Leisure time physical activity is associated with better metabolic control in adults with type 1 and type 2 diabetes mellitus: A cross-sectional study from two public hospitals in Chile

Clustering of risk behaviours and associations between risk behaviours and cardio-metabolic risk factors in adult individuals with type 1 diabetes

AIMS

To assess clustering of risk behaviours and their health determinants.

METHODS

Cross-sectional health behaviour and health data were collected from individuals with type 1 diabetes, in the FinnDiane Study. Clustering of risk behaviours was assessed and associations between behaviours and health variables were investigated.

RESULTS

Data were available from 956 participants (40 % men, mean age 46 years). Altogether, 4.3 % individuals reported no risk behaviours, while 25.7 %, 37.4 %, 24.7 %, 6.8 %, and 1.0 % reported 1, 2, 3, 4, and 5 risk behaviours, respectively. Reporting ≥4 risk behaviours occurred more frequently than expected by chance. Dietary non-adherence was most frequently reported (84.4 %), followed by low LTPA (54.4 %), poor sleep (41.9 %), high alcohol consumption (15.2 %), and smoking (11.2 %). Adjusted for confounders, relative to ≤1 risk behaviour, reporting ≥2 risk behaviours was associated with higher BMI, waist circumference, and diastolic blood pressure. Having ≥3 risk behaviours was associated with larger waist-hip ratio, and higher HbA1c and triglyceride concentration; ≥4 risk behaviours was associated with higher cholesterol concentration. Of the health behaviours, low LTPA had the highest number of deleterious health associations.

CONCLUSIONS

Accumulation of risk behaviors increases negative health outcomes. Exhibiting ≥2 risk behaviours or low LTPA was associated with multiple adverse outcomes.

Association between physical activity before diagnosis and the presence of clinical remission in type 1 diabetes - InlipoDiab1 study

AIM

To investigate whether physical activity is associated with the occurrence of remission in adults with type 1 diabetes.

METHODS

Ninety nine adult participants with newly diagnosed type 1 diabetes were enroled into a prospective, observational study. The participants were advised to exercise 2-3 times a week with moderate intensity for a one-year period. Physical activity was assessed by a self-administrated questionnaire on every fourth visit. We counted the months in which participants fulfiled a partial-remission criteria: HbA1c < 6.5%, C-peptide > 0.5 ng/ml, and daily dose of insulin <0.3 U/kg/day. We assigned the participants to two groups: MORE EFFORT and LESS EFFORT, depending on the median value of physical activity in the studied population.

RESULTS

The occurrence of the remission achieved statistical significance at 6th month with a greater prevalence in MORE EFFORT group (55% vs. 35% p = 0.047). In multivariate logistic regression analysis for the occurrence of remission at 12th month, physical activity before the diagnosis was the only variable that influences the occurrence of the remission (adjusted odds ratios = 3.32 [95% confidence intervals 1.25-8.80]; p = 0.02).

CONCLUSION

In adults with newly diagnosed type 1 diabetes physical activity before the diagnosis is associated with higher occurrence of remission.

Evaluation of hypoglycemic therapeutics and nutritional supplementation for type 2 diabetes mellitus management: An insight on molecular approaches

OBJECTIVE

This review aims to summarize the current management of type 2 diabetes principles, including oral hypoglycemic agents, types of insulin administration, diet maintenance, and various molecular approaches.

METHODS

A literature search was conducted in different databases such as Scopus, ScienceDirect, Google Scholar, and Web of Science by using the following keywords: type-2 diabetes mellitus (T2DM), first-line and second-line treatment, oral hypoglycemic agents, insulin administration, diet/nutritional therapy, gene and stem cell therapy, and diabetic complications.

RESULTS

The first-line treatment of T2DM includes administering oral hypoglycemic agents (OHAs) and second-line treatment by insulin therapy and some OHAs like Sulfonylurea's (SU). The oral hypoglycemic or oral antidiabetic drugs have the function of lowering glucose in the blood. Insulin therapy is recommended for people with A1C levels > 7.0, and insulin administration is evolved drastically from the syringe, pump, pen, inhalation, insulin jet, and patch. The use of OHAs and insulin therapy during glycemic control has a severe effect on weight gain and other side effects. Hence, diet maintenance (macro and micronutrients) and nutritional therapy guidelines were also reviewed/recommended for safe T2DM management. Besides, the recent progress in molecular approaches that focuses on identifying new targets for T2DM (i.e.) consisting of gene therapy, stem cell therapy, and the modulation of insulin signaling pathways for the regulation of glucose storage and uptake also discussed.

CONCLUSION

The analysis of all these key factors is necessary to develop a potential agent to cure T2DM and suggest that a combination of therapies will pave the way for advanced management of T2DM.

[Impact of physical activity on glycemic variability in people with diabetes mellitus type 2]

One of the main roles of the prescription of physical activity for people with type 2 diabetes is to reduce hyperglycemia. The beneficial effect of physical training on glycemic levels is considered as the sum of the effects of each exercise session. A better understanding of acute responses to exercise, through short-term glycemic variability, could explain the differences in the results of distinct training protocols. The objective of this study was to analyze the scientific information on different exercise protocols and their association with short-term glycemic variability in patients with type 2 diabetes. A systematic review of studies published in English and Spanish was carried out. The databases used were PubMed, Cochrane, ScienceDirect, and Medline. Only studies conducted in adults (older than 18 years) were included. A total of 36 studies were identified, which were analyzed and completed using the Covidence® platform. The final analysis included 10 articles with 296 patients. The 10 included articles were divided according to the type of intervention protocol used: group 1, acute exercise, and group 2, training. Significant differences were found in glycemic variability in 71.4% of the articles in group 1 and in 100% of the articles included in group 2. Positive effects of acute exercise and physical training on short-term glycemic variability were demonstrated. The findings were more pronounced in the intervention protocols than in physical training.

The diabetes quality of life brief clinical inventory in combination with the management strategies in type 1 diabetes mellitus with or without the use of insulin pump

Aims

The aims of this study are to evaluate any differences in the Quality of life among Continuous Subcutaneous Insulin Infusion (CSII) and Multiple Dose Injection (MDI) insulin delivery, applying the Diabetes Quality of life Brief Clinical Inventory (DQoL-BCI) questionnaire, and assess the diabetes management strategies between the two groups.

Methods

One hundred and ten adult participants (male/female ratio 1:2.7) with type 1 diabetes were recruited in this online survey. Forty-eight of them were using CSII and the rest 62 (were using) MDI insulin delivery. A 23-item socio-demographic/diabetes management strategies questionnaire and the 15-item DQoL-BCI were administered.

Results

CSII users scored statistically, significantly better at the satisfaction treatment subscale (p = 0.032) of the DQoL-BCI and emerged that they were implemented more management strategies such as dietician guidance services (p = 0.002), carbohydrate education seminars (p = 0.03). Predictive factors were also detected regarding the HbA_1c < 7% (53 mmol/mol) and β-coefficients in relation to DQoL-BCI questionnaire with the subscales of a negative impact and satisfaction treatment.

Conclusion

Diabetes self-management education plays a key role to a better compliance with the treatment. Client-centered multidisciplinary centers in T1DM education are essential so that they be applicable for all T1DM patients irrespective of the type of insulin delivery they used.