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Hamid YH, Mohammed M, Hamid S, Mohamedahmed W, Ahmed O. Impact of Diabetic Foot Ulcer on the Health-Related Quality of Life of Diabetic Patients in Khartoum State. Cureus 2024; 16:e52813. [PMID: 38389641 PMCID: PMC10883763 DOI: 10.7759/cureus.52813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
Background This is a novel study from Sudan aimed at comparing health-related quality of life (HRQoL) between diabetic foot ulcer (DFU) patients and diabetes patients without DFU. Additionally, this study aimed to determine the factors correlating with lower HRQoL. Methodology A descriptive, cross-sectional study with a comparative group was conducted in three diabetes centers in Khartoum, Sudan, in 2020. A total of 120 Sudanese diabetic patients (mean age = 52 years) were divided into two groups, without DFU and with DFU, and interviewed in person. Demographic and clinical variables were recorded. HRQoL was evaluated using the standardized RAND-36 (36-Item Short Form Health Survey) survey for all participants. HRQoL domains and total scores were compared in the two groups using the t-test. Inference against sociodemographic data was determined using Pearson's test and analysis of variance. Results The DFU group (36 males, 24 females) scored significantly lower in five (yet higher in two out of the eight subscales) compared to the non-DFU diabetic group (31 males, 29 females). Energy/fatigue levels remained insignificant. Being a female (p = 0.03), painful ulcers (p = 0.001), insulin use (p = 0.04), and newly developed ulcers (p = 0.005) were associated with lower HRQoL total scores in the DFU group. However, educational levels had a positive correlation (p = 0.02). Conclusions DFU patients have lower HRQoL than diabetic patients without ulcers. They need more support, including disease-specific education, realistic expectations (regarding ulcer's impact, healing, and management), physical rehabilitation, and culturally sensitive assessment tools.
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Affiliation(s)
- Yusra H Hamid
- Community Medicine, Faculty of Medicine, University of Khartoum, Khartoum, SDN
| | - Mathani Mohammed
- General Surgery, Sudan Medical Specialization Board, Khartoum, SDN
| | - Safaa Hamid
- General Surgery, Sudan Medical Specialization Board, Khartoum, SDN
| | | | - Osama Ahmed
- Community Medicine and Public Health, National University, Khartoum, SDN
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Pepera G, Karanasiou E, Blioumpa C, Antoniou V, Kalatzis K, Lanaras L, Batalik L. Tele-Assessment of Functional Capacity through the Six-Minute Walk Test in Patients with Diabetes Mellitus Type 2: Validity and Reliability of Repeated Measurements. SENSORS (BASEL, SWITZERLAND) 2023; 23:1354. [PMID: 36772396 PMCID: PMC9920804 DOI: 10.3390/s23031354] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/05/2023] [Accepted: 01/21/2023] [Indexed: 06/18/2023]
Abstract
A tele-assessed 6MWT (TL 6MWT) could be an alternative method of evaluating functional capacity in patients with diabetes mellitus type 2 (DM2). This study aimed to assess the validity and reliability of a TL 6MWT. The functional capacity of 28 patients with DM2 (75% men) aged 61 ± 13 years was evaluated twice via an indoor, center-based 6MWT (CB 6MWT) and twice outside each patient's home via a web-based platform TL 6MWT. The study showed a high statistically significant correlation between the CB and TL 6MWT (Pearson's r = 0.76, p < 0.001). Reliability testing showed no statistically significant differences in the distance covered (CB1: 492 ± 84 m and CB2: 506 ± 86 m versus TL1: 534 ± 87 m and TL2: 542 ± 93 m, respectively) and in the best distance of the TL 6MWT (545 ± 93 m) compared to the best CB distance (521 ± 83 m). Strong internal reliability for both the CB (intraclass correlation coefficient (ICC) = 0.93) and the TL 6MWT (ICC = 0.98) was found. The results indicate that a TL 6MWT performed outdoors can be a highly valid and reliable tool to assess functional capacity in patients with DM2. No learning effect between the TL and CB assessment was found, minimizing the need for repetition.
