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Han XZ, Sun CZ. The influence of resistance exercise and aerobic exercise on type 2 diabetes: a meta-analysis. J Sports Med Phys Fitness 2024; 64:183-191. [PMID: 38059652 DOI: 10.23736/s0022-4707.23.15263-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
INTRODUCTION Diabetes is a worldwide chronic disease. The incidence rate of this disease is high, and it is a common disease in clinics. At present, the incidence rate of diabetes patients is increasing year by year due to the increasing work pressure, the accelerated pace of life, the change of diet, the reduction of labor, and the acceleration of aging. EVIDENCE ACQUISITION The computer retrieves four databases to obtain random controlled trials on the influence of resistance exercise and aerobic exercise on type 2 diabetes. After a rigorous literature quality evaluation, data analysis was performed using RevMan 5.3 software. EVIDENCE SYNTHESIS Ten studies were ultimately included in this meta-analysis. 10 studies reported the HbA1c of the test group and the control group, which was no significant statistical significance (SMD: -0.01; 95% CI: -0.20,0.19; P=0.959) than the control group, HOMA-IR (SMD: 0.02; 95% CI: -0.65,0.69; P=0.954), SBP (SMD: 3.92; 95% CI: -0.92,8.75; P=0.112), DBP (SMD: 0.67; 95% CI: -3.66,5.01; P=0.761), HDL (SMD: -0.08; 95% CI: -2.79,2.64; P=0.955), TG (SMD: -7.51; 95% CI: -21.25,6.22; P=0.284) and TC (SMD: 9.10; 95% CI: -13.43,31.62; P=0.428). CONCLUSIONS The results of this study suggest that both resistance exercise and aerobic exercise may be effective on patients with type 2 diabetes, as evidenced by HbA1c, HOMA-IR, SBP, DBP, HDL, TG and TC. There is no significant difference in their impact on type 2 diabetes patients, and the above conclusions need to be verified by more high-quality studies.
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Affiliation(s)
- Xiong-Zhe Han
- College of Physical Education, Yanbian University, Yanji, Jilin, China -
| | - Cheng-Zhe Sun
- College of Physical Education, Yanbian University, Yanji, Jilin, China
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ElSayed NA, Aleppo G, Bannuru RR, Beverly EA, Bruemmer D, Collins BS, Darville A, Ekhlaspour L, Hassanein M, Hilliard ME, Johnson EL, Khunti K, Lingvay I, Matfin G, McCoy RG, Perry ML, Pilla SJ, Polsky S, Prahalad P, Pratley RE, Segal AR, Seley JJ, Stanton RC, Gabbay RA. 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2024. Diabetes Care 2024; 47:S77-S110. [PMID: 38078584 PMCID: PMC10725816 DOI: 10.2337/dc24-s005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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Luo X, Wang Z, Li B, Zhang X, Li X. Effect of resistance vs. aerobic exercise in pre-diabetes: an RCT. Trials 2023; 24:110. [PMID: 36788568 PMCID: PMC9930288 DOI: 10.1186/s13063-023-07116-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 01/28/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND This study aimed to assess the different impacts of aerobic and resistance exercise intervention on pre-diabetes and its possible influencing factor (obesity) to identify which exercise intervention mode was better for pre-diabetes to control their blood glucose levels. METHODS Single-blind randomized controlled trial. Participants were recruited from Southwest Hospital between February 2016 and May 2017 and randomly divided into three groups using stratified randomization: aerobic exercise (A), resistance exercise (R), and control (C). The effects of each group were analyzed, and the relationship with obesity was investigated following a 12-week intervention. RESULTS Eighty participants were enrolled (9 were lost, and 1 was excluded). Finally, 26 participants were included in group A, 23 in group R, and 21 in group C. In groups A and R, FPG, OGTT 2-h PG, and HOMA2-IR decreased by 6.17% (P = 0.001) and 4.81% (P = 0.019), 20.39% (P < 0.001) and 16.50% (P < 0.001), and 8.34% (P = 0.026) and 18.31% (P = 0.001, superior to that in group A), respectively (all P < 0.001 compared with group C, with no significant differences between groups A and R). The ratio of reversal to euglycemia was 69.2% (P = 0.003 compared with group C) in group A and 43.5% (P = 0.213 compared with group C) in group R. The decreased ratio of GSP in group R was greater (65.2%, P = 0.008 compared with group C) compared with group A (38.5%, P = 0.355 compared with group C). Decreases in the parameters BMI (3.1 ± 3.2% P < 0.001, moderately positive correlation with the decreased FPG level, r = 0.498, P = 0.010, two-tailed) and waist circumference (3.1 ± 2.7% P < 0.001) were noted in group A, but no significant correlations were noted between other indicators in group R. CONCLUSIONS Both resistance and aerobic exercise can control and reverse IGR. Compared with aerobic exercise, resistance exercise may be superior in terms of GSP and IR improvement. Aerobic exercise decreases blood glucose levels through weight loss. However, the effect of resistance exercise might not be mediated via weight loss and obesity control. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2000038304. Registered on September 17, 2020.
