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He X, Pan J, Pan M, Wang J, Dong J, Yuan H, Zhou L, Chen M, Chen Y, Lu Y, Gu H, Chen Y, Wu L, Chen Y, Jin F, Li B, Gu W. Dietary and physical activity of adult patients with type 2 diabetes in Zhejiang province of eastern China: Data from a cross-sectional study. J Diabetes Investig 2016; 7:529-38. [PMID: 27180625 PMCID: PMC4931203 DOI: 10.1111/jdi.12458] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 11/16/2015] [Accepted: 12/03/2015] [Indexed: 12/15/2022] Open
Abstract
AIMS/INTRODUCTION Lifestyle management helps improve the clinical outcome of patients with type 2 diabetes. The present study aimed to obtain lifestyle data on the dietary and physical activity of adult type 2 diabetes patients in Zhejiang province of eastern China for better patient education and improvement of clinical management. MATERIALS AND METHODS A cross-sectional survey of 607 adult type 2 diabetes patients was carried out in 12 hospitals within eight cities of Zhejiang province. Data were collected for sex, age, basic physical measurement (blood pressure, height, weight, waist circumference and hip circumference), dietary favor and habit (vegetarian diets vs meat diets, preference of salty or light flavors), detailed dietary intake (24-h recall method), as well as the weekly physical activity. RESULTS The mean age of the patients in the analysis was 56.39 ± 12.29 years, and 38.71% of the patients had higher levels of body mass index than recommended. The average daily total energy intake was 1887.71 ± 575.10 kcal. The percentage of calories from carbohydrate, protein and fat were 61.36 ± 11.59%, 13.29 ± 3.37% and 25.35 ± 11.16%, respectively. For physical activity, the patients generally spent most of their daily time sitting and sleeping, and the time for moderate vigorous activity was limited. CONCLUSIONS Adult patients with type 2 diabetes in Zhejiang province have a relatively high carbohydrate and low protein diet, with very limited physical activity. Patient education to achieve a better lifestyle intervention needs to improve in this region.
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Affiliation(s)
- Xiaowen He
- Department of Endocrinology and Metabolism, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jie Pan
- Department of Endocrinology and Metabolism, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Institute of Gastroenterology, Zhejiang University, Hangzhou, China
| | - Mingxia Pan
- Department of Nephrology, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jiawei Wang
- Department of Endocrinology, The 117 Hospital of People's Liberation Army, Hangzhou, China
| | - Jingfen Dong
- Department of Endocrinology, Shaoxing People's Hospital, Shaoxing, China
| | - Hongdi Yuan
- Department of Endocrinology, Sir Run Run Shaw Hospital Affiliated with School of Zhejiang University, Hangzhou, China
| | - Lei Zhou
- Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Minhua Chen
- Department of Endocrinology, Lishui People's Hospital, Lishui, China
| | - Yunfen Chen
- Department of Endocrinology, Taizhou Hospital, Taizhou, China
| | - Yiping Lu
- Department of Endocrinology, Jinhua Municipal Central Hospital, Jinhua, China
| | - Huiqin Gu
- Department of Endocrinology, Chinese Medicine Hospital of Hangzhou, Hangzhou, China
| | - Yanshu Chen
- Department of Endocrinology, Ningbo First Hospital, Ningbo, China
| | - Liqin Wu
- Department of Endocrinology, Quzhou People's Hospital, Quzhou, Zhejiang, China
| | - Yajuan Chen
- Department of Endocrinology, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou, China
| | - Fubi Jin
- Department of Endocrinology, Zhejiang Hospital, Hangzhou, China
| | - Bijun Li
- Department of Endocrinology, Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Wei Gu
- Department of Endocrinology and Metabolism, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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252
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Kenny GP, Sigal RJ, McGinn R. Body temperature regulation in diabetes. Temperature (Austin) 2016; 3:119-45. [PMID: 27227101 PMCID: PMC4861190 DOI: 10.1080/23328940.2015.1131506] [Citation(s) in RCA: 122] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 12/09/2015] [Accepted: 12/09/2015] [Indexed: 01/06/2023] Open
Abstract
The effects of type 1 and type 2 diabetes on the body's physiological response to thermal stress is a relatively new topic in research. Diabetes tends to place individuals at greater risk for heat-related illness during heat waves and physical activity due to an impaired capacity to dissipate heat. Specifically, individuals with diabetes have been reported to have lower skin blood flow and sweating responses during heat exposure and this can have important consequences on cardiovascular regulation and glycemic control. Those who are particularly vulnerable include individuals with poor glycemic control and who are affected by diabetes-related complications. On the other hand, good glycemic control and maintenance of aerobic fitness can often delay the diabetes-related complications and possibly the impairments in heat loss. Despite this, it is alarming to note the lack of information regarding diabetes and heat stress given the vulnerability of this population. In contrast, few studies have examined the effects of cold exposure on individuals with diabetes with the exception of its therapeutic potential, particularly for type 2 diabetes. This review summarizes the current state of knowledge regarding the impact of diabetes on heat and cold exposure with respect to the core temperature regulation, cardiovascular adjustments and glycemic control while also considering the beneficial effects of maintaining aerobic fitness.
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Affiliation(s)
- Glen P Kenny
- Human and Environmental Physiology Research Unit, Faculty of Health Sciences, Ottawa, ON, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Ronald J Sigal
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada; Departments of Medicine, Cardiac Sciences, and Community Health Sciences, Cumming School of Medicine, Faculties of Medicine and Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Ryan McGinn
- Human and Environmental Physiology Research Unit, Faculty of Health Sciences, Ottawa, ON, Canada; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
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253
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Lifestyle Therapy in the Management of Cardiometabolic Risk: Diabetes Prevention, Hypertension, and Dyslipidemia. LIFESTYLE MEDICINE 2016. [DOI: 10.1007/978-3-319-24687-1_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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254
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Effect of straight-line and road network distances to parks and markets on anthropometric measurements, biochemical markers, and a healthy lifestyle in adult people. SPORT SCIENCES FOR HEALTH 2015. [DOI: 10.1007/s11332-015-0253-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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255
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Balducci S, Sacchetti M, Haxhi J, Orlando G, Zanuso S, Cardelli P, Cavallo S, D'Errico V, Ribaudo MC, Di Biase N, Salvi L, Vitale M, Bollanti L, Conti FG, Nicolucci A, Pugliese G. The Italian Diabetes and Exercise Study 2 (IDES-2): a long-term behavioral intervention for adoption and maintenance of a physically active lifestyle. Trials 2015; 16:569. [PMID: 26651484 PMCID: PMC4676117 DOI: 10.1186/s13063-015-1088-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 11/27/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical activity (PA)/exercise have become an integral part of the management of type 2 diabetes mellitus (T2DM). However, current guidelines are difficult to put into action in this population due to a number of barriers, especially the lack of acceptable, feasible, and validated behavioral intervention strategies. The present manuscript reports the rationale, study design and methods, and design considerations of the Italian Diabetes and Exercise Study (IDES)-2, a randomized controlled trial testing the efficacy of a behavior change strategy in increasing total daily PA and reducing sedentary time (SED-time) in patients with T2DM. METHODS/DESIGN Starting 7 January 2014, the IDES_2 began enrolling 300 patients with known T2DM of at least 1-year duration in three tertiary referral outpatient Diabetes Clinics in Rome. Additional requirements are age 40 to 80 years, body mass index 27 to 40 kg/m(2), sedentary lifestyle, and physically inactive for at least 6 months, ability to walk 1.6 km without assistance, and eligibility after cardiovascular evaluation. Patients are randomized by center and within each center, by age and type of diabetes treatment to either the intervention or the control group. Patients in the intervention (INT) group (n = 150) receive theoretical and practical exercise counseling consisting of aggregated behavior change techniques (one individual theoretical counseling session plus eight twice-a-week individual theoretical and practical exercise counseling sessions) once a year for 3 years. Patients in the control (CON) group (n = 150), receive standard care, including general physician recommendations for daily PA. The primary outcomes are total daily PA and SED-time, as measured objectively by the use of an accelerometer. Secondary outcomes include physical fitness, modifiable cardiovascular risk factors, musculoskeletal disturbances, well-being/depression, and health-related quality of life. DISCUSSION The behavioral intervention strategy tested in the IDES_2 is based on solid theoretical grounds and uses several behavioral change techniques, two factors which were found to improve effectiveness of behavioral intervention. In addition, physicians and exercise specialists have been specifically trained for counselling/prescribing and supervising PA/exercise, respectively, in subjects suffering from metabolic disorders. Finally, the large sample size, the long study duration, and the objective measurement of PA allow statistically significant and scientifically robust conclusions to be drawn on the feasibility and efficacy of this intervention in T2DM patients. TRIAL REGISTRATION ClinicalTrials.gov; NCT01600937 ; 10 October 2012.
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Affiliation(s)
- Stefano Balducci
- Department of Clinical and Molecular Medicine, "La Sapienza" University of Rome, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy.
- Diabetes Unit, Sant'Andrea Hospital, Rome, Italy.
- Metabolic Fitness Association, Monterotondo, Rome, Italy.
| | - Massimo Sacchetti
- Department of Human Movement and Sport Sciences, "Foro Italico" University, Rome, Italy.
| | - Jonida Haxhi
- Diabetes Unit, Sant'Andrea Hospital, Rome, Italy.
- Metabolic Fitness Association, Monterotondo, Rome, Italy.
- Department of Human Movement and Sport Sciences, "Foro Italico" University, Rome, Italy.
| | - Giorgio Orlando
- Department of Human Movement and Sport Sciences, "Foro Italico" University, Rome, Italy.
| | | | - Patrizia Cardelli
- Department of Clinical and Molecular Medicine, "La Sapienza" University of Rome, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy.
- Laboratory of Clinical Chemistry, Sant'Andrea Hospital, Rome, Italy.
| | - Stefano Cavallo
- Department of Clinical and Molecular Medicine, "La Sapienza" University of Rome, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy.
- Laboratory of Clinical Chemistry, Sant'Andrea Hospital, Rome, Italy.
| | - Valeria D'Errico
- Diabetes Unit, Sant'Andrea Hospital, Rome, Italy.
- Metabolic Fitness Association, Monterotondo, Rome, Italy.
| | | | | | - Laura Salvi
- Diabetes Unit, Sant'Andrea Hospital, Rome, Italy.
| | | | | | - Francesco G Conti
- Department of Clinical and Molecular Medicine, "La Sapienza" University of Rome, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy.
- Diabetes Unit, Sant'Andrea Hospital, Rome, Italy.
| | - Antonio Nicolucci
- Center for Outcomes Research and Clinical Epidemiology (CORE), Pescara, Italy.
| | - Giuseppe Pugliese
- Department of Clinical and Molecular Medicine, "La Sapienza" University of Rome, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy.
- Diabetes Unit, Sant'Andrea Hospital, Rome, Italy.