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Affiliation(s)
- Garyfallia Pepera
- Clinical Exercise Physiology and Rehabilitation Laboratory, Department of Physiotherapy, Faculty of Health Sciences, University of Thessaly, GR-35100 Lamia, Greece
| | - Evmorfia Karanasiou
- Clinical Exercise Physiology and Rehabilitation Laboratory, Department of Physiotherapy, Faculty of Health Sciences, University of Thessaly, GR-35100 Lamia, Greece
| | - Christina Blioumpa
- Clinical Exercise Physiology and Rehabilitation Laboratory, Department of Physiotherapy, Faculty of Health Sciences, University of Thessaly, GR-35100 Lamia, Greece
| | - Varsamo Antoniou
- Clinical Exercise Physiology and Rehabilitation Laboratory, Department of Physiotherapy, Faculty of Health Sciences, University of Thessaly, GR-35100 Lamia, Greece
| | | | - Leonidas Lanaras
- Department of Internal Medicine, General Hospital of Lamia, GR-35100 Lamia, Greece
| | - Ladislav Batalik
- Department of Rehabilitation, University Hospital Brno, 62500 Brno, Czech Republic
- Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic
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Seixas MB, Ghisi GLDM, Oh P, Pereira DS, Moreira APB, Jansen AK, Batalha APDB, Cândido GDN, de Almeida JA, Pereira DAG, da Silva LP. Feasibility of Remote Delivering an Exercise and Lifestyle Education Program for Individuals Living with Prediabetes and Diabetes in Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16697. [PMID: 36554577 PMCID: PMC9779705 DOI: 10.3390/ijerph192416697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/05/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
This study aimed to test the feasibility of remote delivering a 12-week exercise and lifestyle education program (ExLE) or a 12-week exercise program (Ex) for individuals with prediabetes and diabetes in terms of acceptability, implementation, practicality, and limited efficacy. The programs were internet- or telephone-based delivered, depending on the participants' internet access and technology literacy. Of the 196 individuals screened, 15 were included in the study (internet-based delivery (n = 13); telephone-based delivery (n = 2)). Twelve participants completed the program they were randomized to, and most reported being satisfied with the study interventions (acceptability). Data collection procedures, weekly follow-up, study website visits, and educational materials were proper (implementation), and the adherence rate to study interventions ranged from 24% to 58% (practicality). Additionally, both programs (ExLE and Ex) seemed to promote beneficial changes in functional capacity (limited efficacy). The internet-based remote delivery of the interventions showed feasibility. Therefore, in future trials, exercise and educational interventions can be internet-based remote delivered to individuals with prediabetes and diabetes with internet access and technology literacy. In addition, some adjustments to eligibility criteria, study websites, more accessible ways of recording exercise sessions and using educational materials, and an initial supervised exercise session are recommended.
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Affiliation(s)
- Mariana Balbi Seixas
- Cardiovascular Research Unit and Exercise Physiology, University Hospital, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento S/N, Juiz de Fora 36038-330, MG, Brazil
- Graduate Program in Physical Education, Faculty of Physical Education and Sports, Federal University of Juiz de Fora, Rua José Lourenço Kelmer S/N, Juiz de Fora 36036-900, MG, Brazil
| | - Gabriela Lima de Melo Ghisi
- Cardiovascular Rehabilitation and Prevention Program, Toronto Rehabilitation Institute, University Health Network, 347 Rumsey Road, Toronto, ON M4G 1R7, Canada
| | - Paul Oh
- Cardiovascular Rehabilitation and Prevention Program, Toronto Rehabilitation Institute, University Health Network, 347 Rumsey Road, Toronto, ON M4G 1R7, Canada
| | - Daniele Sirineu Pereira
- Department of Physical Therapy, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte 31270-901, MG, Brazil
- Graduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte 31270-901, MG, Brazil
| | | | - Ann Kristine Jansen
- Department of Nutrition, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte 31270-901, MG, Brazil
| | - Ana Paula Delgado Bomtempo Batalha
- Cardiovascular Research Unit and Exercise Physiology, University Hospital, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento S/N, Juiz de Fora 36038-330, MG, Brazil
- Graduate Program in Physical Education, Faculty of Physical Education and Sports, Federal University of Juiz de Fora, Rua José Lourenço Kelmer S/N, Juiz de Fora 36036-900, MG, Brazil
| | - Gabriela do Nascimento Cândido
- Graduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte 31270-901, MG, Brazil
| | - Josiane Aparecida de Almeida
- Cardiovascular Research Unit and Exercise Physiology, University Hospital, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento S/N, Juiz de Fora 36038-330, MG, Brazil
- Graduate Program in Rehabilitation Sciences and Physical-Functional Performance, Faculty of Physical Therapy, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento S/N, Juiz de Fora 36038-330, MG, Brazil
| | - Danielle Aparecida Gomes Pereira
- Department of Physical Therapy, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte 31270-901, MG, Brazil
- Graduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte 31270-901, MG, Brazil
