-onset type 1 diabetes (T1D) and their parents to increase knowledge and confidence with physical activity (PA) shortly after diagnosis. METHODS Youth initiated continuous glucose monitoring (CGM) and PA trackers within 1 month of diagnosis. Youth and their parents received the 4-session intervention over 12 months. Participants completed self-report questionnaires at baseline, 6- and 12-months. Surveys were analyzed using linear mixed effects models. Semi-structured interviews and focus groups explored experiences with the exercise education intervention. Groups and interviews were audio-recorded, transcribed, and analyzed using content analysis. RESULTS A total of 16 parents (aged 46 ± 7 years; 88 % female; 67 % non-Hispanic White) and 17 youth (aged 14 ± 2 years; 41 % female; 65 % non-Hispanic White) participated. Worry about hypoglycemia did not worsen throughout the study duration. Parents and youth reported increased knowledge and confidence in managing T1D safely and preventing hypoglycemia during PA following receiving the tailored exercise education intervention. CONCLUSION This study assessed a novel structured exercise education program for youth and their parents shortly following T1D diagnosis. These results support the broad translation and acceptability of a structured exercise education program in new-onset T1D.
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Affiliation(s)
- Molly L Tanenbaum
- Division of Endocrinology, Gerontology, & Metabolism, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA; Stanford Diabetes Research Center, Stanford, CA, USA; Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
| | - Ananta Addala
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
| | - Sarah Hanes
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
| | - Victor Ritter
- Department of Medicine, Division of Biomedical Informatics Research, Stanford University, Stanford, CA, USA.
| | - Franziska K Bishop
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
| | - Ana L Cortes
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
| | - Erica Pang
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
| | - Korey K Hood
- Stanford Diabetes Research Center, Stanford, CA, USA; Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
| | - David M Maahs
- Stanford Diabetes Research Center, Stanford, CA, USA; Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
| | - Dessi P Zaharieva
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
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Haryanto H, Oe M, Kardatun T, Ramadhaniyati R, Makmuriana L, Sari Y, Bhakti WK. Risk Factors of Recurrent Diabetic Foot Ulcers Based on the Delphi Method. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2024; 29:56-59. [PMID: 38333331 PMCID: PMC10849292 DOI: 10.4103/ijnmr.ijnmr_391_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 07/15/2023] [Accepted: 08/09/2023] [Indexed: 02/10/2024]
Abstract
Background The risk factors for recurrence are poorly understood. The purpose of study is to investigate the risk factors that contribute to the recurrence of diabetic foot ulcers. Materials and Methods This is a cross-sectional study, and the two-phase Delphi method was used. A category was developed to investigate the risk factors of recurrent diabetic foot ulcers by experts. The recurrent items with risk factors were analyzed. Furthermore, the risk factor variables were clinically tested for inter-rater reliability agreement. Fourteen experts and two patients were included from February 15 to September 28, 2020, Indonesia. Results There were 13 risk factors for recurrent diabetic foot ulcers. The mean authority coefficient was 0.71. The positive coefficients were 100% and 78%, respectively. The Kendall coordination coefficient was statistically significant (p < 0.01), and inter-rater reliability agreement was perfect (1.00). Conclusions This study found some risk variables related with recurrent diabetic foot ulcers, which might serve as guidance to prevent future recurrences.
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Affiliation(s)
- Haryanto Haryanto
- Department of Medical Nursing, Wound Management and Critical Care, The Institute of Technology and Health Muhammadiyah West Kalimantan/STIK Muhammadiyah, Pontianak, Indonesia
| | - Makoto Oe
- Department of Clinical Nursing, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Japan
| | - Tutur Kardatun
- Department of Mental, Community and Management Nursing, The Institute of Technology and Health Muhammadiyah West Kalimantan/STIK Muhammadiyah, Pontianak, Indonesia
| | - Ramadhaniyati Ramadhaniyati
- Department of Child and Maternity Nursing, The Institute of Technology and Health Muhammadiyah West Kalimantan/STIK Muhammadiyah, Pontianak, Indonesia
| | - Lestari Makmuriana
- Department of Medical Nursing, Wound Management and Critical Care, The Institute of Technology and Health Muhammadiyah West Kalimantan/STIK Muhammadiyah, Pontianak, Indonesia
| | - Yunita Sari
- Department of Nursing, Faculty of Health Sciences, University Jenderal Soedirman, Indonesia
| | - Wida K. Bhakti
- Department of Mental, Community and Management of Nursing, The Institute of Technology and Health Muhammadiyah West Kalimantan/STIK Muhammadiyah, Pontianak, Indonesia, Muhammadiyah, Pontianak, Indonesia
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Kunutsor SK, Laukkanen JA. Physical activity, exercise and adverse cardiovascular outcomes in individuals with pre-existing cardiovascular disease: a narrative review. Expert Rev Cardiovasc Ther 2024; 22:91-101. [PMID: 38488568 PMCID: PMC11057847 DOI: 10.1080/14779072.2024.2328644] [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: 10/14/2023] [Accepted: 03/06/2024] [Indexed: 03/28/2024]
Abstract
INTRODUCTION The evidence supporting the cardiovascular health benefits of physical activity and/or exercise training is well-established. While the role of physical activity in primary prevention is unequivocal, its significance in secondary prevention (among those with preexisting cardiovascular disease) is less definitive. Though guidelines universally recommend physical activity as part of the secondary preventive strategy, the empirical evidence underpinning these recommendations is not as robust as that for primary prevention. AREAS COVERED This review distills the body of available observational and interventional evidence on the relationship between physical activity, exercise, and adverse cardiovascular outcomes among those with preexisting cardiovascular disease. The postulated biologic mechanisms underlying the relationships, areas of prevailing uncertainty, and potential public health implications are also discussed. EXPERT OPINION A physical activity level of 500 MET-min/week (equivalent to 150 min of moderate-intensity physical activity or 75 min of vigorous-intensity physical activity or an equivalent combination) may be a minimum requirement for patients with preexisting CVD. However, to reap the maximum benefits of physical activity and also minimize adverse effects, physical activity and/or exercise regimens should be tailored to unique factors such as individual's baseline physical activity habits, cardiovascular health status and the specific nature of their cardiovascular disease.
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Affiliation(s)
- Setor K. Kunutsor
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Jari A. Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland
- Wellbeing Services County of Central Finland, Department of Medicine, Jyväskylä, Finland
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127
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Goswami K, Badruddeen, Arif M, Akhtar J, Khan MI, Ahmad M. Flavonoids, Isoflavonoids and others Bioactives for Insulin Sensitizations. Curr Diabetes Rev 2024; 20:e270423216247. [PMID: 37102490 DOI: 10.2174/1573399819666230427095200] [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: 06/15/2022] [Revised: 02/22/2023] [Accepted: 02/27/2023] [Indexed: 04/28/2023]
Abstract
Diabetes is a chronic condition that has an impact on a huge part of the world. Both animals and humans have been demonstrated to benefit from natural goods, and organisms (animals, or microbes). In 2021, approximately 537 million adults (20-79 years) are living with diabetes, making it the one of the biggest cause of death worldwide. Various phytoconstituent preserved β- cells activity helps to prevent the formation of diabetes problems. As a result, β-cells mass and function are key pharmaceutical targets. The purpose of this review is to provide an overview of flavonoids' effects on pancreatic β-cells. Flavonoids have been demonstrated to improve insulin release in cell lines of isolated pancreatic islets and diabetic animal models. Flavonoids are thought to protect β-cells by inhibiting nuclear factor-κB (NF-κB) signaling, activating the phosphatidylinositol 3-kinase (PI3K) pathway, inhibiting nitric oxide production, and lowering reactive oxygen species levels. Flavonoids boost β-cells secretory capacity by improving mitochondrial bioenergetic function and increasing insulin secretion pathways. Some of the bioactive phytoconstituents such as S-methyl cysteine sulfoxides stimulate insulin synthesis in the body and increase pancreatic output. The berberine increased insulin secretion in the HIT-T15 and Insulinoma 6 (MIN6) mouse cell line. Epigallocatechin-3-Gallate protects against toxicity accrued by cytokines, reactive oxygen species (ROS), and hyperglycemia. Quercetin has been proven to boost insulin production by Insulinoma 1 (INS-1) cells and also protect cell apoptosis. Overall flavonoids have beneficial effects on β-cells by prevented their malfunctioning or degradation and improving synthesis or release of insulin from β-cells.
