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Tokunaga-Nakawatase Y, Taru C, Tsutou A, Nishigaki M, Miyawaki I. Self-management behavior concerning physical activity of Japanese type 2 diabetes patients, characterized by sex, daily energy intake and body mass index. Diabetol Int 2018; 10:206-212. [PMID: 31275787 DOI: 10.1007/s13340-018-0381-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 11/01/2018] [Indexed: 11/24/2022]
Abstract
Objectives We assess differences in physical activity self-management behavior in association with dietary intake and BMI between the sexes in patients with type 2 diabetes. Methods Patients with type 2 diabetes (n = 145) completed a self-administrated questionnaire. Patients were classified into four groups by BMI and dietary intake: non-obesity and non-overeating (NO/NOE); non-obesity and overeating (NO/OE); obesity and non-overeating (O/NOE); obesity and overeating (O/OE). Differences in physical activity self-management behavior between the four groups were determined by the analysis of variance using a Tukey-Kramer post hoc test. Results Male O/OE group showed higher HbA1c (p = 0.001) than the other groups. Male NO/OE group had higher steps/day than O/NOE (p = 0.036) and score of "Exercising to stimulate the enjoyment of eating" was higher than O/OE (p = 0.031). Female NO/OE group showed higher HbA1c (p = 0.001) than NO/NOE and O/NOE. Conclusions BMI and dietary intake were associated with frequencies of physical activity self-management strategies in men. Self-management behavior peculiar to male NO/OE group is "Exercising to stimulate the enjoyment of eating". Health professionals should assess sex, BMI, and dietary intake of patients and endeavor to improve individuals' ability to regulate their caloric balance based on physical activity level.
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Affiliation(s)
- Yuri Tokunaga-Nakawatase
- 1Department of Adult Nursing, Nursing Course, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004 Japan.,2Division of Development Sciences for Practical Nursing, Department of Nursing, Faculty of Health Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142 Japan
| | - Chiemi Taru
- 2Division of Development Sciences for Practical Nursing, Department of Nursing, Faculty of Health Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142 Japan
| | - Akimitsu Tsutou
- 3Division of Preventive Health Science, Department of Community Health Sciences, Faculty of Health Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142 Japan
| | - Masakazu Nishigaki
- 4Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8397 Japan
| | - Ikuko Miyawaki
- 2Division of Development Sciences for Practical Nursing, Department of Nursing, Faculty of Health Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142 Japan
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Shibuta T, Waki K, Tomizawa N, Igarashi A, Yamamoto-Mitani N, Yamaguchi S, Fujita H, Kimura S, Fujiu K, Waki H, Izumida Y, Sasako T, Kobayashi M, Suzuki R, Yamauchi T, Kadowaki T, Ohe K. Willingness of patients with diabetes to use an ICT-based self-management tool: a cross-sectional study. BMJ Open Diabetes Res Care 2017; 5:e000322. [PMID: 28243450 PMCID: PMC5304261 DOI: 10.1136/bmjdrc-2016-000322] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 11/07/2016] [Accepted: 12/04/2016] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To examine the prevalence of the willingness of patients with diabetes to use a self-management tool based on information and communication technology (ICT) such as personal computers, smartphones, and mobile phones; and to examine the patient characteristics associated with that willingness. RESEARCH DESIGN AND METHODS We conducted a cross-sectional interview survey of 312 adults with diabetes at a university hospital in an urban area in Japan. Participants were classified into 2 groups: those who were willing to use an ICT-based self-management tool and those who were unwilling. Multiple logistic regression analysis was used to identify factors associated with the willingness, including clinical and social factors, current use of ICT, self-management practices, self-efficacy, and diabetes-related emotional distress. RESULTS The mean age of the 312 participants was 66.3 years (SD=11.5) and 198 (63%) were male. Most of the participants (93%) had type 2 diabetes. Although only 51 (16%) currently used ICT-based self-management tools, a total of 157 (50%) expressed the willingness to use such a tool. Factors associated with the willingness included: not having nephropathy (OR=2.02, 95% CI 1.14 to 3.58); outpatient visits once a month or more (vs less than once a month, OR=2.13, 95% CI 1.13 to 3.99); current use of personal computers and/or smartphones (OR=4.91, 95% CI 2.69 to 8.98); and having greater diabetes-related emotional distress (OR=1.10, 95% CI 1.01 to 1.20). CONCLUSIONS Approximately half of the patients showed interest in using an ICT-based self-management tool. Willing patients may expect ICT-based self-management tools to complement outpatient visits and to make self-management easier. Starting with patients who display the willingness factors might optimize programs based on such tools.