| | - Lilian Pinto da Silva
- Cardiovascular Research Unit and Exercise Physiology, University Hospital, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento S/N, Juiz de Fora 36038-330, MG, Brazil
- Graduate Program in Physical Education, Faculty of Physical Education and Sports, Federal University of Juiz de Fora, Rua José Lourenço Kelmer S/N, Juiz de Fora 36036-900, MG, Brazil
- Graduate Program in Rehabilitation Sciences and Physical-Functional Performance, Faculty of Physical Therapy, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento S/N, Juiz de Fora 36038-330, MG, Brazil
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Zhang J, Liu M, Hu B, Wang L. Exercise Combined with a Chinese Medicine Herbal Tea for Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:878-886. [PMID: 36037014 DOI: 10.1089/jicm.2022.0580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objectives: Exercise and Traditional Chinese Medicine (TCM) herbal tea may improve glucose metabolism through quite different mechanisms while sharing some common effects. The purpose of this study was to discover whether the intervention of exercise combined with TCM herbal tea intervention could produce advanced improvement in glucose metabolism than exercise alone in community patients with type 2 diabetes mellitus (T2DM). Materials and Methods: This was a 12-week, randomized controlled trial in which 75 community patients with T2DM were randomly assigned to the single group (n = 39) receiving intervention of aerobic and resistance exercise three times per week and the combined group (n = 36) receiving intervention of TCM herbal tea (consisted of six substances) taken once daily besides the exercise. The change of glycated hemoglobin A1 (HbA1c), tested before and after intervention, served as the primary outcome. Other measurements include fasting plasma glucose (FPG), glycated serum protein (GSP), lipid profile, and physical fitness profile. Results: HbA1c and FPG levels and their changes showed no group difference. The level of GSP was lower, and its decrease was also larger after exercise combined with TCM herbal tea than after single exercise intervention (p < 0.05). Lipid profile and physical fitness parameters were similar in the two groups except the larger six-minute walk test (6MWT) power after the combined intervention (p < 0.05). Patients showed good compliance with the intervention and had similar exercise days or amount in the two groups. No patient reported serious adverse events or significant changes in other lifestyles. Conclusions: A 12-week of exercise combined with TCM herbal tea could not enhance the hypoglycemic effects by exercise alone in community patients with type 2 diabetes. However, the lower GSP level and larger 6MWT work brought by combined intervention suggest its potential benefits, and further studies are needed to explore the effects of longer period and larger dosage of intervention. Clinical Trial Registration Number: Chinese Clinical Trial Registry: ChiCTR1800018721.
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Affiliation(s)
- Jiajia Zhang
- School of Nursing, Medical College, Soochow University, Suzhou, China
| | - Minjing Liu
- School of Nursing, Medical College, Soochow University, Suzhou, China
| | - Biyue Hu
- School of Nursing, Medical College, Soochow University, Suzhou, China
| | - Li Wang
- School of Nursing, Medical College, Soochow University, Suzhou, China
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Li J, Cheng W, Ma H. A Comparative Study of Health Efficacy Indicators in Subjects with T2DM Applying Power Cycling to 12 Weeks of Low-Volume High-Intensity Interval Training and Moderate-Intensity Continuous Training. J Diabetes Res 2022; 2022:9273830. [PMID: 35071605 PMCID: PMC8776485 DOI: 10.1155/2022/9273830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 12/22/2021] [Indexed: 11/17/2022] Open
Abstract
This study is aimed at comparing the effects of different exercise intensities, namely, high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT), on body composition, heart and lung fitness, and blood glucose, and blood pressure indices in patients with type 2 diabetes mellitus (T2DM), using power cycling. A total of 96 T2DM volunteers who met the inclusion criteria were recruited from a hospital in Yangpu, Shanghai. Based on the blood index data of their medical examination results which comprised blood pressure, fasting blood glucose, hemoglobin A1c (HbA1c), and insulin, 37 volunteers were included in the study. Exercise prescription was determined based on T2DM exercise guidelines combined with medical diagnosis and exercise test results, and the patients were randomly assigned to three groups: HIIT group, MICT group, and control (CON) group. HIIT involved one-minute power cycling (80%-95% maximal oxygen uptake (VO2max)), one-minute passive or active rest (25%-30% VO2max), and two-minute rounds of eight groups. MICT required the use of a power bike for 30 minutes of continuous training (50%-70% VO2max) five times a week. The CON group was introduced to relevant medicine, exercise, and nutrition knowledge. The exercise interventions were completed under the supervision of an exercise instructor and hospital doctors. The same indicators were measured after 12 weeks of intervention, and the results of the two tests within and between groups were analyzed for comparison. The weight index of the MICT intervention showed statistically significant within-group differences (difference = 3.52, 95% CI = 2.11-4.92, p = 0.001 < 0.01); group differences for the MICT and CON groups were also statistically significant (difference = 3.52 ± 2.09, Cd1 = -0.39 ± 1.25, p = 0.004 < 0.01). Body mass index (BMI) analysis revealed that the overall means of BMI indicators were not statistically different between groups (F = 0.369, p = 0.694 > 0.05) and the before and after values of the MICT and CON (difference = -1.30 ± 0.79, Cd1 = -0.18 ± 0.45, p = 0.001 < 0.01). No statistically significant difference was observed in the overall mean VO2max index between the groups after the 12-week intervention (F = 2.51, p = 0.100 > 0.05). A statistically significant difference was found in the overall means of the data between the two groups (difference = 0.32, 95% CI = 0.23-0.40, p = 0.001 < 0.01). Analysis of fasting blood glucose (FBG) indicators revealed statistically significant differences between the MICT and control groups (p = 0.028 < 0.05). Analysis of HbA1c and fasting insulin (FI) indicators revealed no statistically significant difference in the overall HbA1c index after the 12-week exercise intervention (F = 0.523, p = 0.598 > 0.05), and the overall difference before and after the experiment between the groups was statistically significant (F = 6.13, p = 0.006 < 0.01). No statistically significant difference was found in the FI index overall after the 12-week exercise intervention (F = 2.50, p = 0.1 > 0.05). Analysis of systolic blood pressure (SBP) revealed statistically significant difference before and after the HIIT and CON interventions (Hd7 = -1.10 ± 1.79, Cd7 = 1.2 ± 1.31, p = 0.018 < 0.05) and statistically significant difference before and after the MICT and CON interventions (Md7 = -0.99 ± 0.91, Cd7 = 1.40 ± 1.78, p = 0.02 < 0.05). The diastolic blood pressure (DBP) revealed no statistically significant within-group differences before and after. Exercise interventions applying both low-volume HIIT and MICT, with both intensity exercises designed for power cycling, improved health-related indicators in the participants; low-volume HIIT had more time advantage. The current experiment compared HIIT with MICT in a safe manner: 50% of the exercise time produced similar benefits and advantages in the two indicators of VO2max and FI. However, MICT was superior to HIIT in the two indicators of body weight (weight) and BMI. The effect of power cycling on FI has the advantages of both aerobic and resistance exercise, which may optimize the type, intensity, and time of exercise prescription according to the individual or the type of exercise program. Our results provide a reference for the personalization of exercise prescription for patients with T2DM.
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Affiliation(s)
- Jun Li
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China
| | - Wei Cheng
- Department of Endocrinology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090, China
| | - Haifeng Ma
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China
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Enang O, Omoronyia O, Asibong U, Ayuk A, Nwafor K, Legogie A. A case-control study of pattern and determinants of quality of life of patients with diabetes in a developing country. J Egypt Public Health Assoc 2021; 96:2. [PMID: 33507391 PMCID: PMC7843869 DOI: 10.1186/s42506-020-00061-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 11/04/2020] [Indexed: 01/15/2023]
Abstract
Background Globally, diabetes is a leading cause of impairment of quality of life. In the sub-Saharan African region, there is a need for studies that provide more valid assessment of effect of diabetes on quality of life (QoL). This study aimed at assessing quality of life among patients with diabetes attending a tertiary health service in Nigeria. Methods The study design was a case-control. Diabetic cases were randomly recruited from the University of Calabar Teaching Hospital, while non-diabetic controls were civil servants and retirees. The validated and pretested WHOQoL-BREF instrument was used to assess quality of life, with higher scores indicating higher quality of life. Results Three hundred and thirty subjects were studied, with mean ages of males and females of 55.2 ± 4.8 and 51.8 ± 6.3 years, respectively. The mean total QoL score was 75.77 ± 11.2, with no significant difference between males and females. Among male and female cases, the mean score of the physical health domain was significantly lower for cases compared with controls (p = 0.05). Male cases compared with controls had higher scores for the environment domain (p < 0.05). Older age and higher systemic blood pressure were associated with lower QoL scores for both sexes (p < 0.05). Unmarried status, obesity, and poor glycemic control (HbA1c > 7%) were associated with lower QoL scores (p < 0.05). Fasting blood sugar (FBS) level and lipid profile were not significantly correlated with QoL score in both sexes (p > 0.05). Conclusion Diabetes contributes to low quality of life among males and females, with significant differences in the affected domains. Diabetes care providers should identify affected domains during clinic consultation, in order to improve provision of more effective care.
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Affiliation(s)
- Ofem Enang
- Department of Internal Medicine, University of Calabar, Calabar, Nigeria
| | - Ogban Omoronyia
- Department of Community Medicine, University of Calabar, Calabar, Nigeria.