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Affiliation(s)
- Kushagra Goswami
- Faculty of Pharmacy, Integral University, Kursi Road, Lucknow, U.P. 226026, India
| | - Badruddeen
- Faculty of Pharmacy, Integral University, Kursi Road, Lucknow, U.P. 226026, India
| | - Muhammad Arif
- Faculty of Pharmacy, Integral University, Kursi Road, Lucknow, U.P. 226026, India
| | - Juber Akhtar
- Faculty of Pharmacy, Integral University, Kursi Road, Lucknow, U.P. 226026, India
| | - Mohammad Irfan Khan
- Faculty of Pharmacy, Integral University, Kursi Road, Lucknow, U.P. 226026, India
| | - Mohammad Ahmad
- Faculty of Pharmacy, Integral University, Kursi Road, Lucknow, U.P. 226026, India
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Rajab E, Wasif P, Doherty S, Gaynor D, Malik H, Fredericks S, Al-Qallaf A, Almuqahwi R, Alsharbati W, Rashid-Doubell F. Physical activity and sedentary behaviour of Bahraini people with type 2 diabetes: A cross-sectional study. Digit Health 2024; 10:20552076241251997. [PMID: 38766358 PMCID: PMC11102684 DOI: 10.1177/20552076241251997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2024] [Indexed: 05/22/2024] Open
Abstract
Objective Study patterns of physical activity and sedentary behaviour and the influence of demographics and body mass index (BMI) on these behaviours amongst Bahraini adults with type 2 diabetes over 10 weeks using an activity tracker. Method This cross-sectional observational study was conducted at a Bahrain government health centre. Thirty-three Bahraini Arab adults, 30-60 years old, with controlled type 2 diabetes, wore a Fitbit Flex 2TM activity tracker for 10 weeks. Data on age, sex, marital and employment status, education and BMI were collected at the start of the study. Results A total of N = 32 participants completed the study. The average steps per day were 7859 ± 4131, and there were no differences between baseline, week 5 and 10. A third of participants were sedentary, based on a threshold of 5000 steps/day. Females accumulated fewer average daily steps than males (6728 ± 2936 vs. 10,281 ± 4623, p = 0.018). Daily averages for physical activity intensity were as follows: sedentary (786 ± 109 min), light (250 ± 76 min), moderate (9 ± 10 min) and vigorous (12 ± 18 min). Males had higher daily averages versus females for moderate (13 ± 9 vs. 5 ± 9 min, p = 0.018) and vigorous physical activity (21 ± 23 vs. 5 ± 7 min, p = 0.034). 91% of participants wore the device ≥10 h/day. The adherence rate was 79% based on percentage of days the device was worn continuously over 10 weeks. Conclusion Future physical activity interventions should target sedentary and female participants with type 2 diabetes. In addition, we need to understand the facilitators and barriers to physical activity and the physical activity preferences of these two subgroups.
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Affiliation(s)
- Ebrahim Rajab
- School of Medicine, Royal College of Surgeons in Ireland & Medical University Bahrain, Adliya, Bahrain
| | - Pearl Wasif
- School of Medicine, Royal College of Surgeons in Ireland & Medical University Bahrain, Adliya, Bahrain
| | - Sally Doherty
- School of Medicine, Royal College of Surgeons in Ireland & Medical University Bahrain, Adliya, Bahrain
| | - Declan Gaynor
- School of Medicine, Royal College of Surgeons in Ireland & Medical University Bahrain, Adliya, Bahrain
| | - Hani Malik
- Mohammed Jassim Kanoo Health Centre, Hamad Town, Bahrain
| | - Salim Fredericks
- School of Medicine, Royal College of Surgeons in Ireland & Medical University Bahrain, Adliya, Bahrain
| | - Amal Al-Qallaf
- School of Medicine, Royal College of Surgeons in Ireland & Medical University Bahrain, Adliya, Bahrain
| | - Rabab Almuqahwi
- School of Medicine, Royal College of Surgeons in Ireland & Medical University Bahrain, Adliya, Bahrain
| | | | - Fiza Rashid-Doubell
- School of Medicine, Royal College of Surgeons in Ireland & Medical University Bahrain, Adliya, Bahrain
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129
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Lee J, Kim J, Ju HJ, An SJ, Woo B. A Longitudinal Dose-Response Curve Between Leisure-Time Physical Activity and the Prevalence of Diabetes Based on the Different Levels of Cognitive Function Among Older Adults. Am J Alzheimers Dis Other Demen 2024; 39:15333175241241891. [PMID: 38549562 PMCID: PMC11072067 DOI: 10.1177/15333175241241891] [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] [Indexed: 04/02/2024]
Abstract
This study investigated a dose-response relationship between Leisure-Time Physical Activity participation (LTPA) and the risk of diabetes and a comparison of the risk across different cognitive function groups among older adults. The Health and Retirement Study data were used from 2012 to 2020 (n = 18 746). This study conducted a Cox Proportional Hazard Regression to investigate the Dose-Response Curve between the prevalence of diabetes and the covariates following a level of LTPA participation. The result presented that the Odds Ratio continuously decreased as the level of LTPA participation increased. Among the three cognitive function groups, the high group (OR = .43, P < .05) and the mid group (OR = .71, P < .05) had a larger negative slope coefficient than the low group. This study found that LTPA participation reduces the risk of diabetes and gives evidence for the importance of cognitive function in reducing the prevalence of diabetes.
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Affiliation(s)
- Jungjoo Lee
- School of Health Professions, College of Nursing and Health Professions, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Junhyoung Kim
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Hyo Jin Ju
- Department of Medical Humanities, The Convergence Institute of Healthcare and Medical Science, Catholic Kwandong University, Incheon, South Korea
| | - Sang Joon An
- Department of Neurology, The Convergence Institute of Healthcare and Medical Science, International St. Mary’s Hospital, Catholic Kwandong University, Incheon, South Korea
| | - Bomi Woo
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
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130
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Vas P, Chockalingam N. Improving Physical, Physiological, and Psychological Health Outcomes in Patients with Diabetic Foot Ulcers - State of the Art. Clin Cosmet Investig Dermatol 2023; 16:3547-3560. [PMID: 38107668 PMCID: PMC10725647 DOI: 10.2147/ccid.s333660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 11/30/2023] [Indexed: 12/19/2023]
Abstract
Diabetic foot disease is a complex and challenging complication of diabetes mellitus, which imposes a significant burden of disease on patients, their carers, and the wider health systems. Recurrence rates are high, and current evidence indicates a high mortality associated with it. While management algorithms have primarily focused on the physical aspects of healing, there is increasing recognition of the critical role played by psychological and biomechanical factors in the development and resolution of diabetic foot disease. Therefore, in this paper, we aim to explore how diabetic foot outcomes can be improved by addressing not only the physical but also the psychological and biomechanical aspects that are integral to the development of this condition and its optimal resolution. We explore new technologies that allow for non-invasive objective assessment of the diabetic foot at risk, and we also explore the role of understanding biomechanics, which is essential to determining risk of foot disease, but also the potential for recurrence. In addition, we discuss the evidence linking depression and cognitive impairment to diabetic foot disease and offer our insight on the research direction required before implementing novel information into front-line clinics.
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Affiliation(s)
- Prashanth Vas
- Department of Diabetes and Diabetic Foot, King’s College Hospital NHS Foundation Trust, London, UK
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent, UK
- Department of Diabetes and Endocrinology, Guy’s and St Thomas’ Hospitals NHS Foundation Trust, London, UK
| | - Nachiappan Chockalingam
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent, UK
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131
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Strongman C, Cavallerio F, Timmis MA, Morrison A. Evaluating consistency of physical activity and exercise prescription in the UK for people with diabetes - a Delphi study. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2023; 4:1278597. [PMID: 38130886 PMCID: PMC10733474 DOI: 10.3389/fcdhc.2023.1278597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/17/2023] [Indexed: 12/23/2023]
Abstract
Introduction Increased physical activity is recommended as a cost-effective measure to tackle long-term management of people with diabetes, but research on interventions lacks consistency in terms of effective duration and modality. Methods The aim of this study was to evaluate expert consensus on exercise and physical activity prescription via a three-round Delphi study conducted with 45 UK-based health and fitness professionals experienced in prescribing exercise or physical activity to people with diabetes. Results The majority of items put forward to the panel reached consensus with 70% or above voting these items as important, but the details of the type, duration and/or modality of exercise or physical activity prescription within these items often contradicted each other, suggesting that patients are receiving inconsistent advice. The range of different exercise prescription found in this study suggests that patients are being given inconsistent and potentially confusing advice, which may affect their participation in exercise and long-term lifestyle change. Conclusion More consistent promotion of advice from healthcare and fitness professionals may help with increasing physical activity in this participant group and achieving long term behavior change, reducing patient symptoms as well as reducing the cost to the National Health Service (NHS).
