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Cox ER, Plotnikoff RC, Gibson PG, Keating SE, Acharya S, Lewthwaite H. Prevalence of Long COVID and the Impact on Diabetes Management and Physical Activity Participation in Adults With Type 2 Diabetes: An Australia-wide Cross-sectional Online Survey. Can J Diabetes 2024:S1499-2671(24)00147-3. [PMID: 39159783 DOI: 10.1016/j.jcjd.2024.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 07/29/2024] [Accepted: 08/08/2024] [Indexed: 08/21/2024]
Abstract
OBJECTIVES The aim of this research was to understand the prevalence and impact of long COVID on adults with type 2 diabetes (T2D). Specifically, we sought to identify the proportion of adults with T2D who have had COVID-19 and experienced long COVID symptoms. We also explored how these ongoing symptoms impact diabetes management and physical activity participation. METHODS Our study was carried out using an online survey of adults in Australia with T2D who had confirmed COVID-19 ≥12 weeks before participation. Respondents were asked to report the presence (and severity) of long COVID-19 symptoms, and, for those with long COVID, the impact of their symptoms on diabetes management (blood glucose, body weight) and physical activity participation (activities of daily living, work/study, exercise). RESULTS Survey responses were provided by 1,046 adults with T2D (median age 61.0 [interquartile range 49.8 to 70.0] years; 56.0% men, 42.1% women, and 1% nonbinary/transgender; median T2D duration 10.0 [5.0 to 18.0] years and median time since COVID-19 infection 33.0 [20.3 to 36.1] weeks). Almost one third (30%) of respondents reported long COVID symptoms (present ≥12 weeks after most recent infection); 40% of respondents with long COVID symptoms reported a worsening of their diabetes management since their COVID-19 infection, with 29% reporting trouble controlling their blood glucose and 43% reporting a higher body weight. Two thirds of respondents with ongoing symptoms reported that these symptoms moderately to severely impacted their ability to perform activities of daily living, work, and/or exercise. The majority of those with long COVID reported reducing the frequency, duration, and/or intensity of exercise since their COVID-19 infection, with 36.1% not yet returning to their preinfection exercise levels; 66% cited ongoing symptoms as the primary reason for these limitations. CONCLUSIONS Physical activity is a crucial component of diabetes management. However, the high prevalence of long COVID is hindering participation in this population, as well as deleteriously impacting diabetes management. Developing strategies to support adults with T2D and long COVID to recommence safe levels of physical activity is of critical importance.
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Affiliation(s)
- Emily R Cox
- Centre for Active Living and Learning, University of Newcastle, Callaghan, New South Wales, Australia; Active Living and Learning Research Program, Hunter Medical Research Institute, New Lambton, New South Wales, Australia; School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, New South Wales, Australia.
| | - Ronald C Plotnikoff
- Centre for Active Living and Learning, University of Newcastle, Callaghan, New South Wales, Australia; Active Living and Learning Research Program, Hunter Medical Research Institute, New Lambton, New South Wales, Australia; School of Education, University of Newcastle, Callaghan, New South Wales, Australia
| | - Peter G Gibson
- Treatable Traits Centre for Research Excellence, University of Newcastle, Callaghan, New South Wales, Australia; Asthma and Breathing Research Program, Hunter Medical Research Institute, New Lambton, New South Wales, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; John Hunter Hospital, New Lambton, New South Wales, Australia
| | - Shelley E Keating
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Shamasunder Acharya
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; John Hunter Hospital, New Lambton, New South Wales, Australia
| | - Hayley Lewthwaite
- Treatable Traits Centre for Research Excellence, University of Newcastle, Callaghan, New South Wales, Australia; Asthma and Breathing Research Program, Hunter Medical Research Institute, New Lambton, New South Wales, Australia; School of Nursing and Midwifery, University of Newcastle, Callaghan, New South Wales, Australia