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Affiliation(s)
- Xijuan Luo
- grid.12981.330000 0001 2360 039XDepartment of Sports, Sun Yat-sen University, Guangzhou, 510275 China
| | | | - Bowen Li
- grid.443516.10000 0004 1804 2444School of Sports and Health, Nanjing Sport Institute, Nanjing, 210014 China
| | - Xianbo Zhang
- grid.506261.60000 0001 0706 7839Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730 China
| | - Xin Li
- grid.443344.00000 0001 0492 8867Center of Academic Journals, Chengdu Sport University, Chengdu, 610041 China
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ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, Collins BS, Hilliard ME, Isaacs D, Johnson EL, Kahan S, Khunti K, Leon J, Lyons SK, Perry ML, Prahalad P, Pratley RE, Seley JJ, Stanton RC, Young-Hyman D, Gabbay RA, on behalf of the American Diabetes Association. 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2023. Diabetes Care 2023; 46:S68-S96. [PMID: 36507648 PMCID: PMC9810478 DOI: 10.2337/dc23-s005] [Citation(s) in RCA: 126] [Impact Index Per Article: 126.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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Blonde L, Umpierrez GE, Reddy SS, McGill JB, Berga SL, Bush M, Chandrasekaran S, DeFronzo RA, Einhorn D, Galindo RJ, Gardner TW, Garg R, Garvey WT, Hirsch IB, Hurley DL, Izuora K, Kosiborod M, Olson D, Patel SB, Pop-Busui R, Sadhu AR, Samson SL, Stec C, Tamborlane WV, Tuttle KR, Twining C, Vella A, Vellanki P, Weber SL. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. Endocr Pract 2022; 28:923-1049. [PMID: 35963508 PMCID: PMC10200071 DOI: 10.1016/j.eprac.2022.08.002] [Citation(s) in RCA: 139] [Impact Index Per Article: 69.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The objective of this clinical practice guideline is to provide updated and new evidence-based recommendations for the comprehensive care of persons with diabetes mellitus to clinicians, diabetes-care teams, other health care professionals and stakeholders, and individuals with diabetes and their caregivers. METHODS The American Association of Clinical Endocrinology selected a task force of medical experts and staff who updated and assessed clinical questions and recommendations from the prior 2015 version of this guideline and conducted literature searches for relevant scientific papers published from January 1, 2015, through May 15, 2022. Selected studies from results of literature searches composed the evidence base to update 2015 recommendations as well as to develop new recommendations based on review of clinical evidence, current practice, expertise, and consensus, according to established American Association of Clinical Endocrinology protocol for guideline development. RESULTS This guideline includes 170 updated and new evidence-based clinical practice recommendations for the comprehensive care of persons with diabetes. Recommendations are divided into four sections: (1) screening, diagnosis, glycemic targets, and glycemic monitoring; (2) comorbidities and complications, including obesity and management with lifestyle, nutrition, and bariatric surgery, hypertension, dyslipidemia, retinopathy, neuropathy, diabetic kidney disease, and cardiovascular disease; (3) management of prediabetes, type 2 diabetes with antihyperglycemic pharmacotherapy and glycemic targets, type 1 diabetes with insulin therapy, hypoglycemia, hospitalized persons, and women with diabetes in pregnancy; (4) education and new topics regarding diabetes and infertility, nutritional supplements, secondary diabetes, social determinants of health, and virtual care, as well as updated recommendations on cancer risk, nonpharmacologic components of pediatric care plans, depression, education and team approach, occupational risk, role of sleep medicine, and vaccinations in persons with diabetes. CONCLUSIONS This updated clinical practice guideline provides evidence-based recommendations to assist with person-centered, team-based clinical decision-making to improve the care of persons with diabetes mellitus.
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Affiliation(s)
| | | | - S Sethu Reddy
- Central Michigan University, Mount Pleasant, Michigan
| | | | | | | | | | | | - Daniel Einhorn
- Scripps Whittier Diabetes Institute, La Jolla, California
| | | | | | - Rajesh Garg
- Lundquist Institute/Harbor-UCLA Medical Center, Torrance, California
| | | | | | | | | | | | - Darin Olson
- Colorado Mountain Medical, LLC, Avon, Colorado
| | | | | | - Archana R Sadhu
- Houston Methodist; Weill Cornell Medicine; Texas A&M College of Medicine; Houston, Texas
| | | | - Carla Stec
- American Association of Clinical Endocrinology, Jacksonville, Florida
| | | | - Katherine R Tuttle
- University of Washington and Providence Health Care, Seattle and Spokane, Washington
| | | | | | | | - Sandra L Weber
- University of South Carolina School of Medicine-Greenville, Prisma Health System, Greenville, South Carolina
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Batrakoulis A, Jamurtas AZ, Fatouros IG. Exercise and Type II Diabetes Mellitus: A Brief Guide for Exercise Professionals. Strength Cond J 2022. [DOI: 10.1519/ssc.0000000000000731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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5. Facilitating Behavior Change and Well-being to Improve Health Outcomes: Standards of Medical Care in Diabetes-2022. Diabetes Care 2022; 45:S60-S82. [PMID: 34964866 DOI: 10.2337/dc22-s005] [Citation(s) in RCA: 120] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc22-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc22-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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8
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Jiahao L, Jiajin L, Yifan L. Effects of resistance training on insulin sensitivity in the elderly: A meta-analysis of randomized controlled trials. J Exerc Sci Fit 2021; 19:241-251. [PMID: 34552636 PMCID: PMC8429971 DOI: 10.1016/j.jesf.2021.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/27/2021] [Accepted: 08/13/2021] [Indexed: 01/10/2023] Open
Abstract
We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the effect of resistance training in older adults on insulin sensitivity. METHODS Cochrane, Embase, PubMed, Web of Science and EBSCO were searched from inception to April 2021. We integrated randomized controlled trials published in English, and participants were non-athletic and aged ≥60 years. The outcome of interest was the change in insulin sensitivity, derived from the homeostatic model of insulin resistance (HOMA-IR) and hemoglobin A1c (HbA1c). RESULTS 12 RCTs were included in this meta-analysis comparing resistance training (n = 232) with control (n = 209). Resistance exercise significantly reduced HOMA-IR level (d = -0.25, 95% CI, -0.43 to -0.06; P < 0.05) and HbA1c levels of (d = -0.51, 95% CI, -0.84 to -0.18; P < 0.05). Subgroup analysis of HOMA-IR revealed that the variables "population", "training intensity" and "period" had significant effects on HOMA-IR, with the largest effect sizes for high-intensity (d = -0.43, 95%CI, -0.85 to -0.22, P < 0.05) and long-term (more than 12 weeks) (d = -0.43, 95%CI, -0.85 to -0.22, P < 0.05) training programs in older adults without type 2 diabetes (T2D) (d = -0.23, 95%CI, -0.42 to -0.04, P < 0.05). Subgroup analysis of HbA1c suggested that resistance training programs with moderate intensity (d = -0.51, 95%CI, -0.90 to -0.12, P < 0.05) and short term (less than or equal to 12 weeks) (d = -0.49, 95%CI, -0.84 to -0.14, P < 0.05) have greater effects on HbA1c. CONCLUSION The findings of this meta-analysis suggest that resistance training is effective for inducing improvement in insulin sensitivity for elderly. Subgroup analysis showed that high intensity and long period of resistance exercise improve HOMA-IR in healthy old adults, and that resistance training with moderate intensity and short period improve HbA1c in T2D old people. More studies with high methodological qualities and large sample sizes need to be done to further confirm our conclusion.