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Affiliation(s)
- Clare Strongman
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
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132
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Al-Mhanna SB, Rocha-Rodriguesc S, Mohamed M, Batrakoulis A, Aldhahi MI, Afolabi HA, Yagin FH, Alhussain MH, Gülü M, Abubakar BD, Ghazali WSW, Alghannam AF, Badicu G. Effects of combined aerobic exercise and diet on cardiometabolic health in patients with obesity and type 2 diabetes: a systematic review and meta-analysis. BMC Sports Sci Med Rehabil 2023; 15:165. [PMID: 38049873 PMCID: PMC10696788 DOI: 10.1186/s13102-023-00766-5] [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: 08/14/2023] [Accepted: 11/06/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Lifestyle modifications involving diet and exercise are recommended for patients diagnosed with obesity and type 2 diabetes mellitus (T2DM). The purpose of this review was to systematically evaluate the effects of combined aerobic exercise and diet (AEDT) on various cardiometabolic health-related indicators among individuals with obesity and T2DM. METHODOLOGY A comprehensive search of the PubMed/Medline, Web of Science, Scopus, Science Direct, Cochrane, and Google Scholar databases was conducted for this meta-analysis. The Cochrane risk of bias tool was used to evaluate eligible studies, and the GRADE tool was used to rate the certainty of evidence. A random-effects model for continuous variables was used, and the results were presented as mean differences or standardised mean differences with 95% confidence intervals. RESULTS A total of 16,129 studies were retrieved; 20 studies were included, and data were extracted from 1,192 participants. The findings revealed significant improvements in body mass index, body weight, waist circumference, systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, fasting blood glucose, fasting plasma insulin, glycated hemoglobin, leptin, interleukin-6, C-reactive protein, and adiponectin (p < 0.05) compared to the standard treatment (ST) group. No significant differences were observed between the AEDT and ST groups in fat mass, hip circumference, waist-to-hip ratio, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and tumor necrosis factor-alpha. The present findings are based on low- to moderate-quality evidence. CONCLUSIONS AEDT may be a critical behavior for holistic cardiometabolic health-related benefits as a contemporary anti-obesity medication due to its significant positive impact on patients with obesity and T2DM. Nevertheless, further robust evidence is necessary to determine whether AEDT is an effective intervention for lowering cardiovascular and metabolic risk factors among individuals with obesity and T2DM.
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Affiliation(s)
- Sameer Badri Al-Mhanna
- Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, New Delhi, India
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia
| | - Sílvia Rocha-Rodriguesc
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
- Tumour & Microenvironment Interactions Group, INEB- Institute of Biomedical Engineering, i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Mahaneem Mohamed
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia
| | - Alexios Batrakoulis
- Department of Physical Education and Sport Science, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | - Monira I Aldhahi
- Department of Rehabilitation, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Hafeez Abiola Afolabi
- Department of General Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Fatma Hilal Yagin
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Maha H Alhussain
- Department of Food Science and Nutrition, College of Food and Agricultural Science, King Saud University, Riyadh, Saudi Arabia
| | - Mehmet Gülü
- Department of Sports Management, Faculty of Sport Sciences, Kirikkale University, Kirikkale, Turkey
| | - Bishir Daku Abubakar
- Department of Human Physiology, Federal University Dutse, Dutse, Jigawa State, Nigeria
| | - Wan Syaheedah Wan Ghazali
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia.
| | - Abdullah F Alghannam
- Lifestyle and Health Research Center, Health Sciences Research Center, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Georgian Badicu
- Department of Physical Education and Special Motricity, Transilvania University of Brasov, Brasov, Romania
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133
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Yang X, Han R, Xiang Z, Li H, Zhao Q, Chen L, Gao L. Clinical practice guidelines on physical activity and exercise for pregnant women with gestational diabetes mellitus: A systematic review. Int J Nurs Pract 2023; 29:e13141. [PMID: 36929054 DOI: 10.1111/ijn.13141] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 01/11/2023] [Accepted: 01/27/2023] [Indexed: 03/18/2023]
Abstract
AIM This review aimed to appraise clinical guidelines about exercise for women with gestational diabetes mellitus and summarize consensus and inconsistent recommendations. BACKGROUND Exercise is an effective non-pharmacological therapeutic for gestational diabetes mellitus, but the variety of relevant clinical practice guidelines is confusing for healthcare professionals. DESIGN This is a systematic review of clinical practice guidelines. DATA SOURCES Websites of guideline development institutions, eight literature databases and organizations of obstetricians, gynaecologists, midwives, and medical sports associations were searched for guidelines published from January 2011 to October 2021. REVIEW METHODS Two reviewers independently extracted recommendations. Four reviewers assessed guideline quality using the AGREE II instrument independently. RESULTS Fifteen guidelines were included. All women with diabetes are recommended to exercise during pregnancy. The consistent recommendations were for pre-exercise screening, for 30 min per exercise session on 5 days of the week or every day after meals, exercise at moderate intensity, using aerobic and resistance exercise, and walking. The main non-consistent recommendations included warning signs for women on insulin during exercise, minimum duration per session, intensity assessment, duration and frequency of sessions for strengthening and flexibility exercise and detailed physical activity giving birth. CONCLUSIONS Guidelines strongly support pregnant women with diabetes to exercise regularly. Research is needed to make non-consistent recommendations clear.
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Affiliation(s)
- Xiao Yang
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Rongrong Han
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Zhixuan Xiang
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Hanbing Li
- School of Nursing, University of South China, Hengyang, China
| | - Qian Zhao
- Office of the Dean (Party Committee), Gem Flower Xi'an Changqing Staff Hospital, Xi'an, China
| | - Lu Chen
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Lingling Gao
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
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134
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Hancox JE, Hilton C, Gray K, Game F, Vedhara K. Adherence to limiting weight-bearing activity in patients with diabetic foot ulcers: A qualitative study. Int Wound J 2023; 20:3945-3954. [PMID: 37312664 PMCID: PMC10681470 DOI: 10.1111/iwj.14282] [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: 11/29/2022] [Accepted: 06/01/2023] [Indexed: 06/15/2023] Open
Abstract
Patients with diabetic foot ulcers are advised to limit weight-bearing activity for ulcers to heal. Patients often disregard this advice although the reasons are not yet fully understood. This study explored (1) patients' experiences of receiving the advice and (2) factors influencing adherence to the advice. Semi-structured interviews were conducted with 14 patients with diabetic foot ulcers. Interviews were transcribed and analysed using inductive thematic analysis. Advice regarding limiting weight-bearing activity was described by patients as directive, generic and conflicting with other priorities. Rapport, empathy and rationale supported receptivity to the advice. Barriers and facilitators to limiting weight-bearing activity included demands of daily living, enjoyment of exercise, sick/disabled identity and burden, depression, neuropathy/pain, health benefits, fear of negative consequences, positive feedback, practical support, weather and active/passive role in recovery. It is important that healthcare professionals pay attention to how limiting weight-bearing activity advice is communicated. We propose a more person-centred approach in which advice is tailored to individuals' specific needs with discussion around patient priorities and constraints.
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Affiliation(s)
- Jennie E. Hancox
- School of MedicineUniversity of NottinghamNottinghamUK
- Loughborough UniversityLoughboroughUK
| | | | - Katie Gray
- Derbyshire Community Health Services NHSBakewellUK
| | - Fran Game
- University Hospitals of Derby and Burton NHS Foundation TrustDerbyUK
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135
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Campbell MD, Alobaid AM, Hopkins M, Dempsey PC, Pearson SM, Kietsiriroje N, Churm R, Ajjan RA. Interrupting prolonged sitting with frequent short bouts of light-intensity activity in people with type 1 diabetes improves glycaemic control without increasing hypoglycaemia: The SIT-LESS randomised controlled trial. Diabetes Obes Metab 2023; 25:3589-3598. [PMID: 37622406 DOI: 10.1111/dom.15254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/31/2023] [Accepted: 08/08/2023] [Indexed: 08/26/2023]
Abstract
AIM To examine the impact of interrupting prolonged sitting with frequent short bouts of light-intensity activity on glycaemic control in people with type 1 diabetes (T1D). MATERIALS AND METHODS In total, 32 inactive adults with T1D [aged 27.9 ± 4.7 years, 15 men, diabetes duration 16.0 ± 6.9 years and glycated haemoglobin 8.4 ± 1.4% (68 ± 2.3 mmol/mol)] underwent two 7-h experimental conditions in a randomised crossover fashion with >7-day washout consisting of: uninterrupted sitting (SIT), or, interrupted sitting with 3-min bouts of self-paced walking at 30-min intervals (SIT-LESS). Standardised mixed-macronutrient meals were administered 3.5 h apart during each condition. Blinded continuous glucose monitoring captured interstitial glucose responses during the 7-h experimental period and for a further 48-h under free-living conditions. RESULTS SIT-LESS reduced total mean glucose (SIT 8.2 ± 2.6 vs. SIT-LESS 6.9 ± 1.7 mmol/L, p = .001) and increased time in range (3.9-10.0 mmol/L) by 13.7% (SIT 71.5 ± 9.5 vs. SIT-LESS 85.1 ± 7.1%, p = .002). Hyperglycaemia (>10.0 mmol/L) was reduced by 15.0% under SIT-LESS (SIT 24.2 ± 10.8 vs. SIT-LESS 9.2 ± 6.4%, p = .002), whereas hypoglycaemia exposure (<3.9 mmol/L) (SIT 4.6 ± 3.0 vs. SIT-LESS 6.0 ± 6.0%, p = .583) was comparable across conditions. SIT-LESS reduced glycaemic variability (coefficient of variation %) by 7.8% across the observation window (p = .021). These findings were consistent when assessing discrete time periods, with SIT-LESS improving experimental and free-living postprandial, whole-day and night-time glycaemic outcomes (p < .05). CONCLUSIONS Interrupting prolonged sitting with frequent short bouts of light-intensity activity improves acute postprandial and 48-h glycaemia in adults with T1D. This pragmatic strategy is an efficacious approach to reducing sedentariness and increasing physical activity levels without increasing risk of hypoglycaemia in T1D.
