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Gómez-Peralta F, Menéndez E, Conde S, Conget I, Novials A. Physical activity patterns in type 1 diabetes in Spain: The SED1 study. BMC Sports Sci Med Rehabil 2023; 15:92. [PMID: 37491278 PMCID: PMC10369829 DOI: 10.1186/s13102-023-00695-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 07/03/2023] [Indexed: 07/27/2023]
Abstract
AIMS To describe the physical activity (PA) frequency and intensity in the Spanish type 1 diabetes mellitus (T1D) population and its association with their glycemic control. METHODS A cross-sectional observational study was carried out in 75 Spanish public hospitals (the SED1 study). T1D patients over 14years of age self-completed the International Physical Activity Questionnaire (IPAQ) to determine their level of exercise. The relationship between PA frequency and intensity in T1D patients and glycemic control and the diabetes therapeutic education received were analyzed. RESULTS A total of 592 patients were evaluable. A 6.8% of the sample performed light PA, 20.9% moderate and 72.3% vigorous. Estimated PA presented a high inter-individual variability. Men consumed more energy (METS) than women, these differences being more noticeable in vigorous METS (2865.80 in men vs 1352.12 in women). Women invested more min/week in the domestic and garden area (639.03 vs 344.39, p = 0,022). A correlation between glycemic control and the METs was not observed. CONCLUSIONS The Spanish T1D population performed PA in a higher frequency and intensity than the general population. A relationship between PA and glycemic control couldn´t be shown. However, limitations of the study should be kept in mind to discard a long-term positive influence.
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Affiliation(s)
- F Gómez-Peralta
- Endocrinology and Nutrition Unit, Hospital General de Segovia, Segovia, Spain.
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain.
| | - E Menéndez
- Endocrinology and Nutrition Service, Hospital Universitario Central Asturias, Oviedo, Spain
| | - S Conde
- Centro de Salud de Barbastro, Huesca, Spain
| | - I Conget
- Endocrinology and Nutrition Unit, Hospital Clínic, Barcelona, Spain
| | - A Novials
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain
- Endocrinology and Nutrition Unit, Hospital Clínic, Barcelona, Spain
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McCarthy M, Yan J, Jared MC, You E, Ilkowitz J, Gallagher MP, Vaughan Dickson V. Cardiovascular health in emerging adults with type 1 diabetes. Eur J Cardiovasc Nurs 2021; 21:213-219. [PMID: 34498041 DOI: 10.1093/eurjcn/zvab062] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/19/2021] [Accepted: 07/06/2021] [Indexed: 12/18/2022]
Abstract
AIMS Individuals with type 1 diabetes (T1D) face increased risk for cardiovascular disease (CVD). Controlling individual cardiovascular risk factors can prevent or slow the onset of CVD. Ideal cardiovascular health is associated with a lower incidence of CVD. Identifying areas of suboptimal cardiovascular health can help guide CVD prevention interventions. To assess cardiovascular health and explore the barriers and facilitators to achieving ideal cardiovascular health in a sample of young adults with T1D. METHODS AND RESULTS We used a sequential mixed-method design to assess the seven factors of cardiovascular health according to American Heart Association. Qualitative interviews, guided by Pender's Health Promotion Model, were used to discuss participant's cardiovascular health results and the barriers and facilitators to achieving ideal cardiovascular health. We assessed the frequency of ideal levels of each factor. The qualitative data were analysed using content analysis. Qualitative and quantitative data were integrated in the final analysis phase. The sample (n = 50) was majority female (70%), White (86%), with a mean age of 22 ± 2.4 and diabetes duration of 10.7 ± 5.5 years. Achievement of the seven factors of cardiovascular health were: non-smoking (96%); cholesterol <200 mg/dL (76%); body mass index <25 kg/m2 (54%); blood pressure <120/<80 mmHg (46%); meeting physical activity guidelines (38%); haemoglobin A1c <7% (40%); and healthy diet (14%). Emerging qualitative themes related to the perceived benefits of action, interpersonal influences on their diabetes self-management, and perceived self-efficacy. CONCLUSION We found areas of needed improvement for cardiovascular health. However, these young adults expressed a strong interest in healthy habits which can be supported by their healthcare providers.