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256
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Exercise and type 2 diabetes: focus on metabolism and inflammation. Immunol Cell Biol 2015; 94:146-50. [DOI: 10.1038/icb.2015.101] [Citation(s) in RCA: 138] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 11/10/2015] [Accepted: 11/10/2015] [Indexed: 01/04/2023]
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257
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Comparing the Amount of Disorder of Practical-thought Obsession in the Young Male Athlete and Non-athlete People
I J C T A, 8(2) December 2015, pp. 629-633 © International Science Press. DER DIABETOLOGE 2015. [DOI: 10.1007/s11428-015-0036-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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258
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Park JH, Lee YE. Effects of exercise on glycemic control in type 2 diabetes mellitus in Koreans: the fifth Korea National Health and Nutrition Examination Survey (KNHANES V). J Phys Ther Sci 2015; 27:3559-64. [PMID: 26696738 PMCID: PMC4681945 DOI: 10.1589/jpts.27.3559] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 08/24/2015] [Indexed: 12/19/2022] Open
Abstract
[Purpose] The aim of this study was to investigate the effect of exercise on glycemic control using data from fifth Korea National Health and Nutrition Examination Survey and to provide appropriate exercise guidelines for patients with type 2 diabetes mellitus in Korea. [Subjects and Methods] We selected 1,328 patients from the fifth Korea National Health and Nutrition Examination Survey database who had type 2 diabetes and ranged in age from 30 to 90 years. Statistical analyses included χ(2) tests, multiple linear regression, and logistic regression. [Results] Factors found to be significantly related to glycemic control included income level, physical activity based on intensity of aerobic exercise, use of diabetes medicine, presence of hypertension, duration of diabetes, and waist circumference. In addition, engaging in combined low- and moderate-intensity aerobic exercise when adjusted for resistance exercise was found to lower the risk of glycemic control failure. [Conclusion] Patients with type 2 diabetes mellitus in Korea should engage in combined low- and moderate-intensity aerobic exercise such as walking for 30 minutes or more five times a week. Physical activity is likely to improve glycemic control and thus prevent the acute and chronic complications of diabetes mellitus.
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Affiliation(s)
- Ji-Hye Park
- Department of Dental Hygiene,
Daegu Health College, Republic of Korea
| | - PhD
- Department of Dental Hygiene,
Daegu Health College, Republic of Korea
| | - Young-Eun Lee
- Department of Dental Hygiene,
Daegu Health College, Republic of Korea
| | - PhD
- Department of Dental Hygiene,
Daegu Health College, Republic of Korea
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259
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Lanhers C, Duclos M, Guttmann A, Coudeyre E, Pereira B, Ouchchane L. General Practitioners' Barriers to Prescribe Physical Activity: The Dark Side of the Cluster Effects on the Physical Activity of Their Type 2 Diabetes Patients. PLoS One 2015; 10:e0140429. [PMID: 26468874 PMCID: PMC4607360 DOI: 10.1371/journal.pone.0140429] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 09/25/2015] [Indexed: 12/27/2022] Open
Abstract
Aims/hypothesis To describe barriers to physical activity (PA) in type 2 diabetes patients and their general practitioners (GPs), looking for practitioner’s influence on PA practice of their patients. Methods We conducted a cross-sectional study on GPs (n = 48) and their type 2 diabetes patients (n = 369) measuring respectively barriers to prescribe and practice PA using a self-assessment questionnaire: barriers to physical activity in diabetes (BAPAD). Statistical analysis was performed accounting hierarchical data structure. Similar practitioner’s patients were considered a cluster sharing common patterns. Results The higher the patient’s BAPAD score, the higher the barriers to PA, the higher the risk to declare practicing no PA (p<0.001), low frequency and low duration of PA (p<0.001). A high patient’s BAPAD score was also associated with a higher risk to have HbA1c ≥7% (53 mmol/mol) (p = 0.001). The intra-class correlation coefficient between type 2 diabetes patients and GPs was 34%, indicating a high cluster effect. A high GP’s BAPAD score, regarding the PA prescription, is predictive of a high BAPAD score with their patients, regarding their practice (p = 0.03). Conclusion/interpretation Type 2 diabetes patients with lower BAPAD score, thus lower barriers to physical activity, have a higher PA level and a better glycemic control. An important and deleterious cluster effect between GPs and their patients is demonstrated: the higher the GP’s BAPAD score, the higher the type 2 diabetes patients’ BAPAD score. This important cluster effect might designate GPs as a relevant lever for future interventions regarding patient’s education towards PA and type 2 diabetes management.
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Affiliation(s)
- Charlotte Lanhers
- Department of Sport Medicine and Functional Explorations, Clermont-Ferrand University Hospital (CHU), BP 68, 63001, Clermont-Ferrand, Cedex 1, France
- Clermont University, University of Auvergne, Clermont-Ferrand, France
- * E-mail:
| | - Martine Duclos
- Department of Sport Medicine and Functional Explorations, Clermont-Ferrand University Hospital (CHU), BP 68, 63001, Clermont-Ferrand, Cedex 1, France
- Laboratory of Human Nutrition, INRA UMR 1019, Clermont-Ferrand, France
- Clermont University, University of Auvergne, Clermont-Ferrand, France
| | - Aline Guttmann
- Clermont-Ferrand University Hospital, Department of Public Health, Biostatistics Unit, Clermont-Ferrand, France
- Laboratory of Image Sciences for Interventional Techniques, UMR CNRS UdA 6284 ISIT, Auvergne University, Clermont-Ferrand, F-63001, France
| | - Emmanuel Coudeyre
- Clermont University, University of Auvergne, Clermont-Ferrand, France
- Clermont-Ferrand University Hospital, Department of Physical Medicine and Rehabilitation, Clermont-Ferrand, France
| | - Bruno Pereira
- Laboratory of Image Sciences for Interventional Techniques, UMR CNRS UdA 6284 ISIT, Auvergne University, Clermont-Ferrand, F-63001, France
- Clermont-Ferrand University Hospital, Innovation and Clinical Research, Clermont-Ferrand, France
| | - Lemlih Ouchchane
- Clermont-Ferrand University Hospital, Department of Public Health, Biostatistics Unit, Clermont-Ferrand, France
- Laboratory of Image Sciences for Interventional Techniques, UMR CNRS UdA 6284 ISIT, Auvergne University, Clermont-Ferrand, F-63001, France
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Cunha VN, de Paula Lima M, Motta-Santos D, Pesquero JL, de Andrade RV, de Almeida JA, Araujo RC, Grubert Campbell CS, Lewis JE, Simões HG. Role of exercise intensity on GLUT4 content, aerobic fitness and fasting plasma glucose in type 2 diabetic mice. Cell Biochem Funct 2015; 33:435-42. [DOI: 10.1002/cbf.3128] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 08/03/2015] [Accepted: 08/04/2015] [Indexed: 12/25/2022]
Affiliation(s)
- Verusca Najara Cunha
- Graduate Program on Physical Education and Health; Catholic University of Brasilia; Brasília DF Brazil
| | - Mérica de Paula Lima
- Department of Physiology and Biophysics, Institute of Biological Sciences; Federal University of Minas Gerais; Belo Horizonte MG Brazil
- Basic Nursing Department; School of Nursing, Federal University of Minas Gerais; Belo Horizonte MG Brazil
| | - Daisy Motta-Santos
- Department of Physiology and Biophysics, Institute of Biological Sciences; Federal University of Minas Gerais; Belo Horizonte MG Brazil
- National Institute of Science and Technology in Nanobiopharmaceutics (INCT-NANOBIOFAR); Belo Horizonte MG Brazil
| | - Jorge Luiz Pesquero
- Department of Physiology and Biophysics, Institute of Biological Sciences; Federal University of Minas Gerais; Belo Horizonte MG Brazil
| | | | - Jeeser Alves de Almeida
- National Institute of Science and Technology in Nanobiopharmaceutics (INCT-NANOBIOFAR); Belo Horizonte MG Brazil
| | | | | | - John E. Lewis
- Department of Psychiatry and Behavioral Sciences; University of Miami Miller School of Medicine; Miami FL USA
| | - Herbert Gustavo Simões
- Graduate Program on Physical Education and Health; Catholic University of Brasilia; Brasília DF Brazil
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261
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Riahi S, Mohammadi MT, Sobhani V, Ababzadeh S. Chronic Aerobic Exercise Decreases Lectin-Like Low Density Lipoprotein (LOX-1) Receptor Expression in Heart of Diabetic Rat. IRANIAN BIOMEDICAL JOURNAL 2015; 20:26-32. [PMID: 26432573 PMCID: PMC4689279 DOI: 10.7508/ibj.2016.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Overexpression of lectin-like low density lipoprotein (LOX-1) receptor plays an important role in hyperglycemia-induced vascular complications such as atherosclerosis. Based on the beneficial effects of exercise on preventing cardiovascular complications of diabetes, we aimed to examine the protective effects of aerobic exercise on expression of LOX-1 receptor and production of free radicals in the heart of diabetic rats. METHODS Four groups of rats were used: (n = 5 per group): sedentary normal, trained normal, sedentary diabetes and trained diabetes. Diabetes was induced by a single intraperitoneal injection of streptozotocin (50 mg/kg). The exercise protocol was consisted of swimming 30 min/day, 5 days/week for eight weeks. Plasma glucose was evaluated at initiation, weeks 4 and 8 of experiment. At the end of experiment, rats were sacrificed and the heart was removed for determination of nitrate, malondialdehyde, and LOX-1 gene expression. RESULTS In normal non-diabetic rats, the blood glucose level was <150 mg/dl; however, the induction of diabetes resulted in levels more than >400 mg/dl. Gene expression of LOX-1 was increased in the heart of diabetic rats. Exercise reduced the gene expression of this protein in diabetic states without reducing the blood glucose. Finally, swimming exercise decreased the malondialdehyde and nitrate levels in heart tissue both in control and diabetic rats. CONCLUSION Swimming exercise reduces heart expression of the LOX-1 receptor in accompany with reduction of free radicals production. Since these parameters are important in generation of diabetic complications, swimming exercise is a good candidate for reducing these complications.
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Affiliation(s)
- Simin Riahi
- Exercise Physiology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammad Taghi Mohammadi
- Dept. of Physiology and Biophysics, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Vahid Sobhani
- Exercise Physiology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Shima Ababzadeh
- Dept. Anatomy, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran
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262
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Lee SS, Yoo JH, So YS. Effect of the low- versus high-intensity exercise training on endoplasmic reticulum stress and GLP-1 in adolescents with type 2 diabetes mellitus. J Phys Ther Sci 2015; 27:3063-8. [PMID: 26644644 PMCID: PMC4668135 DOI: 10.1589/jpts.27.3063] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 07/06/2015] [Indexed: 12/17/2022] Open
Abstract
[Purpose] The primary objective of this study was to investigate the effect of low-intensity exercise training compare with high-intensity exercise training on endoplasmic reticulum stress and glucagon-like peptide-1 in adolescents with type 2 diabetes mellitus. [Subjects and Methods] The low-intensity exercise training group performed aerobic exercise training at an intensity of ≤ 45% of the heart rate reserve. The high-intensity interval exercise training group performed interval exercise training at an intensity of ≥ 80% of the heart rate reserve. The exercise-related energy consumption was determined for both groups on a per-week basis (1,200 kcal/week). [Results] Both groups showed improvement in the glucose-regulated protein 78 and dipeptidyl peptidase-4, but the size of the between-group effect was not statistically significant. The high-intensity interval exercise training group showed a significant reduction in percentage body fat. The C-peptide level increased after the 12-weeks programs and was significantly different, between the groups. Fasting glucose, insulin resistance in the fasting state according to homeostasis model assessment, and leptin decreased after the 12-weeks exercise program and were significantly different between the groups, and glucagon-like peptide-1 increased after the 12-week exercise programs and was significantly different between the groups. [Conclusion] In conclusion high-intensity interval exercise training, as defined in this study, may lead to improvements in body composition, glycemic control, endoplasmic reticulum stress, and the glucagon-like peptide-1 in adolescents with type 2 diabetes mellitus.