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Affiliation(s)
- Matthew D Campbell
- John Dawson Drug Discovery and Development Institute, University of Sunderland, Sunderland, UK
- Leeds Institute of Cardiovascular and Metabolic Medicine, Faculty of Medicine, University of Leeds, Leeds, UK
- Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Anwar M Alobaid
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, UK
- Ministry of Health, Farwaniya Hospital, Kuwait, Kuwait
| | - Mark Hopkins
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, UK
| | - Paddy C Dempsey
- Institute of Metabolic Science, University of Cambridge, Cambridge, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
- Baker Heart and Diabetes Institute, Melbourne, Australia
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Sam M Pearson
- Leeds Institute of Cardiovascular and Metabolic Medicine, Faculty of Medicine, University of Leeds, Leeds, UK
| | - Noppadol Kietsiriroje
- Leeds Institute of Cardiovascular and Metabolic Medicine, Faculty of Medicine, University of Leeds, Leeds, UK
- Endocrinology and Metabolism Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Rachel Churm
- Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, Faculty of Science and Engineering, Swansea University, Swansea, UK
| | - Ramzi A Ajjan
- Leeds Institute of Cardiovascular and Metabolic Medicine, Faculty of Medicine, University of Leeds, Leeds, UK
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136
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Yen HY, Lee SC, Lin CF, Lai HR, Yamaguchi Y, Lee PH. Prevalence of sarcopenia and its association with diet and physical activity in older adults with type 2 diabetes: A cross-sectional study. Nurs Health Sci 2023; 25:628-635. [PMID: 37783469 DOI: 10.1111/nhs.13055] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 09/01/2023] [Accepted: 09/19/2023] [Indexed: 10/04/2023]
Abstract
This cross-sectional study explored the prevalence of sarcopenia in older adults with type 2 diabetes and investigated the effects of diet and physical activity on sarcopenia. In total, 577 older adults with diabetes were recruited from a teaching hospital in Taiwan. Diet and physical activity were assessed using self-rated questionnaires, including the Healthy Diet Inventory, the Mini Nutritional Assessment-Short Form, and the International Physical Activity Questionnaire-Short Form. Sarcopenia was defined in accordance with the Asian Working Group for Sarcopenia 2019 guidelines. In total, 51.12% of participants had either possible sarcopenia, sarcopenia, or severe sarcopenia. Participants who were female, old age, prolonged sedentary times, poor nutritional status, and lower level of moderate-to-vigorous physical activity were identified as risk factors for possible to severe sarcopenia. Older adults with diabetes and possible to severe sarcopenia had poor nutrition status and engaged in inadequate physical activity. The findings indicate that sarcopenia may be related to nutrition status and physical activity, especially in older adults with diabetes.
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Affiliation(s)
- Hsin-Yen Yen
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Shu-Chun Lee
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Chiou-Fen Lin
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Hsiang-Ru Lai
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Yuko Yamaguchi
- Graduate School of Health Sciences, Kobe University, Kobe, Japan
| | - Pi-Hsia Lee
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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137
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Chen S, Wu Y, Bushey EL, Pescatello LS. Evaluation of Exercise Mobile Applications for Adults with Cardiovascular Disease Risk Factors. J Cardiovasc Dev Dis 2023; 10:477. [PMID: 38132645 PMCID: PMC10743387 DOI: 10.3390/jcdd10120477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE To conduct a systematic review to determine if there are exercise mobile applications (apps) that can produce evidence-based, individualized exercise plans. MATERIALS AND METHODS We searched the Apple Store and Google Play for exercise apps with terms related to exercise and health. Exercise apps were eligible if they: (1) had a ≥4 out of 5 overall rating with ≥1000 reviews; (2) were free to download; and (3) were not gender specific. Exercise apps were evaluated via the evidence-based exercise prescription (ExRx) standards of the American College of Sports Medicine (ACSM) and American Heart Association. For the exercise app evaluation criteria, an app was included if it (1) was evidence-based; (2) contained a preparticipation health screening protocol; (3) built a cardiovascular disease (CVD) risk factor profile; (4) prioritized one chronic disease or health condition to focus on; (5) framed the exercise plan by the frequency, intensity, time, and type principle (FITT) of ExRx; and (6) specified special considerations. RESULTS Of the 531 potentially qualifying apps, 219 qualified. The qualifying apps were rarely evidenced-based (0.5%) or had a preparticipation screening protocol (3.7%). Only 27.7% built CVD risk factor profiles. Most apps (64.8%) focused on body image and/or athletic performance. Only 4.3% focused on chronic diseases or health conditions, while the remainder (34.5%) did not disclose a focus. No app framed the exercise plans by the FITT of ExRx. Only 1.4% of the apps specified special considerations. CONCLUSION There are no commercially available exercise apps that generate an evidence-based, individualized exercise plan for adults with CVD risk factors.
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Affiliation(s)
- Shiqi Chen
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA; (Y.W.); (E.L.B.); (L.S.P.)
| | - Yin Wu
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA; (Y.W.); (E.L.B.); (L.S.P.)
- Institute for Collaboration on Health Intervention and Policy, University of Connecticut, Storrs, CT 06269, USA
- Department of Research, Hartford Hospital, Hartford, CT 06102, USA
| | - Erica L. Bushey
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA; (Y.W.); (E.L.B.); (L.S.P.)
| | - Linda S. Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA; (Y.W.); (E.L.B.); (L.S.P.)
- Institute for Collaboration on Health Intervention and Policy, University of Connecticut, Storrs, CT 06269, USA
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138
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Dong C, Liu R, Huang Z, Yang Y, Sun S, Li R. Effect of exercise interventions based on family management or self-management on glycaemic control in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Diabetol Metab Syndr 2023; 15:232. [PMID: 37957775 PMCID: PMC10644553 DOI: 10.1186/s13098-023-01209-4] [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: 03/16/2023] [Accepted: 11/02/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Most studies about exercise interventions for patients with type 2 diabetes mellitus (T2DM) have been conducted in hospitals or labs, but it is unclear whether study findings from this specific condition can be generalised to real-life T2DM communities. If patients with T2DM can exercise on their own or with family members, it may also reduce the need for patient supervision by medical staff, thereby reducing the burden of medical treatment and improving condition management's cost-effectiveness and practicability. Much of the current research on exercise interventions for T2DM was focused on the type of exercise and less on the mode of management, so we aimed to examine the effect of exercise interventions based on family management or self-management on glycaemic control in patients with T2DM. METHODS Articles were searched from eight Chinese and English databases. Randomized control trials (RCTs) published in English and Chinese, from inception to October 17, 2022, were included in this review. The methodological quality of the included studies was assessed using the RCT risk of bias assessment tool provided by the Cochrane Collaboration's tool. Meta-analysis was performed using Rev Man 5.4 and Stata 15.0 software. Heterogeneity was investigated using sensitivity analysis and subgroup analyses. Publication bias was tested by funnel plot and Egger's asymmetry tests. RESULTS A total of 10 studies with a total of 913 subjects were finally included in this review. The Meta-analysis showed that exercise interventions based on family management or self-management were more effective than control groups in reducing HbA1c (Z = 3.90; 95% CI MD = - 0.81; - 1.21 to - 0.40; P < 0.0001), fasting glucose (Z = 4.63; 95% CI MD = - 1.17; - 1.67 to - 0.68; P < 0.00001), 2-h plasma glucose (Z = 5.53; 95% CI MD = - 1.84; - 2.50 to - 1.19; P < 0.00001), and Low-density lipoproteins levels (Z = 3.73; 95% CI MD = - 0.38; - 0.58 to - 0.18; P = 0.0002). CONCLUSIONS Exercise interventions based on family management or self-management can significantly reduce glycosylated haemoglobin, fasting glucose, 2-h plasma glucose, and Low-density lipoproteins levels in patients with T2DM, which can effectively delay disease progression and reduce the risk of developing complications. In the future, for exercise interventions based on family or self-management, this review recommended that exercise intervention programmes should be formulated according to 30-60 min per session, more than three times per week, for more than six months of aerobic exercise or aerobic combined with resistance exercise.
