Association between physical activity and diabetes control: multiple cross-sectional studies and a prospective study in a population-based, Swiss cohort

INTRODUCTION

Physical activity (PA) is recommended in patients with type 2 diabetes mellitus (T2DM) to improve their glycaemic control. We aimed to assess PA levels among participants with controlled and uncontrolled T2DM.

RESEARCH DESIGN AND METHODS

Three cross-sectional analyses of a prospective cohort conducted in Lausanne, Switzerland. PA levels (sedentary, light, moderate and vigorous) were either self-reported via questionnaire (first and second survey) or objectively assessed using accelerometry (second and third survey). T2DM control was defined as glycaemia <7.0 mmol/L or glycated haemoglobin <6.5% (48 mmol/mol).

RESULTS

Data from 195 (30.3% women), 199 (30.1% women) and 151 (44.4% women) participants with T2DM were analysed in the first (2009-2012), second (2014-2017) and third (2018-2021) surveys. Approximately half of the participants did not have controlled glycaemia. Using subjective data, over 90% (first survey) and 75% (second survey) of participants reported moderate and vigorous PA >150 min/week. After multivariable adjustment, no differences were found regarding all types of self-reported PA levels between controlled and uncontrolled participants. Objective assessment of PA led to considerable differences according to the software used: 90% and 20% of participants with moderate and vigorous PA >150 min/week, respectively. After multivariable adjustment, no differences were found for all PA levels between controlled and uncontrolled participants, irrespective of the analytical procedure used. Using glycated haemoglobin, almost two-thirds of participants were considered as uncontrolled, and no differences were found for objectively assessed PA between controlled and uncontrolled participants.

CONCLUSIONS

No differences in PA levels were found between participants with controlled and uncontrolled T2DM.

Effect of Elastic-band Baduanjin exercise on older adults with type 2 diabetes mellitus in China: protocol for a randomised controlled trial

INTRODUCTION

In China, older adults have the highest incidence of type 2 diabetes mellitus (T2DM). Bone, joint and physical endurance limit the types of exercise available to older adults with T2DM. Baduanjin is recommended and encouraged as an exercise option. However, Baduanjin exercise alone cannot account for the loss of muscle mass. Resistance training is recommended in the guidelines and offers new options for increasing muscle strength. The purpose of this study is to compare the effects of Elastic-band Baduanjin exercise training with those of Baduanjin alone.

METHODS AND ANALYSIS

This study is a reworking exercise programme, consisting of Baduanjin combined with elastic band resistance exercise training. A 12-week randomised controlled trial will be conducted. Patients aged 60-80 years with T2DM will be assigned to the Elastic-band Baduanjin (intervention) and Baduanjin (control) groups using cluster random sampling. A sample of 70 participants will be conducted. Indicators of muscle strength, body composition, blood glucose and balance function will be collected before and after the intervention. Meanwhile, exercise will be monitored using the International Physical Activity Questionnaire.

ETHICS AND DISSEMINATION

The trial was approved by the Chinese Ethics Committee of Registering Clinical Trials on 19 June 2022 (ChiECRCT20220210). The research results will be published in peer--reviewed publications.

TRIAL REGISTRATION NUMBER

Chinese Clinical Trials Registry (ChiCTR2200062424).

Fluctuations in Self-Reported Symptoms Predict Objective Physical Activity in Adults With Type 2 Diabetes

PURPOSE

The purpose of this study was to examine the association between self-reported symptoms including fatigue and sleep disturbance with moderate-intensity physical activity among adults with type 2 diabetes.

METHODS

This report was a secondary analysis of a cross-sectional study. Data from 53 participants with at least 6 days of repeated measures were used. Daytime physical activity and energy expenditure were assessed using a wrist-worn accelerometer at the free-living setting. Fatigue upon awakening was measured using a 0 to 10 scale. Sleep (eg, restorative sleep, sleep duration, and sleep efficiency) was measured using the Consensus Sleep Diary for Morning. Data were analyzed using linear mixed models by including within- and between-person effects.