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Affiliation(s)
- Sung Soo Lee
- Department of Coaching, Dong-A University, Republic of
Korea
| | - Jae Ho Yoo
- Department of Pediatric, College of Medicine, Dong-A
University Medical Center, Repulic of Korea
| | - Yong Seok So
- Department of Physical Education, Dong-A University, Repulic of Korea
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263
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Bouaziz W, Schmitt E, Kaltenbach G, Geny B, Vogel T. Health benefits of endurance training alone or combined with diet for obese patients over 60: a review. Int J Clin Pract 2015; 69:1032-49. [PMID: 25963846 DOI: 10.1111/ijcp.12648] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The prevalence of obesity is rapidly increasing in older patients and it is ubiquitous in many developed countries. Obesity is related to various negative health outcomes, making it a major public health target for intervention. PURPOSE The aim of this study was to explore and summarise the literature that addresses endurance training alone or combined with nutrition interventions to combat obesity in obese patients over age 60. METHODS We searched online electronic databases up to September 2014 for original observational and intervention studies published between 1995 and 2014 on the relationship between endurance training alone or combined with a diet in obese patients over 60 regarding health outcomes. RESULTS Twenty-six studies examined interventions aimed specifically at promoting endurance training alone or combined with diet for older obese patients over 60. These studies demonstrated a positive effect of this intervention on the primary prevention of cardiovascular disease, and a significant beneficial effect on the lipid profile. Improvement of body composition and insulin sensitivity, and a reduction in blood pressure were also well established. CONCLUSIONS Overall, this review demonstrates a positive effect of endurance training alone or combined with diet on health outcomes and metabolic benefits in older adults. Clinicians can now use this evidence to formulate actions to encourage the older obese to profit from the health benefits of endurance training and diet. This will not only help reduce the dramatic increase in the number of older obese but also help prevent sarcopenic obesity, which is a complex challenge for healthcare professionals.
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Affiliation(s)
- W Bouaziz
- Geriatric Department, University Hospital, Strasbourg, France
- Department of Physiology and EA-3072, Faculty of Medicine, Strasbourg University, Strasbourg, France
| | - E Schmitt
- Geriatric Department, University Hospital, Strasbourg, France
- Department of Physiology and EA-3072, Faculty of Medicine, Strasbourg University, Strasbourg, France
| | - G Kaltenbach
- Geriatric Department, University Hospital, Strasbourg, France
| | - B Geny
- Department of Physiology and EA-3072, Faculty of Medicine, Strasbourg University, Strasbourg, France
- Functional Explorations Department, University Hospital, Strasbourg, France
| | - T Vogel
- Geriatric Department, University Hospital, Strasbourg, France
- Department of Physiology and EA-3072, Faculty of Medicine, Strasbourg University, Strasbourg, France
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Fisken AL, Waters DL, Hing WA, Steele M, Keogh JW. Comparative effects of 2 aqua exercise programs on physical function, balance, and perceived quality of life in older adults with osteoarthritis. J Geriatr Phys Ther 2015; 38:17-27. [PMID: 24743752 DOI: 10.1519/jpt.0000000000000019] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Osteoarthritis (OA) is a degenerative joint disease, which affects a large number of older adults. Many older adults with OA are physically inactive, which can contribute to reduced functional capability, quality of life, and an increased risk of falls. Although hydrotherapy is often recommended for older adults with OA, less is known about aqua fitness (AF), a widely available form of aqua-based exercise. PURPOSE To compare the effect of an AF program and a seated aqua-based exercise program on a range of functional measures and quality of life among older adults with OA. METHODS Thirty-five older adults with OA were allocated to an AF group or an active control group who performed seated exercises in warm water for 12 weeks. The primary outcome measure was the timed up-and-go (TUG) test; other measures included step test, sit-to-stand (STS) test, handgrip strength test, 400-m walk test, Arthritis Impact Measurement Scale-Short Form (AIMS2-SF), and Falls Efficacy Scale-International (FES-I). RESULTS FES-I scores improved significantly in the AF group compared with the control group (P=0.04). Within-group analysis indicated both groups significantly improved their 400-m walk time (P=0.04) and that the AF group significantly improved its step test right (P=0.02) and left (P=0.00) and the AIMS2-SF total score (P=0.02). No significant change in TUG, STS, or handgrip strength was observed for either group. CONCLUSIONS Aqua fitness may offer a number of positive functional and psychosocial benefits for older adults with OA, such as a reduced fear of falling and increased ability to perform everyday tasks.
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Affiliation(s)
- Alison L Fisken
- 1Human Potential Centre, AUT University, New Zealand. 2Department of Preventive and Social Medicine, University of Otago, New Zealand. 3Faculty of Health Sciences and Medicine, Bond University, Australia. 4Health and Rehabilitation Research Institute, AUT University, New Zealand. 5Department of Mathematics and Computing, Universiti Brunei Darussalam, Brunei Darussalam. 6Graduate Research School, Griffith University, Australia. 7Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Australia
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265
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Suk MH, Moon YJ, Park SW, Park CY, Shin YA. Maximal Fat Oxidation Rate during Exercise in Korean Women with Type 2 Diabetes Mellitus. Diabetes Metab J 2015; 39:328-34. [PMID: 26301195 PMCID: PMC4543197 DOI: 10.4093/dmj.2015.39.4.328] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 09/26/2014] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The purpose of this study was to determine the appropriate exercise intensity associated with maximum fat oxidation, improvement of body composition, and metabolic status in Korean women with type 2 diabetes mellitus (T2DM). METHODS The study included a T2DM group (12 women) and a control group (12 women). The groups were matched in age and body mass index. The subjects performed a graded exercise test on a cycle ergometer to measure their maximal fat oxidation (Fatmax). We also measured their body composition, metabolic profiles, and mitochondrial DNA (mtDNA). RESULTS The exercise intensity for Fatmax was significantly lower in the T2DM group (34.19% maximal oxygen uptake [VO2 max]) than the control group (51.80% VO2 max). Additionally, the rate of fat oxidation during exercise (P<0.05) and mtDNA (P<0.05) were significantly lower in the T2DM group than the control group. The VO2 max level (P<0.001) and the insulin level (P<0.05) were positively correlated with the rate of fat oxidation. CONCLUSION The results of this study suggest lower exercise intensity that achieves Fatmax is recommended for improving fat oxidation and enhancing fitness levels in Korean women with T2DM. Our data could be useful when considering an exercise regimen to improve health and fitness.
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Affiliation(s)
- Min Hwa Suk
- Department of Kinesiology and Medical Science, Dankook University College of Medicine, Cheonan, Korea
| | - Yeo-Jin Moon
- Diabetes Center, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Woo Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Cheol-Young Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yun A Shin
- Department of Kinesiology and Medical Science, Dankook University College of Medicine, Cheonan, Korea
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266
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Avery L, Flynn D, Dombrowski SU, van Wersch A, Sniehotta FF, Trenell MI. Successful behavioural strategies to increase physical activity and improve glucose control in adults with Type 2 diabetes. Diabet Med 2015; 32:1058-62. [PMID: 25764343 PMCID: PMC6680111 DOI: 10.1111/dme.12738] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/10/2015] [Indexed: 01/09/2023]
Abstract
AIMS To explore which behaviour change techniques and other intervention features are associated with increased levels of physical activity and improved HbA1c in adults with Type 2 diabetes. METHODS Moderator analyses were performed on a dataset of 21 behaviour change techniques and six intervention features identified in a systematic review of behavioural interventions (N = 1975 patients with Type 2 diabetes) to establish their associations with changes in physical activity and HbA1c . RESULTS Four behaviour change techniques (prompt focus on past success, barrier identification/problem-solving, use of follow-up prompts and provide information on where and when to perform physical activity) had statistically significant associations with increased levels of physical activity. Prompt review of behavioural goals and provide information on where and when to perform physical activity behaviour had statistically significant associations with improved HbA1c . Pedometer use was associated with decreased levels of physical activity. CONCLUSIONS These data suggest that clinical care teams can optimise their consultations by incorporating specific behaviour change techniques that are associated with increased levels of physical activity and improved long-term glycaemic control.
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Affiliation(s)
- L Avery
- Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, UK
| | - D Flynn
- Institute of Health and Society, Newcastle University, Newcastle Upon Tyne, UK
| | - S U Dombrowski
- School of Natural Sciences, Division of Psychology, University of Stirling, Stirling, UK
| | - A van Wersch
- School of Social Sciences and Law, Teesside University, Middlesbrough, UK
| | - F F Sniehotta
- Institute of Health and Society, Newcastle University, Newcastle Upon Tyne, UK
| | - M I Trenell
- Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, UK
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267
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Pandey A, Swift DL, McGuire DK, Ayers CR, Neeland IJ, Blair SN, Johannsen N, Earnest CP, Berry JD, Church TS. Metabolic Effects of Exercise Training Among Fitness-Nonresponsive Patients With Type 2 Diabetes: The HART-D Study. Diabetes Care 2015; 38:1494-501. [PMID: 26084342 PMCID: PMC4512133 DOI: 10.2337/dc14-2378] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 04/27/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To evaluate the impact of exercise training (ET) on metabolic parameters among participants with type 2 diabetes mellitus (T2DM) who do not improve their cardiorespiratory fitness (CRF) with training. RESEARCH DESIGN AND METHODS We studied participants with T2DM participating in the Health Benefits of Aerobic and Resistance Training in Individuals With Type 2 Diabetes (HART-D) trial who were randomized to a control group or one of three supervised ET groups for 9 months. Fitness response to ET was defined as a change in measured peak absolute oxygen uptake (ΔVO(2peak), in liters per minute) from baseline to follow-up. ET participants were classified based on ΔVO(2peak) into fitness responders (ΔVO(2peak) ≥5%) and nonresponders (ΔVO(2peak) <5%), and changes in metabolic profiles were compared across control, fitness responder, and fitness nonresponder groups. RESULTS A total of 202 participants (mean age 57.1 ± 7.9 years, 63% women) were included. Among the exercise groups (n = 161), there was substantial heterogeneity in ΔVO(2peak); 57% had some improvement in CRF (ΔVO(2peak) >0), with only 36.6% having a ≥5% increase in VO(2peak). Both fitness responders and nonresponders (respectively) had significant improvements in hemoglobin A1c and measures of adiposity (ΔHbA(1c): -0.26% [95% CI -0.5 to -0.01] and -0.26% [-0.45 to -0.08]; Δwaist circumference: -2.6 cm [-3.7 to -1.5] and -1.8 cm [-2.6 to -1.0]; Δbody fat: -1.07% [-1.5 to -0.62] and -0.75% [-1.09 to -0.41]). No significant differences were observed in the degree of change of these metabolic parameters between fitness responders and nonresponders. Control group participants had no significant changes in any of these metabolic parameters. CONCLUSIONS ET is associated with significant improvements in metabolic parameters irrespective of improvement in cardiorespiratory fitness.