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Affiliation(s)
- Chenyang Dong
- School of Sport Science, Beijing Sport University, 48 Xinxi Road, Haidian District, Beijing, China
| | - Ruoya Liu
- School of Sport Science, Beijing Sport University, 48 Xinxi Road, Haidian District, Beijing, China
| | - Zhiyang Huang
- School of Sport Science, Beijing Sport University, 48 Xinxi Road, Haidian District, Beijing, China
| | - Yang Yang
- School of Sport Science, Beijing Sport University, 48 Xinxi Road, Haidian District, Beijing, China
| | - Shiyuan Sun
- School of Sport Science, Beijing Sport University, 48 Xinxi Road, Haidian District, Beijing, China
| | - Ran Li
- School of Sport Science, Beijing Sport University, 48 Xinxi Road, Haidian District, Beijing, China.
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139
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Schroeder AE, Rosenkranz RR, Yarrow LK, Haub MD, Rosenkranz SK. Recovery Phase Nutrition and Insulin Strategies for a Collegiate Distance Runner with Type 1 Diabetes Mellitus: A Case Study. Sports (Basel) 2023; 11:214. [PMID: 37999431 PMCID: PMC10674803 DOI: 10.3390/sports11110214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/12/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023] Open
Abstract
PURPOSE There is scant published research regarding nutrition and insulin strategies for athletic performance in collegiate distance runners with type 1 diabetes mellitus (CDRT1). Acute carbohydrate supplementation (CHOsup) and insulin reduction used to minimize hypoglycemia during exercise may result in deteriorated glycemic control post exercise in CDRT1. The present case study of a CDRT1 investigated outcomes associated with a moderate-carbohydrate (ModCHO) diet and 24 h insulin adjustment during recovery phases for improved glycemic control and reduced use of acute strategies. METHODS During an 8-day period, a female CDRT1 followed a ModCHO (~4 g/kg/day) nutrition program. Recovery phase adjustments to insulin doses were made using an equation developed to estimate reduced insulin needs post exercise, as a function of exercise intensity and duration. Daily training was performed in the fasted state at 6:00 a.m. and included additional exercise strategies to reduce glycemic variability when needed. Daily blood glucose time-in-range (TIR) and use of CHOsup were assessed. Athlete well-being was determined using the Student-Athlete Well-Being Scale (SAWS)TM at baseline, and days 1, 3, and 7. RESULTS Throughout the 8-day period, mean TIR increased (77% versus < 50%) and the magnitude of glycemic excursions decreased (~3.8-15 versus ~3.0-26 mmol/L) relative to a prior comparison period. Minimal pre-exercise CHOsup was employed and CHOsup during exercise was not required. Additionally, the athlete achieved a new lifetime best in the 5000 m run and maintained positive well-being. CONCLUSION The present case study provides examples of recovery phase strategies (i.e., ModCHO diet and 24 h insulin adjustments) that may support glycemic control and athletic performance in CDRT1 and provides potential considerations for nutrition and insulin strategies for use by athletes and coaches.
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Affiliation(s)
- Amie E. Schroeder
- Department of Food, Nutrition, Dietetics and Health, College of Health and Human Sciences, Kansas State University, Manhattan, KS 66506, USA; (R.R.R.); (L.K.Y.); (M.D.H.); (S.K.R.)
| | - Richard R. Rosenkranz
- Department of Food, Nutrition, Dietetics and Health, College of Health and Human Sciences, Kansas State University, Manhattan, KS 66506, USA; (R.R.R.); (L.K.Y.); (M.D.H.); (S.K.R.)
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada Las Vegas, Las Vegas, NV 89154, USA
| | - Linda K. Yarrow
- Department of Food, Nutrition, Dietetics and Health, College of Health and Human Sciences, Kansas State University, Manhattan, KS 66506, USA; (R.R.R.); (L.K.Y.); (M.D.H.); (S.K.R.)
| | - Mark D. Haub
- Department of Food, Nutrition, Dietetics and Health, College of Health and Human Sciences, Kansas State University, Manhattan, KS 66506, USA; (R.R.R.); (L.K.Y.); (M.D.H.); (S.K.R.)
| | - Sara K. Rosenkranz
- Department of Food, Nutrition, Dietetics and Health, College of Health and Human Sciences, Kansas State University, Manhattan, KS 66506, USA; (R.R.R.); (L.K.Y.); (M.D.H.); (S.K.R.)
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada Las Vegas, Las Vegas, NV 89154, USA
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140
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Padilha C, Souza R, Grossl FS, Gauer APM, de Sá CA, Rodrigues-Junior SA. Physical exercise and its effects on people with Parkinson's disease: Umbrella review. PLoS One 2023; 18:e0293826. [PMID: 37917715 PMCID: PMC10621990 DOI: 10.1371/journal.pone.0293826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/20/2023] [Indexed: 11/04/2023] Open
Abstract
INTRODUCTION Parkinson's disease is neurodegenerative, complex and progressive, manifesting in a slow and irreversible way. Physical exercise has been proposed as therapeutic alternative to people with Parkinson´s disease. OBJECTIVE To synthesize knowledge about the effects of physical exercise on people with Parkinson´s Disease as presented by published systematic reviews. METHODS Nine electronic databases and two grey literature databases were searched for systematic reviews reporting the effects of physical exercises on people with Parkinson´s Disease. Searches involved a two-phase process, by, at least, two independent reviewers. Methodological quality of the included systematic reviews was assessed using AMSTAR-2. RESULTS From 2,122 systematic reviews, 139 were included. Motor outcomes were assessed in 91% of the studies, with balance being the most studied. Non-motor outcomes were assessed in 68% of the studies, with emphasis on quality of life. Physical exercises were classified into five categories: aerobic exercises, strength, combined, sensorimotor activities and other activity protocols. Findings of the systematic reviews suggest that all exercise categories can be prescribed to improve balance and mobility, while combined exercises, strength, and specific activities improve both motor and non-motor outcomes, and aerobic exercise and sensorimotor activities improve motor outcomes. CONCLUSION Current evidence from systematic reviews suggests that physical exercises impacts both motor and non-motor outcomes in people with Parkinson´s Disease. Limits in evidence provided by the systematic reviews were related to methodological issues and to the description of the interventions and must be considered to improve decision-making and clinical application.
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Affiliation(s)
- Cristiano Padilha
- Health Sciences Post-Graduate Program, Universidade Comunitária da Região de Chapecó–Unochapecó, Chapecó, Santa Catarina, Brazil
| | - Renan Souza
- Health Sciences Post-Graduate Program, Universidade Comunitária da Região de Chapecó–Unochapecó, Chapecó, Santa Catarina, Brazil
| | - Fernando Schorr Grossl
- Health Sciences Post-Graduate Program, Universidade Comunitária da Região de Chapecó–Unochapecó, Chapecó, Santa Catarina, Brazil
| | - Ana Paula Maihack Gauer
- Health Sciences Post-Graduate Program, Universidade Comunitária da Região de Chapecó–Unochapecó, Chapecó, Santa Catarina, Brazil
| | - Clodoaldo Antônio de Sá
- Health Sciences Post-Graduate Program, Universidade Comunitária da Região de Chapecó–Unochapecó, Chapecó, Santa Catarina, Brazil
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141
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Minasian V, Nazari M. The association between type 1 diabetes and exercise/physical activity and prolongation of the honeymoon phase in patients. Life Sci 2023; 332:122114. [PMID: 37739162 DOI: 10.1016/j.lfs.2023.122114] [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: 08/06/2023] [Revised: 09/14/2023] [Accepted: 09/19/2023] [Indexed: 09/24/2023]
Abstract
In type 1 diabetes (T1D), pancreatic beta cells are destroyed by the immune system, causing chronic hyperglycemia and micro and macrovascular complications. However, some people experience a 'honeymoon' phase (or partial remission) after being diagnosed with type 1 diabetes. During this phase, a substantial amount of insulin is still produced by the pancreas, helping to reduce blood sugar levels and the requirement for external insulin. The clinical significance of this phase lies in the potential for pharmacological and non-pharmacological interventions during this time frame to either slow down or arrest beta-cell destruction. Clearly, we need to continue researching novel therapies like immunomodulatory agents, but we also need to look at potentially effective therapies with acceptable side effects that can serve as a complement to the medicines currently being studied. Physical activity and exercise, regardless of its type, is one of the factors its impact on the control of diabetes is being investigated and promising results have been achieved. Although there are still limited reports in this regard, there is some evidence to suggest that regular physical exercise could prolong the honeymoon period in both adults and children. In this review, having described the immune base of type 1 diabetes, we outline the benefits of exercise on the general health of individuals with T1D. Moreover, we centered on the honeymoon and current evidence suggesting the effects of physical activity and exercise on this phase duration.
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Affiliation(s)
- Vazgen Minasian
- Faculty of Sport Sciences, Department of Exercise physiology, University of Isfahan, Isfahan, Iran.
| | - Maryam Nazari
- Faculty of Sport Sciences, Department of Exercise physiology, University of Isfahan, Isfahan, Iran.