| | - Udeme Asibong
- Department of Family Medicine, University of Calabar, Calabar, Nigeria
| | - Agam Ayuk
- Department of Family Medicine, University of Calabar, Calabar, Nigeria
| | - Kenneth Nwafor
- Department of Family Medicine, University of Calabar, Calabar, Nigeria
| | - Annette Legogie
- Department of Family Medicine, University of Calabar, Calabar, Nigeria
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Jackson IL, Onung SI, Oiwoh EP. Self-care activities, glycaemic control and health-related quality of life of patients with type 2 diabetes in a tertiary hospital in Nigeria. Diabetes Metab Syndr 2021; 15:137-143. [PMID: 33340873 DOI: 10.1016/j.dsx.2020.12.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 12/08/2020] [Accepted: 12/13/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Diabetes is one of the global health emergencies of the 21st century. This study sought to assess self-care behaviours, glycaemic control and health-related quality of life (HRQoL) of type 2 diabetes patients at a Nigerian hospital, determine factors associated with HRQoL, and assess the inter-relationship among these outcomes. METHODS The Summary of Diabetes Self-Care Activities (SDSCA) measure was used to assess self-care behaviours; HRQoL was assessed with the Appraisal of Diabetes Scale (ADS) and SF-12v2 Health Survey. Glycaemic control was assessed with fasting blood sugar (FBS). The questionnaires were distributed to 250 eligible patients attending Endocrinology clinic at the University of Uyo Teaching Hospital, Akwa Ibom State, Nigeria. RESULTS Mean scores (±SD) of self-care behaviours were 4.0 ± 1.3, 3.9 ± 1.0, 2.4 ± 1.2, 1.0 ± 1.1, and 2.5 ± 2.1 for general diet, specific diet, exercise, blood glucose monitoring, and foot care respectively. Mean FBS was 7.1 ± 2.1 mmol/L. Mean ADS score was 18.1 ± 4.2. The physical and mental component summary scores were 47.84 ± 8.21 and 45.66 ± 8.74 respectively. HRQoL was significantly associated with patient socio-demographic (except gender) and clinical variables (p < 0.05). Self-care activities, FBS and HRQoL were significantly inter-correlated (rs -0.31 to 0.68; p < 0.01, p < 0.001). CONCLUSIONS Patients were more adherent to diet recommendations than to other aspects of self-care. Though most patients had adequate glucose control, the presence of diabetes had a negative impact on the mental component of health. HRQoL was affected by most of the patient-related variables. Interventions to improve adherence to self-care are recommended to achieve good glycaemic control and improve HRQoL.
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Affiliation(s)
- Idongesit L Jackson
- Department of Clinical Pharmacy and Biopharmacy, University of Uyo, P.M.B, 1017, Uyo, Akwa Ibom State, Nigeria.
| | - Samuel I Onung
- Department of Internal Medicine, Endocrine and Metabolism Unit, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria
| | - Emmanuel P Oiwoh
- Department of Clinical Pharmacy and Biopharmacy, University of Uyo, Uyo, Akwa Ibom State, Nigeria
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8
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Inspiratory Muscle Training on Glucose Control in Diabetes: A Randomized Clinical Trial. Int J Sport Nutr Exerc Metab 2020; 31:21-31. [PMID: 33248438 DOI: 10.1123/ijsnem.2020-0175] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 08/27/2020] [Accepted: 09/03/2020] [Indexed: 11/18/2022]
Abstract
This study evaluated the effects of inspiratory muscle training (IMT) in glucose control and respiratory muscle function in patients with diabetes. It was a randomized clinical trial conducted at the Physiopathology Laboratory of the Hospital de Clínicas de Porto Alegre. Patients with Type 2 diabetes were randomly assigned to IMT or placebo-IMT (P-IMT), performed at 30% and 2% of maximal inspiratory pressure, respectively, every day for 12 weeks. The main outcome measures were HbA1c, glycemia, and respiratory muscle function. Thirty patients were included: 73.3% women, 59.6 ± 10.7 years old, HbA1c 8.7 ± 0.9% (71.6 ± 9.8 mmol/mol), and glycemia 181.8 ± 57.8 mg/dl (10.5 ± 3.2 mmol/L). At the end of the training, HbA1c was 8.2 ±0.3% (66.1 ± 3.3 mmol/mol) and 8.7 ± 0.3% (71.6 ± 3.3 mmol/mol) for the IMT and P-IMT groups, respectively (p = .8). Fasting glycemia decreased in both groups with no difference after training although it was lower in IMT at 8 weeks: 170.0 ± 11.4 mg/dl(9.4 ± 0.6 mmol/L) and 184.4 ± 15.0 mg/dl (10.2 ± 0.8 mmol/L) for IMT and P-IMT, respectively (p < .05). Respiratory endurance time improved in the IMT group (baseline = 325.9 ± 51.1 s and 305.0 ± 37.8 s; after 12 weeks = 441.1 ± 61.7 s and 250.7 ± 39.0 s for the IMT and P-IMT groups, respectively; p < .05). Considering that glucose control did not improve, IMT should not be used as an alternative to other types of exercise in diabetes. Higher exercise intensities or longer training periods might produce better results. The clinical trials identifier is NCT03191435.