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Dong C, Liu R, Huang Z, Yang Y, Sun S, Li R. Effect of exercise interventions based on family management or self-management on glycaemic control in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Diabetol Metab Syndr 2023; 15:232. [PMID: 37957775 PMCID: PMC10644553 DOI: 10.1186/s13098-023-01209-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 11/02/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Most studies about exercise interventions for patients with type 2 diabetes mellitus (T2DM) have been conducted in hospitals or labs, but it is unclear whether study findings from this specific condition can be generalised to real-life T2DM communities. If patients with T2DM can exercise on their own or with family members, it may also reduce the need for patient supervision by medical staff, thereby reducing the burden of medical treatment and improving condition management's cost-effectiveness and practicability. Much of the current research on exercise interventions for T2DM was focused on the type of exercise and less on the mode of management, so we aimed to examine the effect of exercise interventions based on family management or self-management on glycaemic control in patients with T2DM. METHODS Articles were searched from eight Chinese and English databases. Randomized control trials (RCTs) published in English and Chinese, from inception to October 17, 2022, were included in this review. The methodological quality of the included studies was assessed using the RCT risk of bias assessment tool provided by the Cochrane Collaboration's tool. Meta-analysis was performed using Rev Man 5.4 and Stata 15.0 software. Heterogeneity was investigated using sensitivity analysis and subgroup analyses. Publication bias was tested by funnel plot and Egger's asymmetry tests. RESULTS A total of 10 studies with a total of 913 subjects were finally included in this review. The Meta-analysis showed that exercise interventions based on family management or self-management were more effective than control groups in reducing HbA1c (Z = 3.90; 95% CI MD = - 0.81; - 1.21 to - 0.40; P < 0.0001), fasting glucose (Z = 4.63; 95% CI MD = - 1.17; - 1.67 to - 0.68; P < 0.00001), 2-h plasma glucose (Z = 5.53; 95% CI MD = - 1.84; - 2.50 to - 1.19; P < 0.00001), and Low-density lipoproteins levels (Z = 3.73; 95% CI MD = - 0.38; - 0.58 to - 0.18; P = 0.0002). CONCLUSIONS Exercise interventions based on family management or self-management can significantly reduce glycosylated haemoglobin, fasting glucose, 2-h plasma glucose, and Low-density lipoproteins levels in patients with T2DM, which can effectively delay disease progression and reduce the risk of developing complications. In the future, for exercise interventions based on family or self-management, this review recommended that exercise intervention programmes should be formulated according to 30-60 min per session, more than three times per week, for more than six months of aerobic exercise or aerobic combined with resistance exercise.
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Affiliation(s)
- Chenyang Dong
- School of Sport Science, Beijing Sport University, 48 Xinxi Road, Haidian District, Beijing, China
| | - Ruoya Liu
- School of Sport Science, Beijing Sport University, 48 Xinxi Road, Haidian District, Beijing, China
| | - Zhiyang Huang
- School of Sport Science, Beijing Sport University, 48 Xinxi Road, Haidian District, Beijing, China
| | - Yang Yang
- School of Sport Science, Beijing Sport University, 48 Xinxi Road, Haidian District, Beijing, China
| | - Shiyuan Sun
- School of Sport Science, Beijing Sport University, 48 Xinxi Road, Haidian District, Beijing, China
| | - Ran Li
- School of Sport Science, Beijing Sport University, 48 Xinxi Road, Haidian District, Beijing, China.
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Leonel LDS, Brum GD, Alberton CL, Delevatti RS. Aquatic training improves HbA1c, blood pressure and functional outcomes of patients with type 2 diabetes: A systematic review with meta-analysis. Diabetes Res Clin Pract 2023; 197:110575. [PMID: 36780954 DOI: 10.1016/j.diabres.2023.110575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 01/31/2023] [Accepted: 02/08/2023] [Indexed: 02/13/2023]
Abstract
AIM This study aimed to summarize the effects of aquatic training on the health outcomes of type 2 diabetes (T2D) patients. METHODS This is a systematic review with meta-analysis that followed the PRISMA recommendations. Searches were performed in four databases in April 2021. The following eligibility criteria were adopted: adults with T2D; aquatic training (AT) intervention in an upright position; pre- and post-intervention assessments of the following outcomes: HbA1c, SBP and DBP, functional capacity, VO2peak. The random-effects meta-analysis results are presented as mean differences and 95% confidence intervals. RESULTS Of the 375 studies, 12 studies were eligible and included in the meta-analysis. Favorable effects of AT post-intervention were observed in HbA1c (-0.62 %), VO2peak (2.16 mL.Kg-1.min-1), SBP (-5.55 mmHg), DBP (-4.99 mmHg), and the 6-minute walk test (76.64 m). AT also revealed superior effects when compared to the control group (CG) and similar effects to land training (LT) in HbA1c (AT vs CG = -0.67 % and AT vs LT = -0.40 %), VO2peak (AT vs CG = 3.78 mL.Kg-1.min-1; AT vs LT = -0.12 mL/Kg-1.min-1), SBP (AT vs LT = -0.85 mmHg), and DBP (AT vs LT = 2.12 mmHg). CONCLUSION AT improves HbA1c, VO2peak, SBP, DBP, and functional capacity in T2D patients. Beneficial effects favored AT over CG, while similar effects were verified between AT and LT on HbA1c, VO2peak, and blood pressure.