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142
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Maiorino MI, Buzzetti R, Irace C, Laviola L, Napoli N, Pitocco D, Esposito K. An updated algorithm for an effective choice of continuous glucose monitoring for people with insulin-treated diabetes. Endocrine 2023; 82:215-225. [PMID: 37676398 PMCID: PMC10543826 DOI: 10.1007/s12020-023-03473-w] [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: 05/06/2023] [Accepted: 07/25/2023] [Indexed: 09/08/2023]
Abstract
PURPOSE Continuous Glucose Monitoring (CGM) is a key tool for insulin-treated people with diabetes (PwD). CGM devices include both real-time CGM (rtCGM) and intermittently scanned CGM (isCGM), which are associated with an improvement of glucose control and less hypoglycemia in clinical trials of people with type 1 and type 2 diabetes. METHODS This is an expert position to update a previous algorithm on the most suitable choice of CGM for insulin-treated PwD in light of the recent evidence and clinical practice. RESULTS We identified six different clinical scenarios, including type 1 diabetes, type 2 diabetes, pregnancy on intensive insulin therapy, regular physical exercise, new onset of diabetes, and frailty. The use of rtCGM or isCGM is suggested, on the basis of the predominant clinical issue, as suboptimal glucose control or disabling hypoglycemia, regardless of baseline HbA1c or individualized HbA1c target. CONCLUSION The present algorithm may help to select the best CGM device based on patients' clinical characteristics, needs and clinical context, offering a further opportunity of a "tailored" therapy for people with insulin-treated diabetes.
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Affiliation(s)
- Maria Ida Maiorino
- Unit of Endocrinology and Metabolic Diseases, University Hospital Luigi Vanvitelli, Piazza Miraglia 2, 80138, Naples, Italy.
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Piazza Miraglia 2, 80138 Naples, Naples, Italy.
| | - Raffaella Buzzetti
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Concetta Irace
- Department of Health Science, University Magna Graecia, Viale Europa, 88100, Catanzaro, Italy
| | - Luigi Laviola
- Department of Precision and Regenerative Medicine and Ionian Area, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Nicola Napoli
- Fondazione Policlinico Universitario Campus Bio-Medico, Research Unit of Endocrinology and Diabetes, Department of Medicine and Surgery, Università Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, 00128, Rome, Italy
| | - Dario Pitocco
- Diabetes Care Unit, Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Katherine Esposito
- Unit of Endocrinology and Metabolic Diseases, University Hospital Luigi Vanvitelli, Piazza Miraglia 2, 80138, Naples, Italy
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Piazza Miraglia 2, 80138 Naples, Naples, Italy
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143
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Haris F, Jan YK, Liau BY, Hsieh CW, Shen WC, Tai CC, Shih YH, Lung CW. The effects of different inner pressures of air insoles and walking durations on peak plantar pressure. Medicine (Baltimore) 2023; 102:e35704. [PMID: 37904356 PMCID: PMC10615489 DOI: 10.1097/md.0000000000035704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 09/28/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Exercise reduces chronic complications in individuals with diabetes and peripheral vascular diseases. In clinical practice, the use of air insole may reduce peak plantar pressure (PPP), and risk for diabetic foot ulcers (DFUs). However, there is no guideline on selecting air insole pressure for effectively reducing PPP. Therefore, this study aimed to investigate the effects of different air insole pressure on PPP at different walking durations. METHODS We tested 13 participants using repeated measures study design, including 3 air insole pressures (80, 160, and 240 mm Hg) and 2 walking durations (10 and 20 minutes) for 6 walking conditions. PPP values at the first toe, first metatarsal head, and second metatarsal head were calculated. RESULTS The one-way ANOVA showed significant pairwise differences of PPP at 20 minutes duration in the first metatarsal head between 80 and 240 mm Hg (P = .007) and between 160 and 240 mm Hg (P = .038); in the second metatarsal head between 80 and 240 mm Hg (P = .043). The paired t test confirmed that walking duration significantly has lower PPP at 10 minutes than 20 minutes with 240 mm Hg air insole in the first metatarsal head (P = .012) and the second metatarsal head (P = .027). CONCLUSION People at risk of foot ulcers are suggested to wear shoes with 80 mm Hg of air insole for reducing PPP in the first metatarsal head and the second metatarsal head. Moreover, people may avoid wearing the stiffer insole (240 mm Hg) for more than 20 minutes.
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Affiliation(s)
- Fahni Haris
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
- School of Nursing, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
| | - Yih-Kuen Jan
- Rehabilitation Engineering Lab, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Ben-Yi Liau
- Department of Automatic Control Engineering, Feng Chia University, Taichung, Taiwan
| | - Chang-Wei Hsieh
- Department of Computer Science & Information Engineering, Asia University, Taichung, Taiwan
| | - Wei-Cheng Shen
- Department of Digital Media Design, Asia University, Taichung, Taiwan
| | - Chien-Cheng Tai
- School of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Yin-Hwa Shih
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Chi-Wen Lung
- Rehabilitation Engineering Lab, University of Illinois at Urbana-Champaign, Champaign, IL, USA
- Department of Creative Product Design, Asia
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Kvandová M, Rajlic S, Stamm P, Schmal I, Mihaliková D, Kuntic M, Bayo Jimenez MT, Hahad O, Kollárová M, Ubbens H, Strohm L, Frenis K, Duerr GD, Foretz M, Viollet B, Ruan Y, Jiang S, Tang Q, Kleinert H, Rapp S, Gericke A, Schulz E, Oelze M, Keaney JF, Daiber A, Kröller-Schön S, Jansen T, Münzel T. Mitigation of aircraft noise-induced vascular dysfunction and oxidative stress by exercise, fasting, and pharmacological α1AMPK activation: molecular proof of a protective key role of endothelial α1AMPK against environmental noise exposure. Eur J Prev Cardiol 2023; 30:1554-1568. [PMID: 37185661 DOI: 10.1093/eurjpc/zwad075] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/22/2023] [Accepted: 03/11/2023] [Indexed: 05/17/2023]
Abstract
AIMS Environmental stressors such as traffic noise represent a global threat, accounting for 1.6 million healthy life years lost annually in Western Europe. Therefore, the noise-associated health side effects must be effectively prevented or mitigated. Non-pharmacological interventions such as physical activity or a balanced healthy diet are effective due to the activation of the adenosine monophosphate-activated protein kinase (α1AMPK). Here, we investigated for the first time in a murine model of aircraft noise-induced vascular dysfunction the potential protective role of α1AMPK activated via exercise, intermittent fasting, and pharmacological treatment. METHODS AND RESULTS Wild-type (B6.Cg-Tg(Cdh5-cre)7Mlia/J) mice were exposed to aircraft noise [maximum sound pressure level of 85 dB(A), average sound pressure level of 72 dB(A)] for the last 4 days. The α1AMPK was stimulated by different protocols, including 5-aminoimidazole-4-carboxamide riboside application, voluntary exercise, and intermittent fasting. Four days of aircraft noise exposure produced significant endothelial dysfunction in wild-type mice aorta, mesenteric arteries, and retinal arterioles. This was associated with increased vascular oxidative stress and asymmetric dimethylarginine formation. The α1AMPK activation with all three approaches prevented endothelial dysfunction and vascular oxidative stress development, which was supported by RNA sequencing data. Endothelium-specific α1AMPK knockout markedly aggravated noise-induced vascular damage and caused a loss of mitigation effects by exercise or intermittent fasting. CONCLUSION Our results demonstrate that endothelial-specific α1AMPK activation by pharmacological stimulation, exercise, and intermittent fasting effectively mitigates noise-induced cardiovascular damage. Future population-based studies need to clinically prove the concept of exercise/fasting-mediated mitigation of transportation noise-associated disease.