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Bozdemir-Ozel C, Arikan H, Calik-Kutukcu E, Karadüz BN, Inal-Ince D, Kabakci G, Sumer E, Dagdelen S. Subclinical Inflammation Is Associated With Reductions in Muscle Oxygenation, Exercise Capacity and Quality of Life in Adults With Type 2 Diabetes. Can J Diabetes 2020; 44:422-427. [PMID: 32616275 DOI: 10.1016/j.jcjd.2020.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 02/13/2020] [Accepted: 02/28/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Exercise capacity is related to both morbidity and mortality in patients with type 2 diabetes (T2DM). The aim of this study was to investigate the relationship between subclinical inflammation level, exercise capacity, muscle oxygenation and quality of life in T2DM. METHODS This study includes 28 patients with T2DM (mean age, 51.5±5.0 years; male-to-female ratio, 6:22). Exercise capacity was evaluated using an incremental symptom-limited maximal exercise test on a bicycle ergometer. Muscle oxygenation was investigated using a wearable lactate-measuring device. Diabetes-specific quality of life was assessed using the Diabetes Quality of Life Questionnaire (DQOL). Subclinical inflammation was assessed using C-reactive protein (CRP) levels. RESULTS CRP level was negatively correlated with peak workload during the test (r=-0.588, p=0.002), muscle oxygenation (r=-0.465, p=0.019) and the psychological impact of treatment subscale of the DQOL (r=-0.540, p=0.017), and positively correlated with body mass index (r=0.519, p=0.008), waist circumference (r=0.426, p=0.038) and fat percentage (r=0.573, p=0.004). There was no correlation between CRP and fasting blood glucose or glycated hemoglobin level (p>0.05). Peak workload was inversely related to fat percentage (r=-0.467, p=0.016) and the DQOL worry about the future impact of diabetes subscale (r=-0.501, p=0.021). CONCLUSIONS In our study, subclinical inflammation negatively affected muscle oxygenation, exercise capacity and quality of life independently of glycemic indicators. Our findings suggest that the degree of glycemic control is insufficient to explain lower exercise capacity. Further studies are needed to investigate subclinical inflammation-reducing interventions in T2DM.
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Affiliation(s)
- Cemile Bozdemir-Ozel
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Hülya Arikan
- Faculty of Health Sciences, Department of Physiotherapy, Atılım University, Ankara, Turkey
| | - Ebru Calik-Kutukcu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Beyza Nur Karadüz
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Deniz Inal-Ince
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Giray Kabakci
- Department of Cardiology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Erkan Sumer
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Selçuk Dagdelen
- Department of Endocrinology and Metabolism, School of Medicine, Hacettepe University, Ankara, Turkey
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Strollo F, Gentile S, Assaloni R, De Fazio C, Corigliano G. Exercise related care pathways for people with diabetes: Literature review and expert consensus. Diabetes Metab Syndr 2019; 13:2755-2762. [PMID: 31405704 DOI: 10.1016/j.dsx.2019.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 07/10/2019] [Indexed: 11/25/2022]
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Hwang CL, Lim J, Yoo JK, Kim HK, Hwang MH, Handberg EM, Petersen JW, Holmer BJ, Leey Casella JA, Cusi K, Christou DD. Effect of all-extremity high-intensity interval training vs. moderate-intensity continuous training on aerobic fitness in middle-aged and older adults with type 2 diabetes: A randomized controlled trial. Exp Gerontol 2018; 116:46-53. [PMID: 30576716 DOI: 10.1016/j.exger.2018.12.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 12/13/2018] [Accepted: 12/14/2018] [Indexed: 01/16/2023]
Abstract
Aging and diabetes are associated with decreased aerobic fitness, an independent predictor of mortality. Aerobic exercise is prescribed to improve aerobic fitness; however, middle-aged/older diabetic patients often suffer from mobility limitations which restrict walking. Non-weight-bearing/low-impact exercise is recommended but the optimal exercise prescription is uncertain. The goal of this randomized controlled trial was twofold: 1) to test if high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT), implemented on a non-weight-bearing all-extremity ergometer, are feasible, well-tolerated and safe in middle-aged/older adults with type 2 diabetes; and 2) to test whether all-extremity HIIT is more effective in improving aerobic fitness than MICT. A total of 58 sedentary individuals with type 2 diabetes (46 to 78 years; 63 ± 1) were randomized to all-extremity HIIT (n = 23), MICT (n = 19) or non-exercise control (CONT; n = 16). All-extremity HIIT and MICT, performed 4×/week for 8 weeks under supervision, resulted in no adverse events requiring hospitalization or medical treatment. Aerobic fitness (VO2peak) improved by 10% in HIIT and 8% in MICT and maximal exercise tolerance increased by 1.8 and 1.3 min, respectively (P ≤ 0.002 vs. baseline; P ≥ 0.9 for HIIT vs. MICT). In conclusion, all-extremity HIIT and MICT are feasible, well-tolerated and safe and result in similar improvements in aerobic fitness in middle-aged/older individuals with type 2 diabetes. These findings have important implications for exercise prescription for diabetic patients; they indicate that all-extremity exercise is a feasible alternative to weight-bearing exercise and those who are unable or unwilling to engage in HIIT may receive similar benefits from MICT.