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Affiliation(s)
- Li Jiahao
- School of Sports Medicine and Rehabilitation, Beijing Sport University, 100084, China
| | - Li Jiajin
- School of Sports Medicine and Rehabilitation, Beijing Sport University, 100084, China
| | - Lu Yifan
- School of Sports Medicine and Rehabilitation, Beijing Sport University, 100084, China
- Key Laboratory of Sports and Physical Fitness of the Ministry of Education, Beijing Sport University, 100084, China
- Corresponding author. School of Sports Medicine and Rehabilitation, Beijing Sport University, 100084, China.
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Common Risk Factors in Relatives and Spouses of Patients with Type 2 Diabetes in Developing Prediabetes. Healthcare (Basel) 2021; 9:healthcare9081010. [PMID: 34442147 PMCID: PMC8394279 DOI: 10.3390/healthcare9081010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/02/2021] [Accepted: 08/06/2021] [Indexed: 11/25/2022] Open
Abstract
Prediabetes should be viewed as an increased risk for diabetes and cardiovascular disease. In this study, we investigated its prevalence among the relatives and spouses of patients with type 2 diabetes or risk factors for prediabetes, insulin resistance, and β-cell function. A total of 175 individuals were included and stratified into three groups: controls, and relatives and spouses of type 2 diabetic patients. We compared clinical characteristics consisting of a homeostatic model assessment for insulin resistance (HOMA-IR) and beta cell function (HOMA-β), a quantitative insulin sensitivity check index (QUICKI), and triglyceride glucose (TyG) index. After a multivariable linear regression analysis, the relative group was independently correlated with high fasting glucose, a high TyG index, and low β-cell function; the relatives and spouses were independently associated with a low QUICKI. The relatives and spouses equally had a higher prevalence of prediabetes. These study also indicated that the relatives had multiple factors predicting the development of diabetes mellitus, and that the spouses may share a number of common environmental factors associated with low insulin sensitivity.
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Sugimoto T, Araki A, Fujita H, Honda K, Inagaki N, Ishida T, Kato J, Kishi M, Kobayashi K, Kouyama K, Noma H, Ohishi M, Satoh-Asahara N, Shimada H, Sugimoto K, Suzuki S, Takeya Y, Tamura Y, Tokuda H, Umegaki H, Watada H, Yamada Y, Sakurai T. The Multi-Domain Intervention Trial in Older Adults With Diabetes Mellitus for Prevention of Dementia in Japan: Study Protocol for a Multi-Center, Randomized, 18-Month Controlled Trial. Front Aging Neurosci 2021; 13:680341. [PMID: 34322009 PMCID: PMC8312849 DOI: 10.3389/fnagi.2021.680341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 05/31/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The Japan-Multi-domain Intervention Trial for Prevention of Dementia in Older Adults with Diabetes (J-MIND-Diabetes) is an 18-month, multi-centered, open-labeled, randomized controlled trial designed to identify whether multi-domain intervention targeting modifiable risk factors for dementia could prevent the progression of cognitive decline among older adults with type 2 diabetes mellitus (T2DM). This manuscript describes the study protocol for the J-MIND-Diabetes trial. Materials and Methods: Subjects of this trial will comprise a total of 300 T2DM outpatients aged 70-85 years with mild cognitive impairment. Subjects will be centrally randomized into intervention and control groups at a 1:1 allocation ratio using the stratified permuted-block randomization methods. The intervention group will participate in multi-domain intervention programs aimed at: (1) management of metabolic and vascular risk factors; (2) physical exercise and self-monitoring of physical activity; (3) nutritional guidance; and (4) social participation. The control group will receive usual T2DM care and general instructions on dementia prevention. The primary and secondary outcomes will be assessed at baseline, at 6- and 18-month follow-up. The primary outcome is change from baseline at 18 months in a global composite score combining several neuropsychological domains, including global cognitive function, memory, attention, executive function, processing speed and language. Secondary outcomes include: (1) cognitive changes in neuropsychological tests; (2) changes in geriatrics assessments; (3) metabolic control and diabetic complications; (4) changes in blood and urinary markers. Discussion: This trial will be the first trial to demonstrate the effectiveness of multi-domain intervention in preventing cognitive decline in older adults with T2DM at increased risk of dementia in Japan. Trial Registration: UMIN000035911; Registered on the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) 18 February 2019. (https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000040908).