RESULTS

Participants were predominantly females (54.7%) with a mean age of 60.3 years. Controlling for the covariates, at the individual level (within-person), fluctuations in restorative sleep and fatigue upon awakening predicted moderate-intensity PA. Similarly, at the individual level, fluctuations in restorative sleep and fatigue upon awakening predicted average hourly energy expenditure. However, at the group level (between-person), no significant associations were found between fatigue and restorative sleep with moderate-intensity physical activity.

CONCLUSIONS

The study findings suggest that within-person fluctuations in fatigue and restorative sleep upon awakening predict daytime moderate-intensity physical activity. At the individual level, reducing fluctuations in fatigue and restorative sleep might encourage participation in physical activity. More research is warranted to uncover the underlying causes of fluctuations in fatigue and restorative sleep. Meanwhile, diabetes care and education specialists should pay attention to the within-person fluctuations of fatigue and sleep.

The Association Between Leisure-time Physical Activity, Sedentary Behavior, and Low Back Pain: A Cross-sectional Analysis in Primary Care Settings

STUDY DESIGN

Observational cross-sectional.

OBJECTIVE

To investigate the association between leisure-time physical activity (LTPA) and low back pain (LBP) in adults from primary care settings, and to explore how sedentary behavior influences this association.

SUMMARY OF BACKGROUND DATA

LTPA is inversely associated with LBP. However, there is no study investigating this association in primary care settings from a middle-income country. Moreover, the influence of sedentary behavior in this association is unknown.

METHODS

Cross-sectional analysis of an ongoing longitudinal study with adults from Bauru, Brazil (n = 557). Data on physical activity, sedentary behavior (sitting time), LBP, body mass index (BMI), and chronic diseases were assessed by face-to-face interviews, physical evaluation, and medical records. Binary logistic regression was used to test the association of LTPA with the presence of LBP. Sociodemographic, behavioral, and health variables were used as covariables in the multivariable models.

RESULTS

The fully adjusted model showed that active participants were 33% less likely to have LBP when compared with those insufficiently active (odds ratios [OR]: 0.67 [95% CI: 0.46-0.98]). A significant association was found for active participants who spent less than 3 h/day sitting (OR: 0.45 [95% CI: 0.23-0.89]) but not for those who spent 3 h/day or more in sedentary activities (OR: 0.78 [95% CI: 0.48-1.27]). An inverse association of LTPA with LBP was observed in obese participants (OR = 0.49 [95% CI: 0.25-0.94]), but not in those with normal BMI and overweight.

CONCLUSION

LTPA was inversely associated with the prevalence of LBP in adults from primary care. This association was influenced by sedentary behavior and BMI.Level of Evidence: 4.

Objectively Measured Physical Activity and Polypharmacy Among Brazilian Community-Dwelling Older Adults

BACKGROUND

Previous observations regarding association between physical activity (PA) and use of medicines among older adults are derived from self-reported PA. This study aimed to evaluate the association between objectively measured PA and polypharmacy among older adults with multimorbidity in Southern Brazil.

METHODS

This study included 875 noninstitutionalized older people, aged ≥60 years. Prescribed medicines used in the 15 days prior to the interview, socioeconomic data, and the presence of comorbidities were self-reported. Accelerometers were used to evaluate PA following the interview.

RESULTS

Prevalence of polypharmacy (≥5 medicines) was 38.3% (95% confidence interval, 35.0-41.5); those belonging to the lowest tertile of PA used more medicines. The authors observed a significant inverse association for polypharmacy between men belonging to the second and third tertiles of PA for objectively measured overall PA and light PA compared with the most inactive tertile. For women, the association between PA and polypharmacy was significant for overall, light, and moderate to vigorous PA only in the third tertile.

CONCLUSIONS

Overall, light and moderate to vigorous PA were inversely associated to polypharmacy and differed by gender. Promotion of PA in older adults may be an effective intervention to reduce the number of medicines used independent of the number of comorbidities.