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Affiliation(s)
- Chueh-Lung Hwang
- Department of Applied Physiology & Kinesiology, University of Florida, Gainesville, FL, United States of America
| | - Jisok Lim
- Department of Applied Physiology & Kinesiology, University of Florida, Gainesville, FL, United States of America
| | - Jeung-Ki Yoo
- Department of Applied Physiology & Kinesiology, University of Florida, Gainesville, FL, United States of America
| | - Han-Kyul Kim
- Department of Applied Physiology & Kinesiology, University of Florida, Gainesville, FL, United States of America
| | - Moon-Hyon Hwang
- Department of Applied Physiology & Kinesiology, University of Florida, Gainesville, FL, United States of America; Division of Health and Exercise Science, Incheon National University, Incheon, Republic of Korea
| | - Eileen M Handberg
- Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, United States of America
| | - John W Petersen
- Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, United States of America
| | - Brady J Holmer
- Department of Applied Physiology & Kinesiology, University of Florida, Gainesville, FL, United States of America
| | - Julio A Leey Casella
- Division of Endocrinology, Diabetes and Metabolism, University of Florida, Gainesville, FL, United States of America
| | - Kenneth Cusi
- Division of Endocrinology, Diabetes and Metabolism, University of Florida, Gainesville, FL, United States of America
| | - Demetra D Christou
- Department of Applied Physiology & Kinesiology, University of Florida, Gainesville, FL, United States of America.
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Okur I, Taspinar B, Telli Atalay O, Pasali Kilit T, Toru Erbay U, Okur EO. The effects of type 2 diabetes mellitus and its complications on physical and pulmonary functions: A case-control study. Physiother Theory Pract 2018; 36:916-922. [PMID: 30183496 DOI: 10.1080/09593985.2018.1517198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
AIMS This study was planned to determine the effects of type 2 diabetes mellitus (DM) and its complications on physical and pulmonary functions. Methods: A total of 110 individuals aged 40-65 years were included in the study, 58 with type 2 DM (study group) and 52 without DM (control group). Physical activity level, functional capacity, pulmonary function, and comorbidity levels were compared between the groups. Results: The mean age of the individuals was 52.42 ± 5.88 years. Six-minute walk test distance was 507.2 ± 51.70 m in the study group and 532.23 ± 50.32 m in the control group (p < 0.05, Cohen's d = 0.49). The pulmonary function test results of the study and control groups were determined as forced vital capacity (FVC) (%): 99.17 ± 14.13 and 104.65 ± 16.01 (p > 0.05), forced expiratory volume in one second (FEV1) (%): 96.78 ± 14.43 and 99.73 ± 15.80 (p > 0.05), and FEV1/FVC ratio: 81.97 ± 4.62 and 80.16 ± 5.27 (p > 0.05), respectively. The Charlson Comorbidity Index scores of the study and control groups were 1.83 ± 0.82 and 0.12 ± 0.32 (p < 0.05). Conclusions: Type 2 DM was associated with lower functional capacity and higher rates of comorbid diseases. Therefore, potential causes of these parameters should be considered in the rehabilitation of type 2 diabetic patients.
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Affiliation(s)
- Ismail Okur
- Department of Physiotherapy and Rehabilitation, Dumlupinar University , Kutahya, Turkey
| | - Betul Taspinar
- Department of Physiotherapy and Rehabilitation, Dumlupinar University , Kutahya, Turkey
| | - Orcin Telli Atalay
- School of Physical Therapy and Rehabilitation, Pamukkale University , Denizli, Turkey
| | - Turkan Pasali Kilit
- Department of Internal Medicine, Faculty of Medicine, Dumlupinar University , Kutahya, Turkey
| | - Umran Toru Erbay
- Department of Chest Diseases, Faculty of Medicine, Dumlupinar University , Kutahya, Turkey
| | - Eda Ozge Okur
- Department of Physiotherapy and Rehabilitation, Dumlupinar University , Kutahya, Turkey
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Rodríguez-Almagro J, García-Manzanares Á, Lucendo AJ, Hernández-Martínez A. Health-related quality of life in diabetes mellitus and its social, demographic and clinical determinants: A nationwide cross-sectional survey. J Clin Nurs 2018; 27:4212-4223. [PMID: 29987853 DOI: 10.1111/jocn.14624] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 06/27/2018] [Accepted: 07/03/2018] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To investigate health-related quality of life in a representative sample of adults with diabetes mellitus in Spain, as well as its clinical and sociodemographic determinants. BACKGROUND Diabetes mellitus is a chronic disease causing considerable morbidity and mortality worldwide, resulting in an impaired quality of life in affected people. DESIGN A nationwide cross-sectional study, based on an online survey and carried out between February-March 2016, was performed on diabetic subjects recruited through diabetic patients' organisations. METHODS A validated Spanish-language version of the self-administered Diabetes Quality of Life questionnaire was used, with 0 being the worst and 100 the best QoL level. Determinant factors of health-related quality of life were assessed with the aid of multivariate analysis to control for confounding factors. RESULTS The responses provided by 456 patients (52.4% being women) revealed an overall mean score of 66.4 ± 13.3. Social/vocational worries and diabetes-related worries were the dimensions with the highest (74.3 ± 20.1) and lowest (61.1 ± 20.6) scores, respectively. Younger age, female gender, having no studies and poor glycaemic control were all independent determinants for an impaired overall health-related quality of life, with most of these factors having a higher impact than the dimensions negative impact of therapy on daily life, satisfaction with therapy and diabetes-related worries. Married (or equivalent) subjects had better scores in the diabetes-related worries dimension. The perception of health-related quality of life progressively worsens as glycaemic control deteriorates and with an increased number of disease complications. Most of the associations did not vary significantly with the type of diabetes mellitus. CONCLUSION Overall health-related quality of life perception in the Spanish diabetic population is moderate and depends on several sociodemographic factors. Adequate glycaemic control to avoid disease complications improves perception. RELEVANCE TO CLINICAL PRACTICE The results can help health professionals to develop strategies to promote diabetic patient self-care, in order to improve the metabolic control of the disease and avoid its complications, as a therapeutic goal towards an improvement in health-related quality of life perception.