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Affiliation(s)
- Ambarish Pandey
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - Damon L Swift
- Department of Kinesiology, East Carolina University, Greenville, NC
| | - Darren K McGuire
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX
| | - Colby R Ayers
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX
| | - Ian J Neeland
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - Steven N Blair
- Department of Exercise Science, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Neil Johannsen
- School of Kinesiology, College of Human Sciences & Education, Louisiana State University, Baton Rouge, LA
| | - Conrad P Earnest
- Department for Health & Kinesiology, Texas A&M University, College Station, TX
| | - Jarett D Berry
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX
| | - Timothy S Church
- Preventive Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA
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268
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Park SH. Effects of passive static stretching on blood glucose levels in patients with type 2 diabetes mellitus. J Phys Ther Sci 2015; 27:1463-5. [PMID: 26157241 PMCID: PMC4483419 DOI: 10.1589/jpts.27.1463] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 01/17/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study determined the effects of passive static stretching on blood glucose
levels in patients with type 2 diabetes. [Subjects] Fifteen patients (8 males and 7
females) with type 2 diabetes were recruited and randomly assigned to the control group or
passive static stretching group. [Methods] Glycated hemoglobin was measured before and
after the 8-week training period. [Results] Glycated hemoglobin levels decreased
significantly in the passive static stretching group, and there were significant
differences in blood glucose levels between the 2 groups. [Conclusion] Passive static
stretching of the skeletal muscles may be an alternative to exercise to help regulate
blood glucose levels in diabetes patients.
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Affiliation(s)
- Seong Hoon Park
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Republic of Korea
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269
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Rossen J, Yngve A, Hagströmer M, Brismar K, Ainsworth BE, Iskull C, Möller P, Johansson UB. Physical activity promotion in the primary care setting in pre- and type 2 diabetes - the Sophia step study, an RCT. BMC Public Health 2015; 15:647. [PMID: 26164092 PMCID: PMC4499440 DOI: 10.1186/s12889-015-1941-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 06/15/2015] [Indexed: 11/23/2022] Open
Abstract
Background Physical activity prevents or delays progression of impaired glucose tolerance in high-risk individuals. Physical activity promotion should serve as a basis in diabetes care. It is necessary to develop and evaluate health-promoting methods that are feasible as well as cost-effective within diabetes care. The aim of Sophia Step Study is to evaluate the impact of a multi-component and a single component physical activity intervention aiming at improving HbA1c (primary outcome) and other metabolic and cardiovascular risk factors, physical activity levels and overall health in patients with pre- and type 2 diabetes. Methods/design Sophia Step Study is a randomized controlled trial and participants are randomly assigned to either a multi-component intervention group (A), a pedometer group (B) or a control group (C). In total, 310 patients will be included and followed for 24 months. Group A participants are offered pedometers and a website to register steps, physical activity on prescription with yearly follow-ups, motivational interviewing (10 occasions) and group consultations (including walks, 12 occasions). Group B participants are offered pedometers and a website to register steps. Group C are offered usual care. The theoretical framework underpinning the interventions is the Health Belief Model, the Stages of Change Model, and the Social Cognitive Theory. Both the multi-component intervention (group A) and the pedometer intervention (group B) are using several techniques for behavior change such as self-monitoring, goal setting, feedback and relapse prevention. Measurements are made at week 0, 8, 12, 16, month 6, 9, 12, 18 and 24, including metabolic and cardiovascular biomarkers (HbA1c as primary health outcome), accelerometry and daily steps. Furthermore, questionnaires were used to evaluate dietary intake, physical activity, perceived ability to perform physical activity, perceived support for being active, quality of life, anxiety, depression, well-being, perceived treatment, perceived stress and diabetes self- efficacy. Discussion This study will show if a multi-component intervention using pedometers with group- and individual consultations is more effective than a single- component intervention using pedometers alone, in increasing physical activity and improving HbA1c, other metabolic and cardiovascular risk factors, physical activity levels and overall health in patients with pre- and type 2 diabetes. Trial registration ClinicalTrials.gov Identifier: NCT02374788. Registered 28 January 2015.
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Affiliation(s)
- Jenny Rossen
- Sophiahemmet University, Stockholm, Sweden. .,Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
| | - Agneta Yngve
- Sophiahemmet University, Stockholm, Sweden. .,School of Hospitality, Culinary Arts and Meal Sciences, Örebro University, Örebro, Sweden.
| | - Maria Hagströmer
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, and Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden.
| | - Kerstin Brismar
- Department of Molecular Medicine and Surgery, Karolinska Institutet, and Rolf Luft Research Center for Diabetes and Endocrinology, Karolinska University Hospital, Stockholm, Sweden.
| | - Barbara E Ainsworth
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ, USA.
| | | | | | - Unn-Britt Johansson
- Sophiahemmet University, Stockholm, Sweden. .,Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
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270
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Tajima N, Noda M, Origasa H, Noto H, Yabe D, Fujita Y, Goto A, Fujimoto K, Sakamoto M, Haneda M. Evidence-based practice guideline for the treatment for diabetes in Japan 2013. Diabetol Int 2015. [DOI: 10.1007/s13340-015-0206-2] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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271
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Figueira FR, Umpierre D, Cureau FV, Zucatti ATN, Dalzochio MB, Leitão CB, Schaan BD. Association between physical activity advice only or structured exercise training with blood pressure levels in patients with type 2 diabetes: a systematic review and meta-analysis. Sports Med 2015; 44:1557-72. [PMID: 25047852 DOI: 10.1007/s40279-014-0226-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Diabetes is associated with marked cardiovascular morbidity and mortality. However, the association between different types of exercise training and blood pressure (BP) changes is not fully clear in type 2 diabetes. OBJECTIVE The aim of this systematic review and meta-analysis of randomized controlled clinical trials (RCTs) was to determine the effects of structured exercise training (aerobic [AER], resistance [RES], or combined [COMB]) and physical activity (PA) advice only on BP changes in patients with type 2 diabetes. METHODS Searches in five electronic databases were conducted to retrieve studies published from 1980 to 2013. Eligible studies were RCTs consisting of structured exercise training or PA advice versus no intervention in patients with type 2 diabetes. We used random effect models to derive weighted mean differences (WMDs) of exercises on absolute changes in systolic BP (SBP) and diastolic BP (DBP). RESULTS A total of 30 RCTs of structured training (2,217 patients) and 21 of PA advice (7,323 patients) were included. Data were extracted independently in duplicate. Structured exercise was associated with reductions in SBP (WMD -4.22 mmHg; 95% confidence interval [CI] -5.89 to -2.56) and DBP (WMD -2.07 mmHg; 95% CI -3.03 to -1.11) versus controls. In structured exercise interventions, AER and RES were associated with declines in BP, and COMB was not associated with BP changes. However, in sensitivity analysis, a high-intensity protocol within COMB was associated with declines in SBP (WMD -3.30 mmHg; 95% CI -4.71 to -1.89). Structured exercise longer than 150 min/week was associated with greater BP reductions. PA advice only was associated with reduction in SBP (WMD -2.97 mmHg; 95% CI -4.52 to -1.43) and DBP (WMD -1.41 mmHg; 95% CI -1.94 to -0.88) versus controls. CONCLUSIONS AER, RES, and high-intensity combined training are associated with BP reduction in patients with type 2 diabetes, especially in exercise programs lasting more than 150 min/week. PA advice only is also associated with lower BP levels.
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Affiliation(s)
- Franciele R Figueira
- Exercise Pathophysiology Research Laboratory, Hospital de Clinicas de Porto Alegre, Ramiro Barcelos 2350, Porto Alegre, RS, Brazil
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272
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Chacko E. Co-ordinating meals and exercise for diabetes management. Diabetologia 2015; 58:1372-3. [PMID: 25835726 DOI: 10.1007/s00125-015-3576-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 03/17/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Elsamma Chacko
- Connecticut Valley Hospital, PO Box 351, Silver Street, Middletown, CT, 06457, USA,
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273
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Cadore EL, Izquierdo M. Exercise interventions in polypathological aging patients that coexist with diabetes mellitus: improving functional status and quality of life. AGE (DORDRECHT, NETHERLANDS) 2015; 37:64. [PMID: 26054595 PMCID: PMC4493714 DOI: 10.1007/s11357-015-9800-2] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Accepted: 05/28/2015] [Indexed: 05/15/2023]
Abstract
In elderly populations, diabetes is associated with reduced muscle strength, poor muscle quality, and accelerated loss of muscle mass. In addition, diabetes mellitus increases risk for accelerated aging and for the development of frailty syndrome. This disease is also associated with a polypathological condition, and its complications progressively affect quality of life and survival. Exercise interventions, including resistance training, represent the cornerstones of diabetes management, especially in patients at severe functional decline. This review manuscript aimed to describe the beneficial effects of different exercise interventions on the functional capacity of elderly diabetics, including those at polypathological condition. The SciELO, Science Citation Index, MEDLINE, Scopus, SPORTDiscus, and ScienceDirect databases were searched from 1980 to 2015 for articles published from original scientific investigations. In addition to the beneficial effects of exercise interventions on glycemic control, and on the cardiovascular risk factors associated with diabetes, physical exercise is an effective intervention to improve muscle strength, power output, and aerobic power and functional capacity in elderly diabetic patients. Thus, a combination of resistance and endurance training is the most effective exercise intervention to promote overall physical fitness in these patients. In addition, in diabetic patients with frailty and severe functional decline, a multicomponent exercise program including strength and power training, balance exercises, and gait retraining may be an effective intervention to reduce falls and improve functional capacity and quality of life in these patients.
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Affiliation(s)
- Eduardo Lusa Cadore
- />Exercise Research Laboratory, Physical Education School, Federal University of Rio Grande do Sul, Porto Alegre, RS Brazil
| | - Mikel Izquierdo
- />Department of Health Sciences, Public University of Navarre, Av. de Tarazona s/n., 31500 Tudela, Navarra Spain
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274
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Varney JE, Weiland TJ, Inder WJ, Jelinek GA. Effect of hospital-based telephone coaching on glycaemic control and adherence to management guidelines in type 2 diabetes, a randomised controlled trial. Intern Med J 2015; 44:890-7. [PMID: 24963611 DOI: 10.1111/imj.12515] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 06/18/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND Failure to achieve treatment targets is common among people with type 2 diabetes. Cost-effective treatments are required to delay the onset and slow the progression of diabetes-related complications. AIMS This study aimed to measure the effect of a 6-month telephone coaching intervention on glycaemic control, risk factor status and adherence to diabetes management practices at the intervention's conclusion (6 months) and at 12 months. METHOD This randomised controlled trial recruited 94 adults with type 2 diabetes and an HbA1C > 7% from the Diabetes Clinic of St Vincent's Hospital Melbourne. People who were non-English speaking, cognitively impaired, severely hearing impaired or without telephone access were excluded. Participants were randomised to receive usual care plus 6 months of telephone coaching focusing on achieving treatment targets and complication screening, or usual care only. The primary outcome was HbA1C at 6 months; secondary outcomes included other physiological and monitoring measures. RESULTS Significant interaction effects were observed between group and time at 6 months, demonstrating improvement in HbA1C, fasting glucose, diastolic blood pressure and physical activity. The intervention's effect on these parameters was not sustained at 12 months. Intervention group participants also improved compliance with foot examinations and pneumococcal vaccination by 6 months and retinal screening by 12 months. CONCLUSIONS Telephone coaching improved glycaemic control and adherence to complication screening in people with type 2 diabetes, for the duration of its delivery, but these effects were not maintained on withdrawal of the intervention. Strategies that assist patients to sustain these benefits are required.