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Affiliation(s)
- Margaret McCarthy
- Rory Meyers College of Nursing, New York University, 433 First Avenue, New York, NY 10010, USA
| | - Joeyee Yan
- Rory Meyers College of Nursing, New York University, 433 First Avenue, New York, NY 10010, USA
| | - Mary Christine Jared
- Rory Meyers College of Nursing, New York University, 433 First Avenue, New York, NY 10010, USA
| | - Erica You
- Rory Meyers College of Nursing, New York University, 433 First Avenue, New York, NY 10010, USA
| | - Jeniece Ilkowitz
- Pediatric Diabetes Center, New York University Langone Health, 135 East 31st Street, New York, NY 10016, USA
| | - Mary Pat Gallagher
- Pediatric Diabetes Center, New York University Langone Health, 135 East 31st Street, New York, NY 10016, USA
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Brennan MC, Brown JA, Ntoumanis N, Leslie GD. Barriers and facilitators of physical activity participation in adults living with type 1 diabetes: a systematic scoping review. Appl Physiol Nutr Metab 2020; 46:95-107. [PMID: 32835497 DOI: 10.1139/apnm-2020-0461] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
To identify and map barriers and facilitators of physical activity (PA) in adults living with type 1 diabetes (T1D) in any care setting or environment. A scoping review was conducted in accordance with the PRISMA-ScR guidelines to address the aim of this review. Exclusion/inclusion criteria were determined a priori. Articles captured in the search were subject to title and abstract screening before full-text articles were assessed for eligibility against the exclusion/inclusion criteria. Included articles underwent critical appraisal before being charted, mapped, and discussed. Forty-six articles were included in the final synthesis. Most commonly, articles reported cross-sectional survey studies (46%), then qualitative designs (17%), and opinion or text (17%). Experimental studies accounted for 13% of included articles. Hypoglycaemia/fear of hypoglycaemia was the most commonly reported barrier and patient education the most commonly discussed facilitator. Quality appraisal revealed methodological issues among included articles. Higher quality research with theoretically sound behaviour-change interventions combined with targeted patient education is needed to address hypoglycaemia/fear of hypoglycaemia as a barrier to PA. Novelty: Hypoglycaemia and fear of hypoglycaemia were the most commonly reported barriers to PA in adults with T1D. Powered randomised controlled trials are required to establish efficacy of behaviour change interventions targeting these barriers to PA.
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Affiliation(s)
- Marian C Brennan
- School of Nursing, Midwifery and Paramedicine/Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia.,Health Services, Diabetes WA, Subiaco, Australia.,Physical Activity and Well-being Research Group, Curtin University, Perth, WA 6845, Australia
| | - Janie A Brown
- School of Nursing, Midwifery and Paramedicine/Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia.,St John of God Midland Public and Private Hospital, Midland, WA 6056, Australia
| | - Nikos Ntoumanis
- School of Psychology/Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia.,Physical Activity and Well-being Research Group, Curtin University, Perth, WA 6845, Australia
| | - Gavin D Leslie
- School of Nursing, Midwifery and Paramedicine/Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia
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McCarthy MM, Whittemore R, Gholson G, Grey M. Diabetes Distress, Depressive Symptoms, and Cardiovascular Health in Adults With Type 1 Diabetes. Nurs Res 2019; 68:445-452. [PMID: 31693550 PMCID: PMC6852792 DOI: 10.1097/nnr.0000000000000387] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The prevalence of adults with Type 1 diabetes (T1D) is increasing, and their risk of cardiovascular disease is high. Comorbid diabetes distress and depressive symptoms may affect their cardiovascular health. OBJECTIVES The purpose of this study was to describe the relationship between diabetes distress and depressive symptoms with cardiovascular health factors. METHODS This was a cross-sectional survey of a sample of adults with T1D. Valid and reliable instruments were used to collect the data on sociodemographics, diabetes-related complications, psychological factors, and cardiovascular health factors. Independent-sample t tests, analysis of variance, chi-square analyses, and linear regression were used to compare the cardiovascular health factors among the three levels of diabetes distress scores and the two levels of depressive symptom scores. RESULTS Our sample included 83 adults with a mean age of 45.2 years and a mean duration of T1D of 20 years. The majority scored low in the Diabetes Distress Scale, whereas 18% scored moderate and 18% scored high. Twenty-two percent had increased levels of depressive symptoms. There were significant correlations between diabetes distress and fear of hypoglycemia, depressive symptom scores, hemoglobin A1c, and total cholesterol. Depressive symptom scores were significantly correlated with hemoglobin A1c. Hemoglobin A1c and total cholesterol were significantly higher in those with higher levels of diabetes distress. There were no significant differences in cardiovascular health between those who scored below or above the cut point for depressive symptoms, but there was a finding toward higher mean body mass index, hemoglobin A1c, and a lower weekly step count in those who had elevated depressive symptoms. In the linear regression, only diabetes distress was significantly associated with hemoglobin A1c. DISCUSSION This is a sample with elevated diabetes distress and depressive symptoms, both of which may affect their risk of cardiovascular disease.