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Affiliation(s)
- Taiki Sugimoto
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan.,Medical Genome Center, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Atsushi Araki
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | - Hiroki Fujita
- Department of Endocrinology, Diabetes and Geriatric Medicine, Akita University Graduate School of Medicine, Akita, Japan
| | - Keiko Honda
- Department of Medical Nutrition, Kagawa Nutrition University, Saitama, Japan
| | - Nobuya Inagaki
- Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takeshi Ishida
- Department of Internal Medicine, Saitama Citizens Medical Center, Saitama, Japan
| | - Junichi Kato
- Department of Internal Medicine, Hyogo Prefectural Rehabilitation Center at Nishi-Harima, Tatsuno, Japan
| | - Minoru Kishi
- Department of Internal Medicine, Nishiwaki Municipal Hospital, Nishiwaki, Japan
| | - Kazuki Kobayashi
- Department of Diabetes and Metabolic Disease, Asahi General Hospital, Chiba, Japan
| | - Kunichi Kouyama
- Department of Diabetes Medicine, Hyogo-Chuo National Hospital, Sanda, Japan
| | - Hisashi Noma
- Department of Data Science, Institute of Statistical Mathematics, Tokyo, Japan
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Noriko Satoh-Asahara
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
| | - Hiroyuki Shimada
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | | | - Susumu Suzuki
- Diabetes Center, Ohta Nishinouchi Hospital, Koriyama, Japan
| | - Yasushi Takeya
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yoshiaki Tamura
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | - Haruhiko Tokuda
- Medical Genome Center, National Center for Geriatrics and Gerontology, Obu, Japan.,Department of Clinical Laboratory, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hiroyuki Umegaki
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hirotaka Watada
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuichiro Yamada
- Department of Endocrinology, Diabetes and Geriatric Medicine, Akita University Graduate School of Medicine, Akita, Japan
| | - Takashi Sakurai
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan.,Department of Cognition and Behavior Science, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Liu L, Ma X, Xu H, Ruan S, Yuan X. Comparing the effects of 12 months aerobic exercise and resistance training on glucose metabolism among prediabetes phenotype: A explorative randomized controlled trial. Prim Care Diabetes 2021; 15:340-346. [PMID: 33309489 DOI: 10.1016/j.pcd.2020.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/05/2020] [Accepted: 11/05/2020] [Indexed: 01/19/2023]
Abstract
AIMS The pathophysiology of each phenotype of prediabetes is unique that promotes different levels of diabetes and cardiovascular disease risks. Exercise guidelines for individuals with prediabetes including both aerobic and resistance training could improve metabolic control, but its effects on different prediabetes subtypes are unclear. The aim of this explorative randomized controlled trial was to evaluate the effects of aerobic training (AT) or resistance training (RT) on glucose metabolism and lipid profile by different prediabetes subtypes with. METHODS A randomized controlled trial in which 128 individuals with isolated impaired fasting glucose (i-IFG; n = 39), isolated impaired glucose tolerance (i-IGT; n = 29), combined glucose tolerance (CGI; n = 27) and isolated elevated HbA1c (n = 33) were randomly assigned to the control group, AT group and RT group, respectively. Supervised exercise training, including AT and RT were completed at moderate intensity for 60 min per day, three non-consecutive days per week for 12 months. The primary outcome was improvement in glucose metabolism. Secondary outcomes included measure of lipid profile and if these effects were moderated by the prediabetes phenotype. RESULTS Of the initial 128 participants, 118 finished the study, but all participants were included in the intention-to-treat analyses. The improvement in 2 h postprandial plasma glucose (2 hPG) between group difference (AT vs. RT) at 12 months was 0.87 (95% CI, -1.59 to-0.16; p < 0.05). Compared with RT group, AT significantly decreased the 2hPG in participants with i-IGT at 12 months (-1.66, 95% CI -3.04 to -0.28; p < 0.05). CONCLUSIONS AT program conferred benefits in improving 2 h PG and HbA1c compared with RT for prediabetes. These findings may moderate by prediabetes phenotype, and AT appeared more effective in i-IGT. A future trial with large sample size and long time follow up of prediabetes phenotype groups are needed.
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Affiliation(s)
- Lin Liu
- Yangzhou University, 136 Jiangyang Road, Yangzhou, 225009 PR China.
| | - Xiaojun Ma
- Shaoyang University, Meizijing Campus, Xueyuan Road, Daxiang District, Shaoyang City, 422000 PR China.
| | - Huiwen Xu
- Yangzhou University, 136 Jiangyang Road, Yangzhou, 225009 PR China; Nagano College of Nursing, Komagane, Nagano, 399-4117 Japan
| | - Sijie Ruan
- Central Hospital of Shaoyang, 36 Qianyuan Lane, Daxiang District, Shaoyang City, 422000 PR China
| | - Xiaodan Yuan
- Jiangsu Province Academy of Traditional Chinese Medicine, #100 Hongshan Road, Qixia District Nanjing, 210028 PR China.
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5. Facilitating Behavior Change and Well-being to Improve Health Outcomes: Standards of Medical Care in Diabetes-2021. Diabetes Care 2021; 44:S53-S72. [PMID: 33298416 DOI: 10.2337/dc21-s005] [Citation(s) in RCA: 169] [Impact Index Per Article: 56.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc21-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc21-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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13
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Memelink RG, Pasman WJ, Bongers A, Tump A, van Ginkel A, Tromp W, Wopereis S, Verlaan S, de Vogel-van den Bosch J, Weijs PJM. Effect of an Enriched Protein Drink on Muscle Mass and Glycemic Control during Combined Lifestyle Intervention in Older Adults with Obesity and Type 2 Diabetes: A Double-Blind RCT. Nutrients 2020; 13:nu13010064. [PMID: 33379181 PMCID: PMC7823734 DOI: 10.3390/nu13010064] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Weight loss is key to treatment of older adults with obesity and type 2 diabetes, but also a risk for muscle mass loss. This study investigated whether a whey protein drink enriched with leucine and vitamin D could preserve muscle mass and improve glycemic control during combined lifestyle intervention in this population. Methods: 123 older adults with obesity and type 2 diabetes were randomized into a 13-week lifestyle intervention with dietary advice and exercise, receiving either the enriched protein drink (test) or an isocaloric control (control). Muscle mass was assessed with dual-energy X-ray absorptiometry and glycemic control by oral glucose tolerance test. Statistical analyses were performed using a linear mixed model. Results: There was a nonsignificant increase in leg muscle mass (+0.28 kg; 95% CI, −0.01 to 0.56) and a significant increase in appendicular muscle mass (+0.36 kg; 95% CI, 0.005 to 0.71) and total lean mass (+0.92 kg; 95% CI, 0.19 to 1.65) in test vs. control. Insulin sensitivity (Matsuda index) also increased in test vs. control (+0.52; 95% CI, 0.07 to 0.97). Conclusions: Use of an enriched protein drink during combined lifestyle intervention shows beneficial effects on muscle mass and glycemic control in older adults with obesity and type 2 diabetes.