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Affiliation(s)
- J E Varney
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia; Restoring Health, St Vincent's Hospital, Melbourne, Victoria, Australia
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275
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Salonen MK, Wasenius N, Kajantie E, Lano A, Lahti J, Heinonen K, Räikkönen K, Eriksson JG. Physical activity, body composition and metabolic syndrome in young adults. PLoS One 2015; 10:e0126737. [PMID: 25992848 PMCID: PMC4439134 DOI: 10.1371/journal.pone.0126737] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 04/07/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Low physical activity (PA) is a major risk factor for cardiovascular and metabolic disorders in all age groups. We measured intensity and volume of PA and examined the associations between PA and the metabolic syndrome (MS), its components and body composition among young Finnish adults. RESEARCH DESIGN AND METHODS The study comprises 991 men and women born 1985-86, who participated in a clinical study during the years 2009-11 which included assessments of metabolism, body composition and PA. Objectively measured (SenseWear Armband) five-day PA data was available from 737 participants and was expressed in metabolic equivalents of task (MET). RESULTS The prevalence of MS ranged between 8-10%. Higher total mean volume (MET-hours) or intensity (MET) were negatively associated with the risk of MS and separate components of MS, while the time spent at sedentary level of PA was positively associated with MS. CONCLUSIONS MS was prevalent in approximately every tenth of the young adults at the age of 24 years. Higher total mean intensity and volume rates as well as longer duration spent at moderate and vigorous PA level had a beneficial impact on the risk of MS. Longer time spent at the sedentary level of PA increased the risk of MS.
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Affiliation(s)
- Minna K. Salonen
- Folkhälsan Research Centre, Helsinki, Finland
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
- * E-mail:
| | - Niko Wasenius
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Eero Kajantie
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
- Children’s Hospital, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
- Department of Obstetrics and Gynaecology, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Aulikki Lano
- Children’s Hospital, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - Jari Lahti
- Folkhälsan Research Centre, Helsinki, Finland
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
| | - Kati Heinonen
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
| | - Katri Räikkönen
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
| | - Johan G. Eriksson
- Folkhälsan Research Centre, Helsinki, Finland
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
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276
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Parra-Sánchez J, Moreno-Jiménez M, Nicola CM, Nocua-Rodríguez II, Amegló-Parejo MR, Del Carmen-Peña M, Cordero-Prieto C, Gajardo-Barrena MJ. [Evaluation of a supervised physical exercise program in sedentary patients over 65 years with type 2 diabetes mellitus]. Aten Primaria 2015; 47:555-62. [PMID: 25769195 PMCID: PMC6983777 DOI: 10.1016/j.aprim.2015.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Revised: 01/15/2015] [Accepted: 01/16/2015] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE To analyze whether an exercise program can modify glycated hemoglobin (HbA1c), blood pressure (BP), body mass index (BMI), lipids, cardiovascular risk profile (CVR), self-perceived health status (SHS), and pharmaceutical expenditure (PE). DESIGN A randomized, single blind, controlled trial. INTERVENTION program of supervised aerobic physical exercise. Analysis by intention to treat. LOCATION Primary Care: 2 rural health areas. Health Area of Navalmoral. Cáceres. Extremadura. Spain. PARTICIPANTS 100 type 2 diabetic patients, aged 65 to 80 years, sedentary. Distribution: 50% control group (CG) and 50% intervention group (IG). Abandoned 12%. INTERVENTION monitored aerobic exercise: 40minutes, 2 days/week, 3 months. KEY MEASURES HbA1c, BP, BMI, lipid, CVR, SHS, PE. Complications during exercise. RESULTS There were post-intervention differences between groups in HbA1c, BP, BMI, cholesterol and SHS. In the IG, there was a significant decrease in; HbA1c: 0.2±0.4% (95% CI: 0.1 to 0.3), systolic BP: 11.8±8.5mmHg (95% CI: 5.1 to 11.9), BMI: 0.5±1 (95% CI: 0.2 to 0.8), total cholesterol: 14±28.2mg/dl (95% CI: 5.9 to 22.2), LDL: 18.3±28.2mg/dl 95% CI: 10.2 to 26.3), CVR: 6.7±7.7% (95% CI: 4.5 to 8.9), PE: 3.9±10.2 € (95% CI: 0.9 to 6.8), and an increase in SHS; 4.7±5.7 (95% CI: 3 to 6.3). CONCLUSIONS In diabetics over 65 years, a program of monitored aerobic exercise, of easy implementation, improves HbA1c, BP, cholesterol, CVR, PE, and SHS.
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Affiliation(s)
| | | | | | | | | | - Marlen Del Carmen-Peña
- Centro de Salud de Navalmoral de la Mata, Área de Salud de Navalmoral de la Mata, Cáceres, Servicio Extremeño de Salud, España
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277
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Cooper CL, Hind D, Duncan R, Walters S, Lartey A, Lee E, Bradburn M. A rapid review indicated higher recruitment rates in treatment trials than in prevention trials. J Clin Epidemiol 2015; 68:347-54. [DOI: 10.1016/j.jclinepi.2014.10.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 10/13/2014] [Accepted: 10/21/2014] [Indexed: 01/07/2023]
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278
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Sentinelli F, La Cava V, Serpe R, Boi A, Incani M, Manconi E, Solinas A, Cossu E, Lenzi A, Baroni M. Positive effects of Nordic Walking on anthropometric and metabolic variables in women with type 2 diabetes mellitus. Sci Sports 2015. [DOI: 10.1016/j.scispo.2014.10.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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279
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Matoulek M, Svobodova S, Vetrovska R, Stranska Z, Svacina S. Post-exercise changes of beta hydroxybutyrate as a predictor of weight changes. Physiol Res 2015; 63:S321-5. [PMID: 24908238 DOI: 10.33549/physiolres.932815] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The aim was to find the differences in ketogenesis initiation in the early period after the exercise in obese patients and to find if these changes may predict the weight loss during the physical activity program. 96 females were enrolled. A clamped heart rate test (CHR) was performed to establish comparable exercise intensity. Blood samples for beta hydroxybutyrate (BOHB) assessment were collected prior, immediately after and 60 min after the test. Patients underwent a three month fitness program. Anthropometric measurements (fat mass and biochemical parameters) were measured. An energy intake was monitored and comparable in all subjects. A significant increase of BOHB was found in 60(th) minute after the test, when compared with initiation levels (BOHB1 vs. BOHB3; p=0.03). This increase correlates with % fat mass (R=0.196; p=0.02) and negatively with age (R= -0.147; p=0.05) and with weight reduction during the three-month program (R= -0.299; p=0.03). Serum BOHB increase after the single exercise may detect individuals with an ability to induce lipolysis in three-month program of physical activity for obese patients.
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Affiliation(s)
- M Matoulek
- Third Internal Medicine Clinic, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.
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280
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Armstrong MJ, Colberg SR, Sigal RJ. Moving beyond cardio: the value of resistance training, balance training, and other forms of exercise in the management of diabetes. Diabetes Spectr 2015; 28:14-23. [PMID: 25717274 PMCID: PMC4334083 DOI: 10.2337/diaspect.28.1.14] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
IN BRIEF Traditionally, aerobic training has been a central focus of exercise promotion for diabetes management. However, people with diabetes have much to gain from other forms of exercise. This article reviews the evidence and recommendations on resistance, balance, and flexibility training, as well as other, less traditional, forms of exercise such as yoga and Tai Chi.
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Affiliation(s)
- Marni J. Armstrong
- Department of Cardiovascular and Respiratory Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Sheri R. Colberg
- Human Movement Sciences Department, Old Dominion University, Norfolk, VA
| | - Ronald J. Sigal
- Departments of Medicine, Cardiac Sciences, and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
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281
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Hallsworth K, Thoma C, Moore S, Ploetz T, Anstee QM, Taylor R, Day CP, Trenell MI. Non-alcoholic fatty liver disease is associated with higher levels of objectively measured sedentary behaviour and lower levels of physical activity than matched healthy controls. Frontline Gastroenterol 2015; 6:44-51. [PMID: 25580206 PMCID: PMC4283712 DOI: 10.1136/flgastro-2014-100432] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 05/10/2014] [Accepted: 05/12/2014] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND AND AIMS Physical activity is a key determinant of metabolic control and is recommended for people with non-alcoholic fatty liver disease (NAFLD), usually alongside weight loss and dietary change. To date, no studies have reported the relationship between objectively measured sedentary behaviour and physical activity, liver fat and metabolic control in people with NAFLD, limiting the potential to target sedentary behaviour in clinical practice. This study determined the level of sedentary behaviour and physical activity in people with NAFLD, and investigated links between physical activity, liver fat and glucose control. METHODS Sedentary behaviour, physical activity and energy expenditure were assessed in 37 adults with NAFLD using a validated multisensor array over 7 days. Liver fat and glucose control were assessed, respectively, by 1H-MRS and fasting blood samples. Patterns of sedentary behaviour were assessed by power law analyses of the lengths of sedentary bouts fitted from raw sedentary data. An age and sex-matched healthy control group wore the activity monitor for the same time period. RESULTS People with NAFLD spent approximately half an hour extra a day being sedentary (1318±68 vs1289±60 mins/day; p<0.05) and walked 18% fewer steps (8483±2926 vs 10377±3529 steps/day; p<0.01). As a consequence, active energy expenditure was reduced by 40% (432±258 vs 732±345 kcal/day; p<0.01) and total energy expenditure was lower in NAFLD (2690±440 vs 2901±511 kcal/day; p<0.01). Power law analyses of the lengths of sedentary bouts demonstrated that patients with NAFLD also have a lower number of transitions from being sedentary to active compared with controls (13±0.03 vs15±0.03%; p<0.05). CONCLUSIONS People with NAFLD spend more time sedentary and undertake less physical activity on a daily basis than healthy controls. High levels of sedentary behaviour and low levels of physical activity represent a therapeutic target that may prevent progression of metabolic conditions and weight gain in people with NAFLD and should be considered in clinical care.
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Affiliation(s)
- Kate Hallsworth
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Christian Thoma
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Sarah Moore
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Thomas Ploetz
- The School of Computing Science, Newcastle University, Newcastle upon Tyne, UK
| | - Quentin M Anstee
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Roy Taylor
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Christopher P Day
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Michael I Trenell
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
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282
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Lévesque V, Poirier P, Després JP, Alméras N. Assessing and targeting key lifestyle cardiovascular risk factors at the workplace: Effect on hemoglobin A1c levels. Ann Med 2015; 47:605-14. [PMID: 26542534 DOI: 10.3109/07853890.2015.1091943] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
PURPOSE Despite the key role played by lifestyle habits in the epidemic of type 2 diabetes (T2D), nutritional quality and physical activity are not systematically considered in clinical practice. The project was conducted to verify whether assessing/targeting lifestyle habits could reduce hemoglobin A1c (HbA1c) levels of employees. METHODS The intervention consisted of a 3-month competition among teams of five employees to favor peer-based support in the adoption of healthier lifestyle habits (Eat better, Move more, and Quit smoking) (n = 900). A comprehensive cardiometabolic/cardiorespiratory health assessment was conducted before and after the contest (nutrition/physical activity questionnaires, blood pressure, anthropometric measurements, lipid profile, HbA1c, fitness). HbA1c levels were used to identify individuals with prediabetes (5.7%-6.4%) or T2D (≥6.5%). RESULTS At baseline, 51% of the employees had increased HbA1c levels (≥5.7%). The HbA1c levels were associated with waist circumference, independently of body mass index. Subjects with prediabetes showed a higher waist circumference as well as a more deteriorated cardiometabolic profile compared to workers with normal HbA1c levels. After the intervention, employees with elevated HbA1c significantly reduced their HbA1c levels. CONCLUSION Results suggest that assessing/targeting key lifestyle correlates of the cardiometabolic profile represents a relevant approach to target abdominal obesity and fitness with a significant impact on HbA1c levels.