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Affiliation(s)
- Margaret M McCarthy
- Margaret M. McCarthy, PhD, RN, FNP-BC, is an Assistant Professor, the New York University Rory Meyers College of Nursing, New York. Robin Whittemore PhD, APRN, is Professor and Codirector, the National Clinician Scholars Program, Yale School of Nursing, West Haven, Connecticut. Margaret Grey, DrPH, RN, is Annie Goodrich Professor of Nursing, Yale School of Nursing, West Haven, Connecticut. Georica Gholson, PhD, is Psychologist, Walter Reed Medical Center, Bethesda, Maryland
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Salman A, Ukwaja KN, Alkhatib A. Factors Associated with Meeting Current Recommendation for Physical Activity in Scottish Adults with Diabetes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203857. [PMID: 31614752 PMCID: PMC6843691 DOI: 10.3390/ijerph16203857] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 09/25/2019] [Accepted: 09/26/2019] [Indexed: 12/15/2022]
Abstract
It remains unclear which factors are instrumental in meeting the recommended physical activity in people with diabetes. We, therefore, aimed to determine the sociodemographic, health-related behavior and clinical factors associated with meeting the recommended levels of physical activity in Scottish adults with diabetes. The study was based on the nationally-representative cross-sectional Scottish Health Surveys (2014–2017). The study participants included a sub-sample of 1259 adults (≥16 years old) with diabetes. Physical activity was evaluated using international guidelines. Overall, 34.1% of the subjects met the recommended levels of physical activity. Independent determinants of meeting the recommended levels of physical activity include male gender (odds ratio (OR) 1.47; 95% confidence interval (CI) 1.07–2.00) and being a non-smoker (OR 1.62; 95% CI 1.02–2.56). Furthermore, meeting the recommended physical activity levels decreased with age (OR 0.96; 95% CI 0.95–0.97), having a longstanding illness (OR 0.56; 95% CI 0.34–0.93) and body mass index (OR 0.94; 95% CI 0.92–0.97), but increased with higher fruit and vegetable intake (OR 1.16; 95% CI 1.07–1.25) and mental wellbeing (OR 1.04; 95% CI 1.02–1.06). Implementation of health promotion programs that target the identified determinants is needed to improve the recommended levels of physical activity among adults with diabetes.
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Affiliation(s)
- Ahmad Salman
- College of Health Sciences, QU Health, Qatar University, Doha 2713, Qatar.
- Department of Health Sciences, University of York, York YO10 5DD, UK.
| | - Kingsley Nnanna Ukwaja
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki PMB 102, Ebonyi State, Nigeria.
| | - Ahmad Alkhatib
- Institute of Sport Science, University of Taipei, Taipei 11153, Taiwan.
- School of Health and Social Care, Teesside University, Middlesbrough TS1 3BX, UK.