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Affiliation(s)
- Tomomi Shibuta
- School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kayo Waki
- Department of Ubiquitous Health Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nobuko Tomizawa
- Department of Ubiquitous Health Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ayumi Igarashi
- School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Noriko Yamamoto-Mitani
- School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Satoko Yamaguchi
- Department of Ubiquitous Health Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hideo Fujita
- Department of Ubiquitous Health Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shigeko Kimura
- Department of Ubiquitous Health Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsuhito Fujiu
- Department of Ubiquitous Health Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hironori Waki
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshihiko Izumida
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takayoshi Sasako
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masatoshi Kobayashi
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryo Suzuki
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Toshimasa Yamauchi
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takashi Kadowaki
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuhiko Ohe
- Department of Biomedical Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Akabane M, Konishi H, Nishio Y, Yamaji A. Long-Term Glycemic Control after a One Week Hospital Education Program for Inpatients with Type 2 Diabetes. J Pharm Technol 2016. [DOI: 10.1177/875512250702300502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Clinical usefulness of short-term education for long-term glycemic control has been unclear in patients with type 2 diabetes. Objective: To conduct a one week education program, incorporating a clinical path with group education and a team approach, for inpatients with type 2 diabetes and assess the effect of our program on short- and long-term glycemic control in these patients. Methods: Changes in hemoglobin A1c (A1C) values of 29 patients were serially examined for 3 years after discharge at completion of the education program, and findings were compared with those of 22 patients with diabetes who did not participate in the program. Results: A1C values of patients in the education group at the first and third year after discharge were maintained at lower levels than those of patients in the control group. The proportion of patients with A1C values less than 7% was greater in the education group than in the control group during the first and third years. No significant differences in the number of hospital visits were noted over 3 years, and no significant difference between the 2 groups was found in the ratio of patients receiving drug therapy to those supported by a diet/exercise regimen only. Conclusions: Our findings suggest that a one week in-hospital education program contributes to improvement of short- and long-term glycemic control in patients with type 2 diabetes.
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Affiliation(s)
- Michiya Akabane
- MICHIYA AKABANE BS CDE, Clinical Pharmacist, Department of Hospital Pharmacy, Shiga University of Medical Science, Otsu, Japan
| | - Hiroki Konishi
- HIROKI KONISHI PhD, Clinical Pharmacist, Department of Hospital Pharmacy, Shiga University of Medical Science
| | - Yoshihiko Nishio
- YOSHIHIKO NISHIO MD PhD, Associate Professor, Division of Endocrinology and Metabolism, Department of Medicine, Shiga University of Medical Science
| | - Akira Yamaji
- AKIRA YAMAJI PhD, Professor and Director, Department of Hospital Pharmacy, Shiga University of Medical Science
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Brown SA, Becker BJ, García AA, Brown A, Ramírez G. Model-driven meta-analyses for informing health care: a diabetes meta-analysis as an exemplar. West J Nurs Res 2014; 37:517-35. [PMID: 25142707 DOI: 10.1177/0193945914548229] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A relatively novel type of meta-analysis, a model-driven meta-analysis, involves the quantitative synthesis of descriptive, correlational data and is useful for identifying key predictors of health outcomes and informing clinical guidelines. Few such meta-analyses have been conducted and thus, large bodies of research remain unsynthesized and uninterpreted for application in health care. We describe the unique challenges of conducting a model-driven meta-analysis, focusing primarily on issues related to locating a sample of published and unpublished primary studies, extracting and verifying descriptive and correlational data, and conducting analyses. A current meta-analysis of the research on predictors of key health outcomes in diabetes is used to illustrate our main points.