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Affiliation(s)
- Valérie Lévesque
- a Quebec Heart and Lung Institute , Québec , QC , Canada.,b Department of Kinesiology , Faculty of Medicine, Université Laval , Québec , QC , Canada
| | - Paul Poirier
- a Quebec Heart and Lung Institute , Québec , QC , Canada.,c Faculty of Pharmacy, Université Laval , Québec , QC , Canada
| | - Jean-Pierre Després
- a Quebec Heart and Lung Institute , Québec , QC , Canada.,b Department of Kinesiology , Faculty of Medicine, Université Laval , Québec , QC , Canada
| | - Natalie Alméras
- a Quebec Heart and Lung Institute , Québec , QC , Canada.,b Department of Kinesiology , Faculty of Medicine, Université Laval , Québec , QC , Canada
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283
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Kim HJ, Lee KW, Cho HG, Kang KT, Chang BS, Lee CK, Yeom JS. Indirect effects of decompression surgery on glycemic homeostasis in patients with type 2 diabetes mellitus and lumbar spinal stenosis. Spine J 2015; 15:25-33. [PMID: 24983668 DOI: 10.1016/j.spinee.2014.06.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 05/05/2014] [Accepted: 06/13/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Lumbar spinal stenosis (LSS) patients with diabetes mellitus (DM) are presumed to experience difficulty when performing regular daily exercise, although such exercise is of paramount importance for glucose homeostasis and control. Therefore, decompression surgery, which can help patients perform regular physical activity, would have indirect positive effects on blood glucose control in LSS patients with DM. PURPOSE To evaluate the indirect effects of spinal surgery on hemoglobin A(1c) (HbA(1c)) levels in the patient with Type 2 DM and LSS. STUDY DESIGN Prospectively collected observational cohort data. PATIENT SAMPLE Patients with degenerative LSS and DM. OUTCOME MEASURES The fasting total cholesterol (TC), fasting blood glucose (FBG), and HbA1c levels and visual analog scale (VAS) for back pain, VAS for leg pain, and Oswestry Disability Index (ODI). METHODS According to the treatment methods, 31 and 37 patients were allocated to the surgical and conservative treatment groups, respectively. The HbA(1c), TC, and FBG levels and the ODI and VAS for back/leg pain were recorded for all patients before surgical and conservative treatments. At the first and second follow-up assessments after surgical or conservative treatment, the data were reassessed for all patients. RESULTS In both groups, the VAS for back/leg pain and the ODI scores significantly decreased after surgical or conservative treatment. In the surgical treatment group, the HbA(1c) levels were significantly decreased at the first and second assessments after surgery, whereas the conservative treatment group did not show significant reductions in HbA(1c) levels at the first and second follow-up assessments. In both groups, the FBG levels did not differ between the initial and follow-up assessments. The TC levels were significantly decreased at the second follow-up assessment, only in the surgical treatment group. The amount of ODI score reduction correlated positively with the degree of HbA(1c) level reduction at the first follow-up assessment. CONCLUSIONS The present study demonstrates the reduction in HbA(1c) level in patients with DM and LSS after decompression surgery with or without fusion. We believe this reduction in the HbA(1c) level may be a result of increased physical activity, subsequent to successful surgical decompression of the cauda equina.
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Affiliation(s)
- Ho-Joong Kim
- Spine Center and Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, 166 Gumiro, Bundang-gu, Sungnam 463-707, Republic of Korea
| | - Ki-Woong Lee
- Spine Center and Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, 166 Gumiro, Bundang-gu, Sungnam 463-707, Republic of Korea
| | - Hyeon-Guk Cho
- Spine Center and Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, 166 Gumiro, Bundang-gu, Sungnam 463-707, Republic of Korea
| | - Kyoung-Tak Kang
- Department of Mechanical Engineering, Yonsei University, 134 Shinchon-dong, Seodaemun-gu, Seoul, Republic of Korea
| | - Bong-Soon Chang
- Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea
| | - Choon-Ki Lee
- Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea
| | - Jin S Yeom
- Spine Center and Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, 166 Gumiro, Bundang-gu, Sungnam 463-707, Republic of Korea.
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284
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van Dijk JW, van Loon LJ. Exercise strategies to optimize glycemic control in type 2 diabetes: a continuing glucose monitoring perspective. Diabetes Spectr 2015; 28:24-31. [PMID: 25717275 PMCID: PMC4334084 DOI: 10.2337/diaspect.28.1.24] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
IN BRIEF The introduction of continuous glucose monitoring (CGM) several years ago enabled researchers to investigate the impact of exercise strategies on 24-hour glycemic control. Such unique information on the glucoregulatory properties of exercise will ultimately lead to more effective exercise programs to prevent and treat type 2 diabetes. This article reviews the role of exercise and physical activity in the treatment of type 2 diabetes, complemented by recent data obtained by CGM.
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Affiliation(s)
- Jan-Willem van Dijk
- Institute of Sports and Exercise Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
- NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Luc J.C. van Loon
- NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University, Maastricht, The Netherlands
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285
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Montero D, Roberts CK, Vinet A. Effect of aerobic exercise training on arterial stiffness in obese populations : a systematic review and meta-analysis. Sports Med 2014; 44:833-43. [PMID: 24585152 DOI: 10.1007/s40279-014-0165-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND AND OBJECTIVE Controversy exists as to whether aerobic exercise training decreases arterial stiffness in obese subjects. The aim of this study was to systematically review and quantify the effect of aerobic exercise training on arterial stiffness in obese populations. METHODS MEDLINE, Cochrane, Scopus, and Web of Science were searched up until May 2013 for trials assessing the effect of aerobic training interventions lasting 8 weeks or more on arterial stiffness in obese populations (body mass index ≥30 kg/m(2)). Standardized mean difference (SMD) in arterial stiffness parameters (augmentation index, β-stiffness, distensibility, pulse wave velocity, arterial waveforms) was calculated using a random-effects model. Subgroup and meta-regression analyses were used to study potential moderating factors. RESULTS Eight trials, comprising a total of 235 subjects with an age range of 49-70 years, met the inclusion criteria. Arterial stiffness was not significantly reduced by aerobic training (SMD -0.17; 95 % confidence interval (CI) -0.39, 0.06, P = 0.14). Similarly, post-intervention arterial stiffness was similar between the aerobic-trained and control obese groups (SMD 0.02; 95 % CI -0.28, 0.32, P = 0.88). Neither heterogeneity nor publication bias were detected in these analyses. In subgroup analyses, arterial stiffness was significantly reduced in aerobic-trained subgroups having below median values in post- minus pre-intervention systolic blood pressure (SBP) (P < 0.01), exercise intensity rating score (P < 0.01), and methodological quality score (P < 0.01). Equivalent results were obtained in meta-regression analyses. CONCLUSION Based on current published trials, arterial stiffness is generally not reduced in middle-aged and older obese populations in response to aerobic training. However, in studies using low-intensity aerobic training and yielding a decrease in SBP, arterial stiffness may decrease. Long-term studies are needed to assess the prognostic value of these findings.
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Affiliation(s)
- David Montero
- Avignon University, LAPEC EA4278, 84000, Avignon, France,
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286
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Facteurs influençant la prescription d’activités physiques dans la prise en charge thérapeutique du patient diabétique de type 2. NUTR CLIN METAB 2014. [DOI: 10.1016/j.nupar.2014.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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287
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Yardley JE, Hay J, Abou-Setta AM, Marks SD, McGavock J. A systematic review and meta-analysis of exercise interventions in adults with type 1 diabetes. Diabetes Res Clin Pract 2014; 106:393-400. [PMID: 25451913 DOI: 10.1016/j.diabres.2014.09.038] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 08/27/2014] [Accepted: 09/15/2014] [Indexed: 12/11/2022]
Abstract
AIMS Conflicting evidence exists regarding the benefits of physical activity for long-term blood glucose control in adults with type 1 diabetes (T1D). The object of this systematic review was to determine the effects of physical activity on long-term blood glucose control in T1D adults. METHODS PubMed/Medline, Embase, CENTRAL, SPORTdiscus, Global Health and ICTRP were searched up to October 2013 for randomized trials of aerobic or resistance exercise training in T1D adults. Exercises had to be performed at least twice weekly for a minimum of two months. The primary outcome was glycated hemoglobin (HbA1c). Secondary outcomes included cardiorespiratory fitness and insulin dose. RESULTS Six randomized trials were identified (323 adults); sample sizes ranged from n=6 to n=148 participants receiving the intervention. Five trials had an unknown risk of bias; one trial was deemed to be at high risk of bias. Exercise frequency varied from twice weekly to daily, with intensities (50-90% VO2peak), and session durations (20-120 min) varying widely. Four trials reported HbA1c, which decreased with exercise training (mean difference [MD] -0.78% (-9 mmol/mol), 95% CI -1.14 (-13 mmol/mol) to -0.41 (-5 mmol/mol); p<0.0001; I(2) 0%) compared with controls. Exercise training improved cardiorespiratory fitness by 3.45 ml/kg/min (95% CI 0.59 to 6.31, p=0.02, I(2) 0%) compared with controls. One trial reported an effect on insulin dose (MD -0.4U/kg, 95% CI -0.53 to -0.27, p<0.00001) compared to controls. CONCLUSION There are currently insufficient well-designed studies to ascertain the true effect of exercise training on HbA1c in individuals with T1D, but current results are promising.
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Affiliation(s)
- Jane E Yardley
- Manitoba Institute of Child Health, University of Manitoba, Winnipeg, MB, Canada; University of Alberta, Augustana Campus, Camrose, AB, Canada
| | - Jacqueline Hay
- Manitoba Institute of Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - Ahmed M Abou-Setta
- George & Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, MB, Canada; Winnipeg Regional Health Authority, Winnipeg, MB, Canada
| | - Seth D Marks
- Department of Pediatrics, University of Manitoba, Winnipeg, MB, Canada
| | - Jonathan McGavock
- Manitoba Institute of Child Health, University of Manitoba, Winnipeg, MB, Canada.