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A descriptive, cross-sectional study examining treatment burden in people living with HIV. Appl Nurs Res 2019; 46:31-36. [PMID: 30853073 DOI: 10.1016/j.apnr.2019.02.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 12/28/2018] [Accepted: 02/10/2019] [Indexed: 12/20/2022]
Abstract
AIM (1) describe the percentage of people living with HIV (PLWH) experiencing high levels of treatment burden who are at risk for self-management non-adherence, and (2) examine the relationship between known antecedent correlates (the number of chronic conditions, social capital, and age) of self-management and treatment burden while controlling for sample socio-demographics. BACKGROUND Chronic condition self-management is key to maintaining optimal health in the aging population of PLWH. Despite the efforts of providers, patients, and caregivers, self-management non-adherence is still a factor contributing to poor chronic condition self-management and subsequent poor health outcomes. Recent research has identified treatment burden as a risk factor of poor chronic disease self-management adherence. METHOD Cross-sectional, secondary analysis of a sub-sample of 103 community dwelling, men and women diagnosed with HIV/AIDS derived from a larger parent study examining physical activity patterns in PLWH. RESULTS Participants reported an overall low level of treatment burden (M = 22.84; SD = 24.57), although 16% (n = 16) of the sample indicated experiencing high treatment burden. The number of chronic conditions (r = 0.25; p ≤ .01) and social capital (r = -0.19; p = .03) were significantly correlated with treatment burden. Multivariate analysis testing known antecedent correlates of treatment burden was statistically significant (p < .05), but only explained 8% of treatment burden's variance. CONCLUSION Findings have implications for nursing care of PLWH demonstrating a subset of PLWH experience high treatment burden related to chronic condition self-management. Findings also identify characteristics of PLWH who may be at high risk for treatment burden and subsequent self-management non-adherence.
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Dyck RA, Kleinman NJ, Funk DR, Yeung RO, Senior P, Yardley JE. We Can Work (It) Out Together: Type 1 Diabetes Boot Camp for Adult Patients and Providers Improves Exercise Self-Efficacy. Can J Diabetes 2018; 42:619-625. [PMID: 29909966 DOI: 10.1016/j.jcjd.2018.02.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 02/08/2018] [Indexed: 01/10/2023]
Abstract
OBJECTIVES This project aimed to use education sessions and exercise classes to improve exercise self-efficacy in individuals with type 1 diabetes and in diabetes care providers (DCPs). METHODS We recruited 12 adults with type 1 diabetes and 12 DCPs who participated in 4 weekly group sessions to learn about exercise physiology and to experience various exercise types. We provided participants who had type 1 diabetes with real-time continuous glucose monitors and heart rate monitors to enhance experiential learning. Both groups completed questionnaires before and after the study to assess confidence concerning exercise. Following the study, focus groups assessed the impact of the study on knowledge and self-efficacy. RESULTS There was an improvement in DCPs' attitudes toward exercise (p=0.004). DCPs' confidence in providing clients with advice regarding the time, type and intensity of exercise (p=0.005) and strategies for overcoming barriers to exercise (p=0.016) improved significantly. We found no significant changes in results in the questionnaires of participants with type 1 diabetes. Focus group analysis suggested that the study improved awareness of the importance of exercise as well as knowledge about the effects of exercise in type 1 diabetes by both DCPs and participants. Continuous glucose monitor use alleviated fear of hypoglycemia by participants with type 1 diabetes. CONCLUSIONS These findings suggest that a 4-week education- and exercise-focused program improves DCPs' self-efficacy in providing exercise advice to patients. People with type 1 diabetes did not experience an improvement in exercise self-efficacy; however, the study supports the use of continuous glucose monitoring and the grouping of DCPs and individuals with type 1 diabetes to facilitate experiential learning.
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Affiliation(s)
- Rebecca A Dyck
- University of Alberta, Augustana Faculty, Camrose, Alberta, Canada
| | | | | | - Roseanne O Yeung
- Division of Endocrinology and Metabolism, University of Alberta, Edmonton, Alberta, Canada; Alberta Diabetes Institute, Edmonton, Alberta, Canada
| | - Peter Senior
- Division of Endocrinology and Metabolism, University of Alberta, Edmonton, Alberta, Canada; Alberta Diabetes Institute, Edmonton, Alberta, Canada
| | - Jane Elizabeth Yardley
- Division of Endocrinology and Metabolism, University of Alberta, Edmonton, Alberta, Canada; Alberta Diabetes Institute, Edmonton, Alberta, Canada.
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