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Affiliation(s)
| | - Álvaro García-Manzanares
- Department of Endocrinology and Nutrition, Hospital General La Mancha-Centro, Alcázar de San Juan, Ciudad Real, Spain
| | - Alfredo J Lucendo
- Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Ciudad Real, Spain.,Centro de Investigación en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid
| | - Antonio Hernández-Martínez
- Nursing Midwife Teaching Unit, Hospital General La Mancha-Centro, Alcázar de San Juan, Ciudad Real, Spain
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Awotidebe TO, Ativie RN, Oke KI, Akindele MO, Adedoyin RA, Olaogun MO, Olubayode TE, Kolawole BA. Relationships among exercise capacity, dynamic balance and gait characteristics of Nigerian patients with type-2 diabetes: an indication for fall prevention. J Exerc Rehabil 2016; 12:581-588. [PMID: 28119881 PMCID: PMC5227321 DOI: 10.12965/jer.1632706.353] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Accepted: 11/28/2016] [Indexed: 11/22/2022] Open
Abstract
This study investigated the relationships among exercise capacity (EC), dynamic balance (DB), and gait characteristics (GCs) of patients with type-2 diabetes (T2D) and healthy controls (HCs). This observational controlled study involved 125 patients with T2D receiving treatment at a Nigerian university teaching hospital and 125 apparently healthy patients' relatives and hospital staff recruited as controls. EC maximum oxygen consumption (VO2max) was estimated following a 6-min walk test. DB and GC were assessed using the Time Up to Go Test and an accelerometer (BTS G-Walk) assessing gait speed, step length, stride length, and cadence respectively during a self-selected walk. Data were analyzed using descriptive and inferential statistics. Alpha level was set at P<0.05. The mean ages of patients with T2D and HCs were 57.6±6.6 and 60.0±7.0 years, respectively. All physical characteristics were comparable (P>0.05). There were significant differences in the VO2max and DB between patients with T2D and HCs; 7.6±0.6 mL/kg/min vs. 9.6±0.6 mL/kg/min (t=-16.6, P=0.001) and 14.2±2.1 sec vs. 10.4±1.5 sec (t=-6.37, P=0.001), respectively. Furthermore, significant differences were found in GC between patients with T2D and HCs; gait speed: 0.7±0.1 m/sec vs. 1.2±0.1 m/sec (t=-16.60, P=0.001), step length: 0.6±0.2 m vs. 0.9±0.3 m (t=-7.56, P=0.001) and stride length: 0.9±0.1 m vs. 1.1±0.5 m (t=-6.09, P=0.001). There were significant correlations between EC and gait speed in both groups (T2D: r=-0.26, P=0.032 and HCs: r=0.51, P=0.003). In conclusion, patients with T2D demonstrated lower EC, unstable DB, and altered GCs compared with HCs. Exercise interventions to improve EC and gait balance are recommended.
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Affiliation(s)
- Taofeek O. Awotidebe
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife,
Nigeria
| | - Rita N. Ativie
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, University of Nigeria, Enugu Campus, Enugu,
Nigeria
| | - Kayode I. Oke
- Department of Physiotherapy, School of Medical Sciences, University of Benin, Benin City,
Nigeria
| | - Mukadas O. Akindele
- Department of Physiotherapy, Faculty of Allied Health Sciences, Bayero University Kano, Kano,
Nigeria
| | - Rufus A. Adedoyin
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife,
Nigeria
| | - Mathew O.B. Olaogun
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife,
Nigeria
| | - Temitope E. Olubayode
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife,
Nigeria
| | - Babatope A. Kolawole
- Endocrinology and Metabolism Unit, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife,
Nigeria
- Department of Medicine, College of Health Sciences, Obafemi Awolowo University, Ile-Ife,
Nigeria
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