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288
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Soto NL, Martínez MU, Mac-Kay FV, De la Barra GS. Reality of physical activity in schoolchildren with asthma and diabetes in education. SPORT SCIENCES FOR HEALTH 2014. [DOI: 10.1007/s11332-014-0189-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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289
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Fowles JR, Shields C, d’Entremont L, McQuaid S, Barron B, Dunbar P. Implementation of Resources to Support Patient Physical Activity through Diabetes Centres in Nova Scotia: The Effectiveness of Enhanced Support for Exercise Participation. Can J Diabetes 2014; 38:423-31. [DOI: 10.1016/j.jcjd.2014.02.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 02/10/2014] [Accepted: 02/11/2014] [Indexed: 11/15/2022]
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290
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Fowles JR, Shields C, Barron B, McQuaid S, Dunbar P. Implementation of Resources to Support Patient Physical Activity Through Diabetes Centres in Atlantic Canada: The Effectiveness of Toolkit-Based Physical Activity Counselling. Can J Diabetes 2014; 38:415-22. [DOI: 10.1016/j.jcjd.2014.02.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 02/12/2014] [Accepted: 02/13/2014] [Indexed: 11/15/2022]
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291
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Rocha RER, Coelho I, Pequito DCT, Yamagushi A, Borghetti G, Yamazaki RK, Brito GAPD, Machado J, Kryczyk M, Nunes EA, Venera G, Fernandes LC. Interval training attenuates the metabolic disturbances in type 1 diabetes rat model. ACTA ACUST UNITED AC 2014; 57:594-602. [PMID: 24343627 DOI: 10.1590/s0004-27302013000800003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 06/30/2013] [Indexed: 01/16/2023]
Abstract
OBJECTIVE This study investigated the effect of interval training on blood biochemistry and immune parameters in type 1 diabetic rats. MATERIALS AND METHODS Male Wistar rats were divided into four groups: sedentary (SE, n = 15), interval training (IT, n = 17), diabetic sedentary (DSE, n = 17), diabetic interval training (DIT, n = 17). Diabetes was induced by i.v. injection of streptozotocin (60 mg/kg). Swimming Interval Training consisted of 30-s exercise with 30-s rest, for 30 minutes, during 6 weeks, four times a week, with an overload of 15% of body mass. Plasma glucose, lactate, triacylglycerol and total cholesterol concentrations, phagocytic capacity, cationic vesicle content, and superoxide anion and hydrogen peroxide production by blood neutrophils and peritoneal macrophages were evaluated. Proliferation of mesenteric lymphocytes was also estimated. RESULTS Interval training resulted in attenuation of the resting hyperglycemic state and decreased blood lipids in the DIT group. Diabetes increased the functionality of blood neutrophils and peritoneal macrophages in the DSE group. Interval training increased all functionality parameters of peritoneal macrophages in the IT group. Interval training also led to a twofold increase in the proliferation of mesenteric lymphocytes after 6 weeks of exercise in the DIT group. CONCLUSION Low-volume high-intensity physical exercise attenuates hyperglycemia and dislipidemia induced by type 1 diabetes, and induces changes in the functionality of innate and acquired immunity.
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292
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Qiu S, Cai X, Schumann U, Velders M, Sun Z, Steinacker JM. Impact of walking on glycemic control and other cardiovascular risk factors in type 2 diabetes: a meta-analysis. PLoS One 2014; 9:e109767. [PMID: 25329391 PMCID: PMC4201471 DOI: 10.1371/journal.pone.0109767] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 09/10/2014] [Indexed: 12/14/2022] Open
Abstract
Background Walking is the most popular and most preferred exercise among type 2 diabetes patients, yet compelling evidence regarding its beneficial effects on cardiovascular risk factors is still lacking. The aim of this meta-analysis of randomized controlled trials (RCTs) was to evaluate the association between walking and glycemic control and other cardiovascular risk factors in type 2 diabetes patients. Methods Three databases were searched up to August 2014. English-language RCTs were eligible for inclusion if they had assessed the walking effects (duration ≥8 weeks) on glycemic control or other cardiovascular risk factors among type 2 diabetes patients. Data were pooled using a random-effects model. Subgroup analyses based on supervision status and meta-regression analyses of variables regarding characteristics of participants and walking were performed to investigate their association with glycemic control. Results Eighteen studies involving 20 RCTs (866 participants) were included. Walking significantly decreased glycosylated haemoglobin A1c (HbA1c) by 0.50% (95% confidence intervals [CI]: −0.78% to −0.21%). Supervised walking was associated with a pronounced decrease in HbA1c (WMD −0.58%, 95% CI: −0.93% to −0.23%), whereas non-supervised walking was not. Further subgroup analysis suggested non-supervised walking using motivational strategies is also effective in decreasing HbA1c (WMD −0.53%, 95% CI: −1.05% to −0.02%). Effects of covariates on HbA1c change were generally unclear. For other cardiovascular risk factors, walking significantly reduced body mass index (BMI) and lowered diastolic blood pressure (DBP), but non-significantly lowered systolic blood pressure (SBP), or changed high-density or low-density lipoprotein cholesterol levels. Conclusions This meta-analysis supports that walking decreases HbA1c among type 2 diabetes patients. Supervision or the use of motivational strategies should be suggested when prescribed walking to ensure optimal glycemic control. Walking also reduces BMI and lowers DBP, however, it remains insufficient regarding the association of walking with lowered SBP or improved lipoprotein profiles. Trial Registration PROSPERO CRD42014009515
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Affiliation(s)
- Shanhu Qiu
- Division of Sports and Rehabilitation Medicine, Department of Medicine II, Ulm University, Ulm, Germany
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, Nanjing, P. R. China
| | - Xue Cai
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, Nanjing, P. R. China
| | - Uwe Schumann
- Division of Sports and Rehabilitation Medicine, Department of Medicine II, Ulm University, Ulm, Germany
| | - Martina Velders
- Division of Sports and Rehabilitation Medicine, Department of Medicine II, Ulm University, Ulm, Germany
| | - Zilin Sun
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, Nanjing, P. R. China
- * E-mail:
| | - Jürgen Michael Steinacker
- Division of Sports and Rehabilitation Medicine, Department of Medicine II, Ulm University, Ulm, Germany
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293
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Ashor AW, Lara J, Siervo M, Celis-Morales C, Mathers JC. Effects of exercise modalities on arterial stiffness and wave reflection: a systematic review and meta-analysis of randomized controlled trials. PLoS One 2014; 9:e110034. [PMID: 25333969 PMCID: PMC4198209 DOI: 10.1371/journal.pone.0110034] [Citation(s) in RCA: 272] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Accepted: 09/06/2014] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Physical activity is associated with lower cardiovascular and all-cause mortality. However, the effects of different exercise modalities on arterial stiffness are currently unclear. Our objectives were to investigate the effects of exercise modalities (aerobic, resistance or combined) on pulse wave velocity (PWV) and augmentation index (AIx), and to determine whether the effects on these indices differed according to the participants' or exercise characteristics. METHODS We searched the Medline, Embase and Cochrane Library databases from inception until April 2014 for randomized controlled trials lasting ≥ 4 weeks investigating the effects of exercise modalities on PWV and AIx in adults aged ≥ 18 years. RESULTS Forty-two studies (1627 participants) were included in this analysis. Aerobic exercise improved both PWV (WMD: -0.63 m/s, 95% CI: -0.90, -0.35) and AIx (WMD:-2.63%, 95% CI: -5.25 to -0.02) significantly. Aerobic exercise training showed significantly greater reduction in brachial-ankle (WMD: -1.01 m/s, 95% CI: -1.57, -0.44) than in carotid-femoral (WMD: -0.39 m/s, 95% CI: -0.52, -0.27) PWV. Higher aerobic exercise intensity was associated with larger reductions in AIx (β: -1.55%, CI -3.09, 0.0001). In addition, aerobic exercise had a significantly larger effect in reducing PWV (WMD:-1.0 m/s, 95% CI: -1.43, -0.57) in participants with stiffer arteries (PWV ≥ 8 m/s). Resistance exercise had no effect on PWV and AIx. There was no significant effect of combined exercise on PWV and AIx. CONCLUSIONS We conclude that aerobic exercise improved arterial stiffness significantly and that the effect was enhanced with higher aerobic exercise intensity and in participants with greater arterial stiffness at baseline. TRIAL REGISTRATION PROSPERO Database registration: CRD42014009744.
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Affiliation(s)
- Ammar W. Ashor
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, United Kingdom
- College of Medicine, University of Al-Mustansiriyah, Baghdad, Iraq
- * E-mail:
| | - Jose Lara
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, United Kingdom
| | - Mario Siervo
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, United Kingdom
| | - Carlos Celis-Morales
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, United Kingdom
| | - John C. Mathers
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, United Kingdom
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294
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Toste S, Viamonte S, Barreira A, Fernandes P, Lopes Gomes J, Torres S. Cardiac rehabilitation in patients with type 2 diabetes mellitus and coronary disease: a comparative study. Rev Port Cardiol 2014; 33:599-608. [PMID: 25307705 DOI: 10.1016/j.repc.2014.01.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Revised: 01/18/2014] [Accepted: 01/27/2014] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION AND AIMS Diabetic patients have a 2-4 times higher risk of cardiovascular disease than non-diabetic individuals. The aims of this study are to evaluate the effects of a cardiac rehabilitation program (phase II) in patients with diabetes and coronary disease and to compare the results with regard to control of cardiovascular risk factors and improvement in functional capacity with coronary patients without diabetes. METHODS This was a prospective study of patients diagnosed with ischemic heart disease referred for a cardiac rehabilitation program between January 2009 and June 2013. The population was divided into two groups: diabetic and non-diabetic. Patients were assessed at the beginning of phase II and three months later and the following parameters were recorded: body mass index, waist circumference, lipid profile, blood glucose and glycated hemoglobin in diabetic patients, blood pressure, smoking, physical activity level (using the International Physical Activity Questionnaire) and functional capacity (on treadmill stress testing). RESULTS The study population consisted of 682 patients (253 diabetic and 429 non-diabetic). Diabetic patients were significantly older, had a worse cardiovascular risk profile (higher prevalence of overweight, dyslipidemia, hypertension and sedentary lifestyle) and lower functional capacity. At the end of phase II, there was a statistically significant improvement (p<0.05) in all risk factors and functional capacity, which was similar in both groups, except for body mass index, triglycerides and functional capacity. CONCLUSIONS Diabetic patients may benefit from a cardiac rehabilitation program and achieve comparable results to non-diabetic patients.
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Affiliation(s)
- Sofia Toste
- Serviço de Fisiatria, Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal.
| | - Sofia Viamonte
- Serviço de Fisiatria, Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal.
| | - Ana Barreira
- Serviço de Cardiologia, Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal
| | - Preza Fernandes
- Serviço de Cardiologia, Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal
| | - José Lopes Gomes
- Serviço de Cardiologia, Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal
| | - Severo Torres
- Serviço de Cardiologia, Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal
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295
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Stoneman A, Atkinson D, Davey M, Marley JV. Quality improvement in practice: improving diabetes care and patient outcomes in Aboriginal Community Controlled Health Services. BMC Health Serv Res 2014; 14:481. [PMID: 25288282 PMCID: PMC4282197 DOI: 10.1186/1472-6963-14-481] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 09/29/2014] [Indexed: 11/10/2022] Open
Abstract
Background Management of chronic disease, including diabetes, is a central focus of most Aboriginal Community Controlled Health Services (ACCHSs) in Australia. We have previously demonstrated that diabetes monitoring and outcomes can be improved and maintained over a 10-year period at Derby Aboriginal Health Service (DAHS). While continuous quality improvement (CQI) has been shown to improve service delivery rates and clinical outcome measures, the process of interpreting audit results and developing strategies for improvement is less well described. This paper describes the evaluation of care of patients with type 2 diabetes mellitus (T2DM) and features of effective CQI in ACCHSs in the remote Kimberley region of north Western Australia. Methods Retrospective audit of records for Aboriginal and Torres Strait Islander primary care patients aged ≥15 years with a confirmed diagnosis of T2DM at four Kimberley ACCHSs from 1 July 2011 to 30 June 2012. Interviews with health service staff and focus group discussions with patients post audit. Main outcome measures: diabetes care related activities, clinical outcome measures and factors influencing good diabetes related care and effective CQI. Results A total of 348 patients from the four ACCHSs were included in the study. Clinical care activities were generally high across three of the four health services (at least 71% of patients had cholesterol recorded, 89% blood pressure, 84% HbA1c). Patients from DAHS had lower median cholesterol levels (4.4 mmol/L) and the highest proportion of patients meeting clinical targets for HbA1c (31% v 16% ACCHS-3; P = 0.02). Features that facilitated good care included clearly defined staff roles for diabetes management, support and involvement of Aboriginal Health Workers, efficient recall systems, and well-coordinated allied health services. Effective CQI features included seamless and timely data collection, local ownership of the process, openness to admitting deficiencies and willingness to embrace change. Conclusions Well-designed health care delivery and CQI systems, with a strong sense of ownership over diabetes management led to increased service delivery rates and improved clinical outcome measures in ACCHSs. Locally run CQI processes may be more responsive to individual health services and more sustainable than externally driven systems.