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Fonseca VA, Kirkman MS, Darsow T, Ratner RE. The American Diabetes Association diabetes research perspective. Diabetes Care 2012; 35:1380-7. [PMID: 22619289 PMCID: PMC3357230 DOI: 10.2337/dc12-9001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Vivian A Fonseca
- Division of Endocrinology, Department of Medicine, Tulane University Medical Center, New Orleans, Louisiana, USA
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Affiliation(s)
- Vivian A. Fonseca
- Division of Endocrinology, Department of Medicine, Tulane University Medical Center, New Orleans, Louisiana
- President, Medicine & Science, American Diabetes Association, Alexandria, Virginia
| | - M. Sue Kirkman
- Medical Affairs and Community Information, American Diabetes Association, Alexandria, Virginia
| | - Tamara Darsow
- Research Programs, American Diabetes Association, Alexandria, Virginia
- Corresponding author: Tamara Darsow,
| | - Robert E. Ratner
- Scientific and Medical Division, American Diabetes Association, Alexandria, Virginia
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Ferrer RL, Carrasco AV. Capability and clinical success. Ann Fam Med 2010; 8:454-60. [PMID: 20843888 PMCID: PMC2939422 DOI: 10.1370/afm.1163] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2009] [Revised: 03/02/2010] [Accepted: 03/15/2010] [Indexed: 11/09/2022] Open
Abstract
Better outcomes for chronic diseases remain elusive because success depends on events outside the control of the health care system: patients' ability to mange their health behaviors and chronic diseases. Among the most powerful influences on self-management are the social and environmental constraints on healthy living, yet the clinical response to these environmental determinants is poorly developed. A potential approach for addressing social determinants in practice, as well as planning and evaluating community responses, is the capability framework. Defined as the real opportunity to achieve a desired lifestyle, capability focuses attention on the material conditions that constrain real opportunity and how opportunity emerges from the interaction between personal resources and the social environment. Using examples relevant to chronic disease and behavior change, we discuss the clinical application of the capability framework.
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Affiliation(s)
- Robert L Ferrer
- Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229-3900, USA.
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Huizinga MM, Gebretsadik T, Garcia Ulen C, Shintani AK, Michon SR, Shackleford LO, Wolff KL, Brown AW, Rothman RL, Elasy TA. Preventing glycaemic relapse in recently controlled type 2 diabetes patients: a randomised controlled trial. Diabetologia 2010; 53:832-9. [PMID: 20084363 PMCID: PMC2863104 DOI: 10.1007/s00125-010-1658-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2009] [Accepted: 12/16/2009] [Indexed: 10/20/2022]
Abstract
AIMS/HYPOTHESIS After achieving glycaemic control, many type 2 diabetic patients relapse to clinically significant levels of hyperglycaemia. We sought to determine the optimal frequency of telephone contact by nurse practitioners that was necessary to prevent glycaemic relapse. METHODS This parallel, randomised controlled trial ran from June 2002 to February 2006 at an academic medical centre, studying 164 type 2 diabetic patients who had recently achieved glycaemic control. Participants were randomly assigned by sequential, concealed, computer-generated allocation to a 2 year maintenance strategy consisting of: (1) routine follow-up (n = 54); (2) routine follow-up and quarterly telephone contact (n = 55); or (3) routine follow-up and monthly telephone contact (n = 55). Blinding was not possible. The primary outcome was cumulative incidence of glycaemic relapse, defined as an increase in HbA(1c) of > or =1%; all participants were analysed. Cumulative incidence and prevalent proportions were compared. Weight change and hypoglycaemia were also assessed. RESULTS All participants randomised were included in the analyses. The study was completed by 90% of participants and intervention fidelity was high. At 24 months, the cumulative incidence of relapse was 41%. At 12 months, prevalent proportions of relapse were 20%, 14% and 15% for control, quarterly contact and monthly contact, respectively. At 24 months, they were 25%, 21% and 29%, respectively. There was no statistically significant difference in cumulative incidence or prevalent proportions of relapse among the study arms. Adverse events did not differ between study arms. CONCLUSIONS/INTERPRETATION This first randomised controlled trial to test an intervention to prevent glycaemic relapse found that regularly scheduled telephone contact by a nurse practitioner was no more effective than routine follow-up care in preventing glycaemic relapse.
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Affiliation(s)
- M M Huizinga
- Johns Hopkins University School of Medicine, 2024 E Monument Street, Suite 2-500, Baltimore, MD 21205, USA.
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Affiliation(s)
- Katie Weinger
- Center of Innovation in Diabetes Education, Joslin Diabetes Center, Boston, MA, USA.
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Abstract
Depression and anxiety can adversely affect the course of chronic physical illnesses, increasing morbidity and mortality. The literature during the past year is reviewed for gastrointestinal disorders, cancer, pain, heart disease, diabetes, and pulmonary disease. Causes for this relationship are behavioral and biological. Behavioral factors in patients with depressive and anxiety disorders include unhealthy lifestyle choices, disrupted sleep, and poor adherence to medical regimens. Biological mechanisms include increased inflammatory response and disruption of the hypothalamic-pituitary-adrenal axis.
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Affiliation(s)
- Richard M Sobel
- Department of Psychiatry, Jefferson Medical College, 1518 Walnut Street, Suite 1110, Philadelphia, PA 19102, USA.
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Psychiatric aspects of pancreas and islet cell transplantation. Curr Opin Organ Transplant 2004. [DOI: 10.1097/01.mot.0000143458.54205.a9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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