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Affiliation(s)
- Robert G. Memelink
- Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands;
- Correspondence: ; Tel.: +31-20-5953400
| | - Wilrike J. Pasman
- Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands; (W.J.P.); (S.W.)
| | - Anke Bongers
- Danone Nutricia Research, Specialized Nutrition, 3584 CT Utrecht, The Netherlands; (A.B.); (J.d.V.-v.d.B.)
| | - Anita Tump
- Vialente-Diëtheek, 3447 GW Woerden, The Netherlands; (A.T.); (A.v.G.)
| | | | - Wim Tromp
- Tromp Medical, 1901 ND Castricum, The Netherlands;
| | - Suzan Wopereis
- Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands; (W.J.P.); (S.W.)
| | - Sjors Verlaan
- Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands;
| | | | - Peter J. M. Weijs
- Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands;
- Department of Nutrition and Dietetics, Amsterdam University Medical Centers, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
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14
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Pasman WJ, Memelink RG, de Vogel-Van den Bosch J, Begieneman MPV, van den Brink WJ, Weijs PJM, Wopereis S. Obese Older Type 2 Diabetes Mellitus Patients with Muscle Insulin Resistance Benefit from an Enriched Protein Drink during Combined Lifestyle Intervention: The PROBE Study. Nutrients 2020; 12:E2979. [PMID: 33003389 PMCID: PMC7601009 DOI: 10.3390/nu12102979] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/16/2020] [Accepted: 09/24/2020] [Indexed: 12/25/2022] Open
Abstract
(1) Background: Recent research showed that subtypes of patients with type 2 diabetes may differ in response to lifestyle interventions based on their organ-specific insulin resistance (IR). (2) Methods: 123 Subjects with type 2 diabetes were randomized into 13-week lifestyle intervention, receiving either an enriched protein drink (protein+) or an isocaloric control drink (control). Before and after the intervention, anthropometrical and physiological data was collected. An oral glucose tolerance test was used to calculate indices representing organ insulin resistance (muscle, liver, and adipose tissue) and β-cell functioning. In 82 study-compliant subjects (per-protocol), we retrospectively examined the intervention effect in patients with muscle IR (MIR, n = 42) and without MIR (no-MIR, n = 40). (3) Results: Only in patients from the MIR subgroup that received protein+ drink, fasting plasma glucose and insulin, whole body, liver and adipose IR, and appendicular skeletal muscle mass improved versus control. Lifestyle intervention improved body weight and fat mass in both subgroups. Furthermore, for the MIR subgroup decreased systolic blood pressure and increased VO2peak and for the no-MIR subgroup, a decreased 2-h glucose concentration was found. (4) Conclusions: Enriched protein drink during combined lifestyle intervention seems to be especially effective on increasing muscle mass and improving insulin resistance in obese older, type 2 diabetes patients with muscle IR.
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Affiliation(s)
- Wilrike J. Pasman
- Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands; (M.P.V.B.); (W.J.v.d.B.); (S.W.)
| | - Robert G. Memelink
- Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands; (R.G.M.); (P.J.M.W.)
| | | | - Mark P. V. Begieneman
- Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands; (M.P.V.B.); (W.J.v.d.B.); (S.W.)
| | - Willem J. van den Brink
- Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands; (M.P.V.B.); (W.J.v.d.B.); (S.W.)
| | - Peter J. M. Weijs
- Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands; (R.G.M.); (P.J.M.W.)
- Department of Nutrition and Dietetics, Amsterdam University Medical Centres, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
| | - Suzan Wopereis
- Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands; (M.P.V.B.); (W.J.v.d.B.); (S.W.)
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15
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Wang B, Mu XL, Zhao J, Jiang HP, Li SS, Yan G, Hua YY, Ren XY, Xing LX, Liang Y, Zhang SD, Zhao YC. Effects of lifestyle interventions on rural patients with type 2 diabetes mellitus. World J Diabetes 2020; 11:261-268. [PMID: 32547700 PMCID: PMC7284015 DOI: 10.4239/wjd.v11.i6.261] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 03/30/2020] [Accepted: 05/05/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The prevalence of type 2 diabetes mellitus (T2DM) is rising rapidly in rural areas, and lifestyle interventions can effectively reduce the blood glucose levels of patients with T2DM. However, current dietary and exercise guidelines are still at experimental stages and are difficult for subjects to understand and implement. The Human Metabolism Analyzer provides real life interventions for the prevention and treatment of T2DM, and our pilot research has demonstrated its effectiveness and good compliance.
AIM To investigate the effect of and compliance with lifestyle interventions in rural patients with T2DM.
METHODS A total of ten rural villages were randomly selected in Chaoshui Township, Penglai City, Shandong Province, China, to conduct health screening among residents aged 50 years or older. Each rural village represented a group, and 12 patients with T2DM were randomly selected from each group (total: 120) to participate in this study and receive real life lifestyle interventions and medication guidance. Lifestyle interventions included changing the meal order (A), postprandial activities (B), resistance exercise (C), and reverse abdominal breathing (D). Diabetes education was conducted at least once a month with a weekly phone follow-up to monitor exercise and diet. Waist circumference, blood pressure, body mass index (BMI), motor function, body composition, fasting blood glucose, and glycated hemoglobin (HbA1c) were analyzed before and 3 mo after the intervention. Moreover, patient compliance and adjustments of hypoglycemic drugs were evaluated.
RESULTS A total of 109 subjects completed the study. The compliance rates for lifestyle interventions A, B, C, and D were 57.79%, 60.55%, 64.22%, and 75.23%, respectively. Among the subjects who received hypoglycemic drugs, the dose was reduced 2 to 3 times based on blood glucose in 54 (67.50%) subjects and was tapered and discontinued in 5 (6.25%) subjects within 3 mo, with no significant fluctuations in blood glucose after dose reduction and withdrawal. After lifestyle interventions, waist circumference, BMI, fasting blood glucose, and HbA1c significantly decreased (P < 0.001); motor function and body composition also significantly improved (P < 0.001).
CONCLUSION For patients with T2DM, compliance to real-life lifestyle interventions is good, and the interventions significantly improve metabolic indicators such as waist circumference, BMI, blood pressure, HbA1c, body composition, and motor function. Some patients are able to taper or discontinue hypoglycemic drugs.