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Affiliation(s)
- Alice Stoneman
- Launceston Clinical School, University of Tasmania, Locked Bag 1377, Launceston, TAS 7250, Australia.
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296
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Toste S, Viamonte S, Barreira A, Fernandes P, Gomes JL, Torres S. Cardiac rehabilitation in patients with type 2 diabetes mellitus and coronary disease: A comparative study. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2014. [DOI: 10.1016/j.repce.2014.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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297
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Park SY, Lee IH. Effects on training and detraining on physical function, control of diabetes and anthropometrics in type 2 diabetes; a randomized controlled trial. Physiother Theory Pract 2014; 31:83-8. [PMID: 25230894 DOI: 10.3109/09593985.2014.958265] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The purpose of this study was to investigate the effect of circuit exercise training and detraining, which is defined by termination of training without additional physical activities, in type 2 diabetic patients. Elderly with type 2 diabetes were divided into a group that exercised for 1 h three times a week for 12 weeks, followed by detraining for 8 weeks, or into a control group. Muscular strength, endurance, flexibility, agility, balance, body mass index (BMI), glycosylated hemoglobin (HbA1c), and blood lipid profile were measured. Of the 98 diabetic participants who joined this study, 37 patients completed the program (exercise group = 24, control group = 13). After training, muscular strength, flexibility, balance, agility, and endurance in the training group were significantly higher than at baseline and compared to the control group. HbA1c levels decreased in the training group. There was no significant improvement in BMI and blood lipid profile in either group. Flexibility and agility in the training group declined significantly after detraining. In spite of this decline, flexibility and agility were significantly higher compared to the baseline and to the control group. In type 2 diabetic patients, circuit training had a beneficial effect on the indices of physical function and glucose metabolism. Training resulted in good improvement; and during detraining, the effect of exercise training was maintained except in some parameters.
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Affiliation(s)
- Sang-Young Park
- Department of Physical Therapy, Uiduk University , Donghaedaero 261 Gangdong Gyeongju, Gyeongbuk , Korea and
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298
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Cugusi L, Cadeddu C, Nocco S, Orrù F, Bandino S, Deidda M, Caria A, Bassareo PP, Piras A, Cabras S, Mercuro G. Effects of an aquatic-based exercise program to improve cardiometabolic profile, quality of life, and physical activity levels in men with type 2 diabetes mellitus. PM R 2014; 7:141-8; quiz 148. [PMID: 25217820 DOI: 10.1016/j.pmrj.2014.09.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 09/01/2014] [Accepted: 09/04/2014] [Indexed: 01/22/2023]
Abstract
BACKGROUND The role of structured exercise in improving cardiometabolic profile and quality of life in patients with type 2 diabetes mellitus (2DM) has been widely demonstrated. Little is known about the effects of an aquatic-based exercise program in patients with 2DM. OBJECTIVE To evaluate the effects of a supervised aquatic-based exercise program on cardiometabolic profile, quality of life, and physical activity levels in patients with 2DM. DESIGN AND SETTING Observational study, community pre-post aquatic-based exercise program, primary care intervention. PATIENTS Eighteen men diagnosed with 2DM (52.2 ± 9.3 years). METHODS and MAIN OUTCOME MEASUREMENTS Cardiometabolic profile, quality of life, and physical activity levels were assessed before and after 12 weeks of an aquatic-based exercise program. RESULTS The results show a significant improvement of cardiometabolic assessments (maximum oxygen consumption: 24.1 versus 21.1 mL/kg/min, P < .05; blood pressure: 125.4/77 versus 130.7/82.5 mm Hg, P < .05; fasting blood glucose: 119.6 versus 132.5 mg/dL, P < .05; body mass index: 29.9 versus 31.1 kg/m², P < .005; low-density lipoprotein cholesterol: 95.2 versus 104.9 mg/dL, P < .05; and diastolic function: E/E' 9.1 versus 10.1, P < .005) and an increase in quality of life and physical activity levels (Medical Outcome Study 36-item Short Form Health Survey mental component summary: 72.3 versus 67, P < .05; Problems Area About Diabetes: 20.1 versus 33.2, P < .005) and energy expenditure in general physical activity (physical activity: 3888.7 versus 1239.5 kcal/wk, P < .05). CONCLUSIONS These findings demonstrate that an aquatic-based exercise program produces benefits for the cardiovascular system and metabolic profile and appears to be safe and effective in improving quality of life and increasing physical activity levels in patients with 2DM.
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Affiliation(s)
- Lucia Cugusi
- Department of Medical Sciences "M. Aresu," University of Cagliari, Italy; Adapted Physical Activity Master Degree Course, University of Cagliari, Italy(∗).
| | - Christian Cadeddu
- Department of Medical Sciences "M. Aresu," University of Cagliari, Italy(†)
| | - Silvio Nocco
- Department of Medical Sciences "M. Aresu," University of Cagliari, Italy(‡)
| | - Fabio Orrù
- Department of Medical Sciences "M. Aresu," University of Cagliari, Italy(§)
| | - Stefano Bandino
- Department of Medical Sciences "M. Aresu," University of Cagliari, Italy(¶)
| | - Martino Deidda
- Department of Medical Sciences "M. Aresu," University of Cagliari, Italy(#)
| | - Alessandra Caria
- Adapted Physical Activity Master Degree Course, University of Cagliari, Italy(∗∗)
| | - Pier Paolo Bassareo
- Department of Medical Sciences "M. Aresu," University of Cagliari, Italy(††)
| | - Alessandra Piras
- Department of Medical Sciences "M. Aresu," University of Cagliari, Italy(‡‡)
| | - Sergio Cabras
- Casa di Cura Madonna del Rimedio, Oristano, Italy(§§)
| | - Giuseppe Mercuro
- Department of Medical Sciences "M. Aresu," University of Cagliari, Italy; Adapted Physical Activity Master Degree Course, University of Cagliari, Italy(¶¶)
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299
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Schwingshackl L, Missbach B, Dias S, König J, Hoffmann G. Impact of different training modalities on glycaemic control and blood lipids in patients with type 2 diabetes: a systematic review and network meta-analysis. Diabetologia 2014; 57:1789-97. [PMID: 24996616 DOI: 10.1007/s00125-014-3303-z] [Citation(s) in RCA: 156] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 06/02/2014] [Indexed: 01/17/2023]
Abstract
AIMS/HYPOTHESIS This study aimed to systematically review randomised controlled trials comparing the effects of aerobic exercise training (AET), resistance training (RT) and combined training (CT) on glycaemic control and blood lipids in patients with type 2 diabetes mellitus. METHODS Searches were performed in MEDLINE, EMBASE and the Cochrane Library. Inclusion criteria were: type 2 diabetes mellitus, adult, supervised training and a minimum intervention period of 8 weeks. Pooled effects were calculated by fixed/random effect pairwise and Bayesian fixed/random effects network meta-analyses. RESULTS A total of 14 trials enrolling 915 participants were included. AET was more effective than RT in improving HbA1c levels (mean difference [MD] -0.20% [-2.2 mmol/mol]; 95% CI -0.32, -0.08; p = 0.0007, 10 trials/515 participants) and fasting glucose (MD -0.9 mmol/l; 95% CI -1.71, -0.09; p = 0.03, 8 trials/245 participants). Compared with AET, CT resulted in a significantly more pronounced reduction in HbA1c (MD -0.17% [-1.87 mmol/mol]; 95% CI -0.31, -0.03; p = 0.02, 9 trials/493 participants). Compared with RT, the MD of the change in HbA1c (MD -0.62%, [-6.82 mmol/mol]; 95% CI -0.95, -0.30; p = 0.0002, 5 trials/362 participants], fasting glucose (MD -1.99 mmol/l; 95% CI -3.07, -0.90; p = 0.0003, 3 trials/99 participants) and triacylglycerols (MD -0.28 mmol/l; 95% CI -0.46, -0.10; p = 0.003, 4 trials/213 participants) were all in favour of CT. The exclusion of trials with a high risk of bias yielded only non-significant results. CONCLUSIONS/INTERPRETATION The present data suggest that CT might be the most efficacious exercise modality to improve glycaemic control and blood lipids. Interpretation with respect to clinical relevance is limited by the low quality of the studies included and the limited information on the clinically important outcomes or adverse effects of exercise.
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Affiliation(s)
- Lukas Schwingshackl
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Althanstraße 14 (UZAII), 1090, Vienna, Austria,
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300
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Schreuder THA, Duncker DJ, Hopman MTE, Thijssen DHJ. Randomized controlled trial using bosentan to enhance the impact of exercise training in subjects with type 2 diabetes mellitus. Exp Physiol 2014; 99:1538-47. [PMID: 25172889 DOI: 10.1113/expphysiol.2014.081182] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In type 2 diabetes patients, endothelin (ET) receptor blockade may enhance blood flow responses to exercise training. The combination of exercise training and ET receptor blockade may represent a more potent stimulus than training alone to improve vascular function, physical fitness and glucose homeostasis. We assessed the effect of an 8 week exercise training programme combined with either ET blockade or placebo on vasculature, fitness and glucose homeostasis in people with type 2 diabetes. In a double-blind randomized controlled trial, brachial endothelium-dependent and ‑independent dilatation (using flow-mediated dilatation and glyceryl trinitrate, respectively), glucose homeostasis (using Homeostasis Model Assessment for Insulin Resistance (HOMA-IR)) and physical fitness (maximal cycling test) were assessed in 18 men with type 2 diabetes (60 ± 6 years old). Subjects underwent an 8 week exercise training programme, with half of the subjects receiving ET receptor blockade (bosentan) and the other half a placebo, followed by reassessment of the tests above. Exercise training improved physical fitness to a similar extent in both groups, but we did not detect changes in vascular function in either group. This study suggests that there is no adaptation in brachial and femoral artery endothelial function after 8 weeks of training in type 2 diabetes patients. Endothelin receptor blockade combined with exercise training does not additionally alter conduit artery endothelial function or physical fitness in type 2 diabetes.
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Affiliation(s)
- Tim H A Schreuder
- Department of Physiology, Radboud University Nijmegen Medical Centre, The Netherlands
| | - Dirk J Duncker
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Maria T E Hopman
- Department of Physiology, Radboud University Nijmegen Medical Centre, The Netherlands
| | - Dick H J Thijssen
- Department of Physiology, Radboud University Nijmegen Medical Centre, The Netherlands Division of Experimental Cardiology, Department of Cardiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
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