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Affiliation(s)
- Larissa Dos Santos Leonel
- Federal University of Santa Catarina, Department of Physical Education, Florianopolis, Santa Catarina, Brazil.
| | - Guilherme de Brum
- Federal University of Santa Catarina, Department of Physical Education, Florianopolis, Santa Catarina, Brazil.
| | | | - Rodrigo Sudatti Delevatti
- Federal University of Santa Catarina, Department of Physical Education, Florianopolis, Santa Catarina, Brazil.
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Supervised Exercise in Water: Is It a Viable Alternative in Overweight/Obese People with or without Type 2 Diabetes? A Pilot Study. Nutrients 2022; 14:nu14234963. [PMID: 36500993 PMCID: PMC9737856 DOI: 10.3390/nu14234963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 11/20/2022] [Indexed: 11/24/2022] Open
Abstract
The study of the effects of a water-based exercise program in overweight/obese people with or without type 2 diabetes is a topic of relatively recent interest. This type of exercise presents some advantages in reducing the risk of injury or trauma, and it can be a valuable therapeutic card to play for sedentary or physically inactive patients who have chronic metabolic diseases. This work aims to make a contribution showing the effects of a water-based exercise intervention, supervised by graduates in sports sciences, in a group of overweight/obese people with or without type 2 diabetes. In total, 93 adults (age 60.59 ± 10.44 years), including 72 women (age 60.19 ± 10.97 years) and 21 men (age 61.95 ± 8.48 years), were recruited to follow a water-based exercise program (2 sessions/week, for 12 weeks) at the C.U.R.I.A.Mo. Healthy Lifestyle Institute of Perugia University. Results showed an improvement in body mass index (−0.90 ± 1.56, p = 0.001), waist circumference (−4.32 ± 6.03, p < 0.001), and systolic (−7.78 ± 13.37, p = 0.001) and diastolic (−6.30 ± 10.91, p = 0.001) blood pressure. The supervised water-based intervention was useful in managing patients with metabolic diseases who often present with other health impairments, such as musculoskeletal problems or cardiovascular or rheumatic disease that could contraindicate gym-based exercise.
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de Barcelos GT, Heberle I, Coneglian JC, Vieira BA, Delevatti RS, Gerage AM. Effects of Aerobic Training Progression on Blood Pressure in Individuals With Hypertension: A Systematic Review With Meta-Analysis and Meta-Regression. Front Sports Act Living 2022; 4:719063. [PMID: 35252853 PMCID: PMC8891157 DOI: 10.3389/fspor.2022.719063] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Aerobic training of moderate intensity is the primary modality recommended in the management of hypertension. The manipulation of training variables can be an important strategy for the continuity of health benefits; however, little is known about the effects of the progression of aerobic training variables in the adaptations of blood pressure in hypertensive adults. OBJECTIVE To analyze, through a systematic review with meta-analysis, the effects of aerobic training with and without progression on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in hypertensive adults. METHOD The search for the studies was carried out in the PubMed, Cochrane Central, SPORTDiscus and LILACS databases. Clinical trials that analyzed the effect of aerobic training, lasting at least six weeks, on blood pressure in hypertensive individuals comparing with a control group without intervention were selected. The selection of studies and data extraction were carried out independently by two pairs of researchers. The results are presented as mean difference and 95% confidence interval. Statistical significance was considered with p < 0.05. RESULTS Of the 13,028 studies found, 24 were selected and included in this review, 12 with progression of training variables and 12 without progression, with a total of 1,207 participants analyzed. There was a reduction in SBP after aerobic training with progression (-10.67 mmHg; 95% CI -15.421, -5.926; p < 0.001) and without progression (-10.17 mmHg; CI -12.213, -8.120; p < 0.001). DBP also decreased after aerobic training with progression (-5.49 mmHg; 95% CI -8.663, -2.310; p < 0.001) and without progression (-6.51 mmHg; 95% CI -9.147, -3.868; p < 0.001). According to the results of the meta-regression analyses, only age showed an association with the reduction of SBP (β: -0.323; CI -0.339, -0.307; p < 0.001). CONCLUSION Aerobic training promotes a reduction in the SBP and DBP levels of adults with hypertension, regardless of whether or not the training variables progression.