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Affiliation(s)
- Bo Wang
- Department of Internal Medicine, Yantaishan Hospital, Yantai 264025, Shandong Province, China
| | - Xiao-Li Mu
- Department of Internal Medicine, Yantaishan Hospital, Yantai 264025, Shandong Province, China
| | - Juan Zhao
- Department of Internal Medicine, Yantaishan Hospital, Yantai 264025, Shandong Province, China
| | - Hai-Ping Jiang
- Department of Internal Medicine, Yantaishan Hospital, Yantai 264025, Shandong Province, China
| | - Shan-Shan Li
- Department of Internal Medicine, Yantaishan Hospital, Yantai 264025, Shandong Province, China
| | - Ge Yan
- Department of Internal Medicine, Yantaishan Hospital, Yantai 264025, Shandong Province, China
| | - Ying-Ying Hua
- Department of Internal Medicine, Yantaishan Hospital, Yantai 264025, Shandong Province, China
| | - Xue-Yi Ren
- Department of Internal Medicine, Yantaishan Hospital, Yantai 264025, Shandong Province, China
| | - Li-Xia Xing
- Department of Internal Medicine, Yantaishan Hospital, Yantai 264025, Shandong Province, China
| | - Yan Liang
- Department of Internal Medicine, Yantaishan Hospital, Yantai 264025, Shandong Province, China
| | - Shu-Dong Zhang
- Department of Internal Medicine, Yantaishan Hospital, Yantai 264025, Shandong Province, China
| | - Yu-Chi Zhao
- Department of Osteoarthropathy, Yantaishan Hospital, Yantai 264025, Shandong Province, China
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16
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5. Facilitating Behavior Change and Well-being to Improve Health Outcomes: Standards of Medical Care in Diabetes-2020. Diabetes Care 2020; 43:S48-S65. [PMID: 31862748 DOI: 10.2337/dc20-s005] [Citation(s) in RCA: 212] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc20-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc20-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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17
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Hamdy Deso D, Abd El-Wah MS, Nour El-Di SM. Effect of Low Level Laser Therapy on Hand Function Performance
of Children with Type I Diabetes Cheiroarthropathy. JOURNAL OF MEDICAL SCIENCES 2019. [DOI: 10.3923/jms.2019.56.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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18
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Hangping Z, Xiaona Q, Qi Z, Qingchun L, Na Y, Lijin J, Siying L, Shuo Z, Xiaoming Z, Xiaoxia L, Qian X, Jaimovich D, Yiming L, Bin L. The impact on glycemic control through progressive resistance training with bioDensity TM in Chinese elderly patients with type 2 diabetes: The PReTTy2 (Progressive Resistance Training in Type 2 Diabetes) Trial. Diabetes Res Clin Pract 2019; 150:64-71. [PMID: 30779971 DOI: 10.1016/j.diabres.2019.02.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 01/14/2019] [Accepted: 02/13/2019] [Indexed: 12/12/2022]
Abstract
AIMS To evaluate the effects of a novel, low-volume, high-intensity Progressive Resistance Training (PRT) technique on blood glucose control in elderly Chinese patients with Type 2 Diabetes. MATERIALS AND METHODS The PReTTy2 trial enrolled 300 male and female patients with Type 2 Diabetes in a randomized resistance training program with the bioDensity™ technique. 100 were control patients with no training intervention and 200 had resistance training. Anthropometry, biochemical parameters, HbA1c and fasting plasma glucose (FPG) were measured at baseline, 3-month and 6-month intervals. RESULTS 265 patients completed the study with no adverse events. There were no statistically significant differences in HbA1c for all patients, control and PRT groups, at baseline (p = 0.60), 3 months (p = 0.42) and 6-months (p = 0.45). Subgroup analysis with baseline HbA1c > 7.5% (58 mmol/mol), showed statistically significant differences in HbA1c and FPG between groups at 6 months (p < 0.05). All PRT group patients had statistically significant differences from baseline at 6 months for HDL (1.25 + 0.32 vs. 1.17 + 0.26 mmol/L, p < 0.001), LDL (3.23 ± 0.89 vs. 2.93 ± 0.80 mmol/L, p < 0.001) and total cholesterol (4.97 ± 1.22 vs. 4.58 ± 1.03 mmol/L, p < 0.001). CONCLUSIONS PRT improves glycemic indices in elderly patients with Type 2 Diabetes with poor glucose control as an adjunct to diet and medication. Progressive Resistance Training with bioDensity™ is feasible, safe and effective in elderly patients with Type 2 Diabetes.
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Affiliation(s)
- Zheng Hangping
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Qiao Xiaona
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Zhang Qi
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Li Qingchun
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Yi Na
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Ji Lijin
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Liu Siying
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Zhang Shuo
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Zhu Xiaoming
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Liu Xiaoxia
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Xiong Qian
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, People's Republic of China
| | | | - Li Yiming
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
| | - Lu Bin
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
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Affiliation(s)
- Martijn Scherrenberg
- 1 Heart Centre Hasselt, Jessa Hospital, Belgium.,2 Faculty of Medicine & Life Sciences, Hasselt University, Belgium
| | - Paul Dendale
- 1 Heart Centre Hasselt, Jessa Hospital, Belgium.,2 Faculty of Medicine & Life Sciences, Hasselt University, Belgium
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20
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Pharmacologic and Exercise Considerations in Older Adults With Diabetes. TOPICS IN GERIATRIC REHABILITATION 2019. [DOI: 10.1097/tgr.0000000000000214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Abstract
The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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22
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Abdullah N, Murad NAA, Attia J, Oldmeadow C, Kamaruddin MA, Jalal NA, Ismail N, Jamal R, Scott RJ, Holliday EG. Differing Contributions of Classical Risk Factors to Type 2 Diabetes in Multi-Ethnic Malaysian Populations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2813. [PMID: 30544761 PMCID: PMC6313591 DOI: 10.3390/ijerph15122813] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/03/2018] [Accepted: 12/04/2018] [Indexed: 12/12/2022]
Abstract
The prevalence of type 2 diabetes is escalating rapidly in Asian countries, with the rapid increase likely attributable to a combination of genetic and lifestyle factors. Recent research suggests that common genetic risk variants contribute minimally to the rapidly rising prevalence. Rather, recent changes in dietary patterns and physical activity may be more important. This nested case-control study assessed the association and predictive utility of type 2 diabetes lifestyle risk factors in participants from Malaysia, an understudied Asian population with comparatively high disease prevalence. The study sample comprised 4077 participants from The Malaysian Cohort project and included sub-samples from the three major ancestral groups: Malay (n = 1323), Chinese (n = 1344) and Indian (n = 1410). Association of lifestyle factors with type 2 diabetes was assessed within and across ancestral groups using logistic regression. Predictive utility was quantified and compared between groups using the Area Under the Receiver-Operating Characteristic Curve (AUC). In predictive models including age, gender, waist-to-hip ratio, physical activity, location, family history of diabetes and average sleep duration, the AUC ranged from 0.76 to 0.85 across groups and was significantly higher in Chinese than Malays or Indians, likely reflecting anthropometric differences. This study suggests that obesity, advancing age, a family history of diabetes and living in a rural area are important drivers of the escalating prevalence of type 2 diabetes in Malaysia.