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Affiliation(s)
- Miroslava Kvandová
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- Institute of Normal and Pathological Physiology, Center of Experimental Medicine, Slovak Academy of Sciences, Sienkiewiczova 1813 71 Bratislava, Slovak Republic
| | - Sanela Rajlic
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- Department of Cardiovascular Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Paul Stamm
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Isabella Schmal
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Dominika Mihaliková
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Marin Kuntic
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Maria Teresa Bayo Jimenez
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Omar Hahad
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Marta Kollárová
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- Institute of Physiology, Faculty of Medicine, Comenius University Bratislava, Sasinkova 2, 811 08 Bratislava, Slovakia
| | - Henning Ubbens
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Lea Strohm
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Katie Frenis
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Georg Daniel Duerr
- Department of Cardiovascular Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Marc Foretz
- Université Paris Cité, CNRS, INSERM, Institut Cochin, F-75014 Paris, France
| | - Benoit Viollet
- Université Paris Cité, CNRS, INSERM, Institut Cochin, F-75014 Paris, France
| | - Yue Ruan
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Subao Jiang
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Qi Tang
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Hartmut Kleinert
- Department of Pharmacology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Steffen Rapp
- Department of Cardiology, Preventive Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Adrian Gericke
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | | | - Matthias Oelze
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - John F Keaney
- Division of Cardiovascular Medicine, UMass Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Andreas Daiber
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Swenja Kröller-Schön
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Thomas Jansen
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- Department of Cardiology, KVB Hospital Königstein, 61462 Königstein, Germany
| | - Thomas Münzel
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Langenbeckstr. 1, 55131 Mainz, Germany
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Yadegar A, Mohammadi F, Rabizadeh S, Meysamie A, Nabipoorashrafi SA, Seyedi SA, Esteghamati A, Nakhjavani M. Decreasing trend of blood lipid profile in type 2 diabetes: Not a promising change in HDL-C, a serial cross-sectional study. PLoS One 2023; 18:e0293410. [PMID: 37878656 PMCID: PMC10599547 DOI: 10.1371/journal.pone.0293410] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 10/03/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND The prevalence of dyslipidemia in patients with type 2 diabetes (T2D) has been reported to be relatively high. The current study aimed to investigate the trend of serum lipid levels and the prevalence of dyslipidemia in patients with T2D. METHODS Data were extracted from a cohort of patients with T2D who had regular follow-ups every year for three years. TG, TC, LDL-C, HDL-C, and non-HDL-C were analyzed. The atherogenic index of plasma (AIP) was calculated using log (TG/HDL-C). RESULTS A total of 747 patients with T2D were included in this study, consisting of 469 (62.8%) women and 278 (37.2%) men. There was a significant downward trend in mean TG, TC, LDL-C, non-HDL-C, and AIP levels. The trend of mean HDL-C levels showed no significant change. The prevalence of high TG, high TC, high LDL-C, and high non-HDL-C significantly decreased from the first to the last visit. There was no significant change in the trend of prevalence of low HDL-C. The prevalence of high AIP significantly decreased in women and showed no significant changes in men. CONCLUSIONS A decreasing trend was observed in the mean levels and prevalence of TG, TC, LDL-C, non-HDL-C, and AIP. HDL-C did not change significantly. The success rate in achieving a complete normal lipid profile during follow-up years was not promising and continues to be challenging.
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Affiliation(s)
- Amirhossein Yadegar
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Mohammadi
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Soghra Rabizadeh
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alipasha Meysamie
- Department of Community and Preventive Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Cardiac Primary Prevention Research Center (CPPRC), Cardiovascular Diseases Research Institute (CVDRI), Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Nabipoorashrafi
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Arsalan Seyedi
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Esteghamati
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Manouchehr Nakhjavani
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Muema FW, Nanjala C, Oulo MA, Wangchuk P. Phytochemical Content and Antidiabetic Properties of Most Commonly Used Antidiabetic Medicinal Plants of Kenya. Molecules 2023; 28:7202. [PMID: 37894680 PMCID: PMC10609527 DOI: 10.3390/molecules28207202] [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: 09/27/2023] [Revised: 10/13/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
Traditional medicinal plants have been used for decades in folk medicines in the treatment and management of several ailments and diseases including diabetes, pain, ulcers, cancers, and wounds, among others. This study focused on the phytochemical and antidiabetic activity of the commonly used antidiabetic medicinal species in Kenya. Phytochemical profiling of these species revealed flavonoids and terpenoids as the major chemical classes reported which have been linked with strong biological activities against the aforementioned diseases, among others. However, out of the selected twenty-two species, many of the natural product isolation studies have focused on only a few species, as highlighted in the study. All of the examined crude extracts from thirteen antidiabetic species demonstrated strong antidiabetic activities by inhibiting α-glucosidase and α-amylase among other mechanisms, while nine are yet to be evaluated for their antidiabetic activities. Isolated compounds S-Methylcysteine sulfoxide, quercetin, alliuocide G, 2-(3,4-Dihydroxybenzoyl)-2,4,6-trihydroxy-3 (2H)-benzofuranone, Luteolin-7-O-D-glucopyranoside, quercetin, 1,3,11α-Trihydroxy-9-(3,5,7-trihydroxy-4H-1-benzopyran-7-on-2-yl)-5α-(3,4-dihydroxy-phenyl)-5,6,11-hexahydro-5,6,11-trioxanaphthacene-12-one and [1,3,11α-Trihydroxy-9-(3,5,7-trihydroxy-4H-1-benzopyran-7-on-2-yl)-5α-(3,4-dihydroxy-phenyl)-5,6,11-hexahydro-5,6,11-trioxanaphthacene-12-one]-4'-O-D-gluco-pyranoside from Allium cepa have been found to exhibit significant antidiabetic activities. With the huge number of adults living with diabetes in Kenya and the available treatment methods being expensive yet not so effective, this study highlights alternative remedies by documenting the commonly used antidiabetic medicinal plants. Further, the study supports the antidiabetic use of these plants with the existing pharmacological profiles and highlights research study gaps. Therefore, it is urgent to conduct natural products isolation work on the selected antidiabetic species commonly used in Kenya and evaluate their antidiabetic activities, both in vitro and in vivo, to validate their antidiabetic use and come up with new antidiabetic drugs.
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Affiliation(s)
- Felix Wambua Muema
- CAS Key Laboratory of Plant Germplasm Enhancement and Specialty Agriculture, Wuhan Botanical Garden, Chinese Academy of Sciences, Wuhan 430074, China; (F.W.M.); (M.A.O.)
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Consolata Nanjala
- College of Science and Engineering, James Cook University, Cairns, QLD 4870, Australia;
- Australian Tropical Herbarium, James Cook University, Cairns, QLD 4878, Australia
| | - Millicent Akinyi Oulo
- CAS Key Laboratory of Plant Germplasm Enhancement and Specialty Agriculture, Wuhan Botanical Garden, Chinese Academy of Sciences, Wuhan 430074, China; (F.W.M.); (M.A.O.)
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Phurpa Wangchuk
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Building E4, McGregor Rd., Smithfield, Cairns, QLD 4878, Australia
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Zaccaria S, Di Perna P, Giurato L, Pecchioli C, Sperti P, Arciprete F, Del Grande A, Nardone I, Wolde Sellasie S, Iani C, Uccioli L. Diabetic Polyneuropathy and Physical Activity in Type 1 Diabetes Mellitus: A Cross-Sectional Study. J Clin Med 2023; 12:6597. [PMID: 37892734 PMCID: PMC10607752 DOI: 10.3390/jcm12206597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/09/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND The purpose of this study is to access whether a personal attitude to physical activity (PA) may influence the appearance of diabetic polyneuropathy (DPN) patients with well-controlled type 1 diabetes mellitus. METHODS Ninety patients attending the diabetes technology outpatient clinic were enrolled. DPN was investigated according to the Toronto consensus diagnostic criteria. PA was assessed using the International Physical Activity Questionnaire. RESULTS PA was low in 21.1%, moderate in 42.2% and high in 36.7% of patients. According to Toronto criteria, we defined two categories: the first one with DPN absent or possible (57 (63.3%)) and a second one with DPN certain or probable (33 (36.7%)). The χ2-test of the PA groups and the DPN categories showed a statistically significant difference (p < 0.001), with less neuropathy in patients belonging to the group of moderate/high PA. Exposure to a minimum of 600 MET minutes/week was protective factor against the onset of DPN (odd ratio 0.221, c.i. 0.068-0.720, p = 0.012). CONCLUSIONS This study suggests that DPN is less present in type 1 diabetic patients with good metabolic control and a good personal habit of PA. Moderate-to-vigorous PA of at least 600 MET minutes/week might be a protective factor against DPN.
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Affiliation(s)
- Simona Zaccaria
- Division of Endocrinology and Diabetes, CTO Andrea Alesini Hospital, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.Z.); (P.D.P.); (L.G.); (C.P.); (P.S.); (I.N.); (S.W.S.)
| | - Pasquale Di Perna
- Division of Endocrinology and Diabetes, CTO Andrea Alesini Hospital, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.Z.); (P.D.P.); (L.G.); (C.P.); (P.S.); (I.N.); (S.W.S.)
| | - Laura Giurato
- Division of Endocrinology and Diabetes, CTO Andrea Alesini Hospital, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.Z.); (P.D.P.); (L.G.); (C.P.); (P.S.); (I.N.); (S.W.S.)
| | - Chiara Pecchioli
- Division of Endocrinology and Diabetes, CTO Andrea Alesini Hospital, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.Z.); (P.D.P.); (L.G.); (C.P.); (P.S.); (I.N.); (S.W.S.)
| | - Patrizia Sperti
- Division of Endocrinology and Diabetes, CTO Andrea Alesini Hospital, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.Z.); (P.D.P.); (L.G.); (C.P.); (P.S.); (I.N.); (S.W.S.)
| | - Flavio Arciprete
- Division of Neurology, Sant’Eugenio Hospital, 00144 Rome, Italy; (F.A.); (A.D.G.); (C.I.)
| | - Alessandra Del Grande
- Division of Neurology, Sant’Eugenio Hospital, 00144 Rome, Italy; (F.A.); (A.D.G.); (C.I.)
| | - Isabella Nardone
- Division of Endocrinology and Diabetes, CTO Andrea Alesini Hospital, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.Z.); (P.D.P.); (L.G.); (C.P.); (P.S.); (I.N.); (S.W.S.)
| | - Sium Wolde Sellasie
- Division of Endocrinology and Diabetes, CTO Andrea Alesini Hospital, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.Z.); (P.D.P.); (L.G.); (C.P.); (P.S.); (I.N.); (S.W.S.)
| | - Cesare Iani
- Division of Neurology, Sant’Eugenio Hospital, 00144 Rome, Italy; (F.A.); (A.D.G.); (C.I.)
| | - Luigi Uccioli
- Division of Endocrinology and Diabetes, CTO Andrea Alesini Hospital, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.Z.); (P.D.P.); (L.G.); (C.P.); (P.S.); (I.N.); (S.W.S.)