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Affiliation(s)
- Guilherme Tadeu de Barcelos
- Department of Physical Education, Sports Center, Federal University of Santa Catarina, Florianópolis, Brazil
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Terakawa A, Bouchi R, Kodani N, Hisatake T, Sugiyama T, Matsumoto M, Ihana-Sugiyama N, Ohsugi M, Ueki K, Kajio H. Living and working environments are important determinants of glycemic control in patients with diabetes during the COVID-19 pandemic: a retrospective observational study. J Diabetes Investig 2022; 13:1094-1104. [PMID: 35088564 PMCID: PMC9153838 DOI: 10.1111/jdi.13758] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/09/2022] [Accepted: 01/24/2022] [Indexed: 11/26/2022] Open
Abstract
AIM To investigate 1) the association of lifestyle changes and living and working conditions with glycemic control and 2) whether treatment was intensified appropriately in diabetes patients under the first COVID-19 state of emergency in Japan. MATERIALS AND METHODS A total of 321 participants were included. Participants completed a questionnaire regarding lifestyle changes, including diet, physical activity, and living and working conditions during the COVID-19 pandemic. We estimated the change in hemoglobin A1c (HbA1c) levels between before (from June 1, 2019, to August 31, 2019) and during (from June 1, 2020, to August 31, 2020) the pandemic. Factors associated with changes in HbA1c levels were examined by multiple linear regression analysis. Proportion of patients who received treatment intensification for diabetes was compared between before and during the pandemic. RESULTS There was no significant change in HbA1c levels between before and during the pandemic (7.13 ± 0.98% versus 7.18 ± 1.01%, P=0.186). Teleworking (estimate 0.206, P=0.004) and living with a dog (estimate -0.149, P=0.038) were significantly associated with changes in HbA1c levels after adjusting for covariates. There was no significant difference in the proportion of patients who received treatment intensification for diabetes between during the pandemic and before the pandemic in either the elderly or non-elderly patients. CONCLUSIONS Overall glycemic control did not worsen during the pandemic. Nonetheless, environmental factors, including telework, were found to influence glycemic control in diabetes patients. Further studies are needed to clarify whether the COVID-19 pandemic could affect treatment intensification for diabetes.
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Affiliation(s)
- Aiko Terakawa
- Department of Diabetes, Endocrinology and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ryotaro Bouchi
- Department of Diabetes, Endocrinology and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan.,Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Noriko Kodani
- Department of Diabetes, Endocrinology and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tomoko Hisatake
- Department of Diabetes, Endocrinology and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan.,Medical corporation Rikkuikai Tokyo, Japan
| | - Takehiro Sugiyama
- Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan.,Department of Public Health/Health Policy, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Michihiro Matsumoto
- Department of Molecular Metabolic Regulation, Diabetes Research Center, Research Institute national Center for Global Health and Medicine, Tokyo, Japan
| | - Noriko Ihana-Sugiyama
- Department of Diabetes, Endocrinology and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan.,Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mitsuru Ohsugi
- Department of Diabetes, Endocrinology and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan.,Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kohjiro Ueki
- Department of Diabetes, Endocrinology and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan.,Diabetes Research Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroshi Kajio
- Department of Diabetes, Endocrinology and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan
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