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Affiliation(s)
- Noraidatulakma Abdullah
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, 2308, Australia.
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia.
| | - Nor Azian Abdul Murad
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia.
| | - John Attia
- Clinical Research Design, IT and Statistical Support (CReDITSS) Unit, Hunter Medical Research Institute, Newcastle, New South Wales, 2305, Australia.
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, 2308, Australia.
| | - Christopher Oldmeadow
- Clinical Research Design, IT and Statistical Support (CReDITSS) Unit, Hunter Medical Research Institute, Newcastle, New South Wales, 2305, Australia.
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, 2308, Australia.
| | - Mohd Arman Kamaruddin
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia.
| | - Nazihah Abd Jalal
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia.
| | - Norliza Ismail
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia.
| | - Rahman Jamal
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia.
| | - Rodney J Scott
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, 2308, Australia.
- Hunter Area Pathology Service, John Hunter Hospital, Newcastle, New South Wales, 2305, Australia.
| | - Elizabeth G Holliday
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, 2308, Australia.
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23
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Byrne H, Caulfield B, De Vito G. Effects of Self-directed Exercise Programmes on Individuals with Type 2 Diabetes Mellitus: A Systematic Review Evaluating Their Effect on HbA 1c and Other Metabolic Outcomes, Physical Characteristics, Cardiorespiratory Fitness and Functional Outcomes. Sports Med 2018; 47:717-733. [PMID: 27459860 DOI: 10.1007/s40279-016-0593-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Type two diabetes mellitus (T2DM) is caused and progressed by an individual's lifestyle and, therefore, its optimal day-to-day management may involve the patient taking responsibility for this, including fulfilling a planned and prescribed exercise regime used as part of the treatment. A prescription of exercise designed to meet a patient's individual needs with minimal supervision from healthcare practitioners would facilitate this. However, the optimal prescription of exercise in the population remains unclear. OBJECTIVE This review examines the effects planned self-directed exercise has on glycosylated haemoglobin and other outcomes in individuals with T2DM and aims to identify the most suitable forms of planned self-directed exercise for individuals with T2DM that can be carried out independently. METHODS A search of the electronic databases PubMed, SPORTDiscus, CINAHL, EMBASE, Cochrane (Trials) and ClinicalTrials.gov was conducted along with reference lists of previous reviews. Randomised controlled trials published in English between January 1990 and February 2015 examining participants diagnosed with T2DM only were included. Studies were critically appraised using the PEDro (Physiotherapy Evidence Database) scale and data were presented on standardised tables. RESULTS Twenty-eight articles that used five element gymnastics, a games console exercise intervention (Wii fit plus) or aerobic, resistance or combined training were included. CONCLUSION This review comprehensively summarised the effects planned self-directed exercise interventions had on individuals with T2DM. The review found that self-directed exercise was found to be beneficial for individuals with T2DM for improving glycosylated haemoglobin, physical characteristics, cardiorespiratory fitness, functional measures and other metabolic outcomes.
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Affiliation(s)
- Hugh Byrne
- The Insight Centre for Data Analytics, O'Brien Centre for Science, University College Dublin, Science Centre East, Belfield, Dublin 4, Ireland. .,UCD School of Public Health, Physiotherapy and Sports Science, Belfield, Dublin, Ireland.
| | - Brian Caulfield
- The Insight Centre for Data Analytics, O'Brien Centre for Science, University College Dublin, Science Centre East, Belfield, Dublin 4, Ireland.,UCD School of Public Health, Physiotherapy and Sports Science, Belfield, Dublin, Ireland
| | - Giuseppe De Vito
- The Insight Centre for Data Analytics, O'Brien Centre for Science, University College Dublin, Science Centre East, Belfield, Dublin 4, Ireland.,UCD School of Public Health, Physiotherapy and Sports Science, Belfield, Dublin, Ireland
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24
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Abstract
The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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25
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Sleeve Gastrectomy Decreases Body Weight, Whole-Body Adiposity, and Blood Pressure Even in Aged Diet-Induced Obese Rats. Obes Surg 2017; 26:1549-58. [PMID: 26439733 DOI: 10.1007/s11695-015-1919-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Aging and obesity are two conditions associated with increased risk of cardiovascular disease. Our aim was to analyze whether an advanced age affects the beneficial effects of sleeve gastrectomy on weight loss and blood pressure in an experimental model of diet-induced obesity (DIO). METHODS Young (6-month-old) and old (18-month-old) male Wistar DIO rats (n = 101) were subjected to surgical (sham operation and sleeve gastrectomy) or dietary interventions (pair-fed to the amount of food eaten by sleeve gastrectomized animals). Systolic (SBP), diastolic (DBP), and mean (MBP) blood pressure values and heart rate (HR) were recorded in conscious, resting animals by non-invasive tail-cuff plethysmography before and 4 weeks after surgical or dietary interventions. RESULTS Aging was associated with higher (P < 0.05) body weight and subcutaneous and perirenal fat mass as well as mild cardiac hypertrophy. Sleeve gastrectomy induced a reduction in body weight, whole-body adiposity, and serum total ghrelin in both young and old DIO rats. The younger group achieved a higher excess weight loss than the older group (164 ± 60 vs. 82 ± 17 %, P < 0.05). A significant (P < 0.05) decrease in insulin resistance, SBP, DBP, MBP, and HR without changes in heart weight was observed after sleeve gastrectomy independently of age. CONCLUSION Our results provide evidence for the effectiveness of sleeve gastrectomy without increased operative risk in body weight and blood pressure reduction even in aged animals via endocrine changes that go beyond the mere caloric restriction.