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Mohsin S, Brock F, Kaimala S, Greenwood C, Sulaiman M, Rogers K, Adeghate E. A pilot study: effect of irisin on trabecular bone in a streptozotocin-induced animal model of type 1 diabetic osteopathy utilizing a micro-CT. PeerJ 2023; 11:e16278. [PMID: 37868046 PMCID: PMC10588705 DOI: 10.7717/peerj.16278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/20/2023] [Indexed: 10/24/2023] Open
Abstract
Background Osteoporosis is a significant co-morbidity of type 1 diabetes mellitus (DM1) leading to increased fracture risk. Exercise-induced hormone 'irisin' in low dosage has been shown to have a beneficial effect on bone metabolism by increasing osteoblast differentiation and reducing osteoclast maturation, and inhibiting apoptosis and inflammation. We investigated the role of irisin in treating diabetic osteopathy by observing its effect on trabecular bone. Methods DM1 was induced by intraperitoneal injection of streptozotocin 60 mg/kg body weight. Irisin in low dosage (5 µg twice a week for 6 weeks I/P) was injected into half of the control and 4-week diabetic male Wistar rats. Animals were sacrificed six months after induction of diabetes. The trabecular bone in the femoral head and neck was analyzed using a micro-CT technique. Bone turnover markers were measured using ELISA, Western blot, and RT-PCR techniques. Results It was found that DM1 deteriorates the trabecular bone microstructure by increasing trabecular separation (Tb-Sp) and decreasing trabecular thickness (Tb-Th), bone volume fraction (BV/TV), and bone mineral density (BMD). Irisin treatment positively affects bone quality by increasing trabecular number p < 0.05 and improves the BMD, Tb-Sp, and BV/TV by 21-28%. The deterioration in bone microarchitecture is mainly attributed to decreased bone formation observed as low osteocalcin and high sclerostin levels in diabetic bone samples p < 0.001. The irisin treatment significantly suppressed the serum and bone sclerostin levels p < 0.001, increased the serum CTX1 levels p < 0.05, and also showed non-significant improvement in osteocalcin levels. Conclusions This is the first pilot study to our knowledge that shows that a low dose of irisin marginally improves the trabecular bone in DM1 and is an effective peptide in reducing sclerostin levels.
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Affiliation(s)
- Sahar Mohsin
- Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abudhabi, United Arab Emirates
| | - Fiona Brock
- Cranfield Forensic Institute, Cranfield University, Shrivenham, United Kingdom
| | - Suneesh Kaimala
- Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abudhabi, United Arab Emirates
| | - Charlene Greenwood
- School of Chemical and Physical Sciences, Keele University, Newcastle-under-Lyme, Staffordshire, United Kingdom
| | - Mohsin Sulaiman
- Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abudhabi, United Arab Emirates
| | - Keith Rogers
- Cranfield Forensic Institute, Cranfield University, Shrivenham, United Kingdom
| | - Ernest Adeghate
- Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abudhabi, United Arab Emirates
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Marx N, Federici M, Schütt K, Müller-Wieland D, Ajjan RA, Antunes MJ, Christodorescu RM, Crawford C, Di Angelantonio E, Eliasson B, Espinola-Klein C, Fauchier L, Halle M, Herrington WG, Kautzky-Willer A, Lambrinou E, Lesiak M, Lettino M, McGuire DK, Mullens W, Rocca B, Sattar N. 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes. Eur Heart J 2023; 44:4043-4140. [PMID: 37622663 DOI: 10.1093/eurheartj/ehad192] [Citation(s) in RCA: 197] [Impact Index Per Article: 197.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/26/2023] Open
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de Sousa Azulay RS, Rodrigues V, França de Abreu JDM, Pereira de Almeida AGF, Lago D, Tavares MDG, Nascimento G, Rocha V, Magalhães M, Facundo A, de Oliveira Neto CP, Guimarães Sá A, Parente CRV, Silva DA, Gomes MB, Faria MDS. Healthy lifestyle and genomic ancestry related to good glycemic control in type 1 diabetes patients from Northeastern Brazil: a hierarchical analysis. Front Endocrinol (Lausanne) 2023; 14:1233050. [PMID: 37900142 PMCID: PMC10611485 DOI: 10.3389/fendo.2023.1233050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 10/03/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction This study aimed to investigate the sociodemographic factors, dietary adherence, regular physical activity, and genomic ancestry percentage associated with good glycemic control in Brazilian patients with type 1 diabetes (T1D) using a hierarchical approach. Methods A cross-sectional study was conducted in 152 T1D patients. Glycated hemoglobin (HbA1C) levels were measured to evaluate the glycemic control status (good, moderate, or poor). Independent factors included sex, age, self-reported skin color, educational level, family income, dietary patterns, and physical activity. The percentage of genomic ancestry (Native American, European, and African) was influenced by a panel of 46 autosomal insertion/deletion ancestry markers. Statistical analyses included receiver operating characteristic curves, and hierarchical logistic regression analysis. Results The hierarchical analysis, patients who had high dietary adherence showed a positive association with good glycemic control (adjustedOR = 2.56, 95% CI:1.18-5.59, P = 0.016). Thus, age greater than 40 years was associated with good glycemic control compared to the children and adolescents group (adjustedOR = 4.55, 95% CI:1.14-18.1, P = 0.031). Males were associated with good glycemic control (adjustedOR = 2.00, 95% CI:1.01-4.00, P =0.047). Conclusion The study findings suggest that consistent adherence to dietary regimens is associated with good glycemic control after adjusting for sociodemographic and genomic ancestry factors in an admixed population of T1D patients from Northeast Brazil.
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Affiliation(s)
- Rossana Santiago de Sousa Azulay
- Service of Endocrinology, University Hospital of the Federal University of Maranhão (HUUFMA), São Luís, Brazil
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), Federal University of Maranhão, São Luís, Brazil
| | - Vandilson Rodrigues
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), Federal University of Maranhão, São Luís, Brazil
| | - Joana D’Arc Matos França de Abreu
- Service of Endocrinology, University Hospital of the Federal University of Maranhão (HUUFMA), São Luís, Brazil
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), Federal University of Maranhão, São Luís, Brazil
| | | | - Débora Lago
- Service of Endocrinology, University Hospital of the Federal University of Maranhão (HUUFMA), São Luís, Brazil
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), Federal University of Maranhão, São Luís, Brazil
| | - Maria da Glória Tavares
- Service of Endocrinology, University Hospital of the Federal University of Maranhão (HUUFMA), São Luís, Brazil
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), Federal University of Maranhão, São Luís, Brazil
| | - Gilvan Nascimento
- Service of Endocrinology, University Hospital of the Federal University of Maranhão (HUUFMA), São Luís, Brazil
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), Federal University of Maranhão, São Luís, Brazil
| | - Viviane Rocha
- Service of Endocrinology, University Hospital of the Federal University of Maranhão (HUUFMA), São Luís, Brazil
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), Federal University of Maranhão, São Luís, Brazil
| | - Marcelo Magalhães
- Service of Endocrinology, University Hospital of the Federal University of Maranhão (HUUFMA), São Luís, Brazil
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), Federal University of Maranhão, São Luís, Brazil
| | - Alexandre Facundo
- Service of Endocrinology, University Hospital of the Federal University of Maranhão (HUUFMA), São Luís, Brazil
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), Federal University of Maranhão, São Luís, Brazil
| | - Clariano Pires de Oliveira Neto
- Service of Endocrinology, University Hospital of the Federal University of Maranhão (HUUFMA), São Luís, Brazil
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), Federal University of Maranhão, São Luís, Brazil
| | - Adriana Guimarães Sá
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), Federal University of Maranhão, São Luís, Brazil
| | - Conceição Ribeiro Veiga Parente
- Service of Endocrinology, University Hospital of the Federal University of Maranhão (HUUFMA), São Luís, Brazil
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), Federal University of Maranhão, São Luís, Brazil
| | - Dayse Aparecida Silva
- DNA Diagnostic Laboratory (LDD), Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Marília Brito Gomes
- Diabetes Unit, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Manuel dos Santos Faria
- Service of Endocrinology, University Hospital of the Federal University of Maranhão (HUUFMA), São Luís, Brazil
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), Federal University of Maranhão, São Luís, Brazil
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