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26
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Colberg SR. Key Points from the Updated Guidelines on Exercise and Diabetes. Front Endocrinol (Lausanne) 2017; 8:33. [PMID: 28265261 PMCID: PMC5317029 DOI: 10.3389/fendo.2017.00033] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 02/07/2017] [Indexed: 12/27/2022] Open
Affiliation(s)
- Sheri R. Colberg
- Human Movement Sciences Department, Old Dominion University, Norfolk, VA, USA
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27
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Awotidebe TO, Adedoyin RA, Oke KI, Ativie RN, Opiyo R, Ikujeyisi EO, Ikem RT, Afolabi MA. Relationship between functional capacity and health-related quality of life of patients with type-2 diabetes. Diabetes Metab Syndr 2017; 11:1-5. [PMID: 27389077 DOI: 10.1016/j.dsx.2016.06.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 06/06/2016] [Indexed: 11/28/2022]
Abstract
AIMS Physical function is a determinant of survival in chronic diseases, however, little is known about functional capacity (FC) and self-reported health status of patients with type-2 diabetes (T2D). This study investigated the relationship between FC and health related quality of life (HRQoL) of patients with T2D. MATERIALS AND METHODS This cross-sectional survey recruited 150 patients with T2D from a Nigerian university teaching hospital using purposive sampling technique. Socio-demographic and physical characteristics were assessed. FC and HRQoL including physical and mental health component summary (PCS and MCS) were assessed using the six minute walk test (6MWT) and Short-Form (SF-12) questionnaire respectively. Maximum oxygen consumption (VO2 max) was estimated, pre and post 6MWT cardiovascular parameters and fasting blood glucose (FBG) were assessed. Data were analyzed using descriptive and inferential statistics. Alpha level was set at p<0.05. RESULTS There were 83(55.3%) women, means of age and FBG of participants were 64.2±8.7years and 7.4±2.4mmol/L respectively. The means of 6-min walk distance (6-MWD) and estimated VO2 max were 341.55±41.82m and 9.2±0.7mL/kg/min respectively. Significant differences were found between pre and post HR (t=-44.71; p=0.001), SBP (t=-38.38; p=0.001) and DBP (t=-38.58; p=0.001) following 6MWT. The means of PCS and MCS of HRQoL were 48.67±5.51 and 58.39±2.86 respectively. There were significant correlations between FC and each of PCS (r=0.678; p=0.001) and MCS (r=0.211; p=0.009). CONCLUSION Patients with T2D demonstrated low functional capacity and reduced HRQoL. Significant relationship exists between FC and physical and mental component summary of HRQoL. Exercise intervention to improve FC and HRQoL were recommended.
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Affiliation(s)
- Taofeek O Awotidebe
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - Rufus A Adedoyin
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Kayode I Oke
- Department of Physiotherapy, College of Medical Sciences, University of Benin, Benin City, Edo State, Nigeria
| | - Rita N Ativie
- Department of Physiotherapy, University of Nigeria Teaching Hospital, Enugu, Enugu State, Nigeria
| | - Rose Opiyo
- Department of Nutrition, School of Public Health, University of Nairobi, Nairobi, Kenya
| | - Ebenezer O Ikujeyisi
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Rosemary T Ikem
- Department of Medicine, Endocrine and Metabolism Unit, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Mubaraq A Afolabi
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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Colberg SR, Sigal RJ, Yardley JE, Riddell MC, Dunstan DW, Dempsey PC, Horton ES, Castorino K, Tate DF. Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care 2016; 39:2065-2079. [PMID: 27926890 PMCID: PMC6908414 DOI: 10.2337/dc16-1728] [Citation(s) in RCA: 1348] [Impact Index Per Article: 168.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Sheri R Colberg
- Department of Human Movement Sciences, Old Dominion University, Norfolk, VA
| | - Ronald J Sigal
- Departments of Medicine, Cardiac Sciences, and Community Health Sciences, Faculties of Medicine and Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Jane E Yardley
- Department of Social Sciences, Augustana Campus, University of Alberta, Camrose, Alberta, Canada
| | - Michael C Riddell
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - David W Dunstan
- Baker IDI Heart & Diabetes Institute, Melbourne, Victoria, Australia
| | - Paddy C Dempsey
- Baker IDI Heart & Diabetes Institute, Melbourne, Victoria, Australia
| | - Edward S Horton
- Harvard Medical School and Joslin Diabetes Center, Boston, MA
| | | | - Deborah F Tate
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
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Drenowatz C, Hand GA, Sagner M, Shook RP, Burgess S, Blair SN. The Prospective Association between Different Types of Exercise and Body Composition. Med Sci Sports Exerc 2016; 47:2535-41. [PMID: 25970664 DOI: 10.1249/mss.0000000000000701] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE Despite the widely accepted benefits of exercise on chronic disease risk, controversy remains on the role of exercise in weight loss. This study examined the effect of different exercise types on measures of adiposity across different fat categories. METHODS A total of 348 young adults (49% male; 28 ± 4 yr), participating in an ongoing observational study provided valid data over a period of 12 months. Fat mass (FM) and lean mass (LM) were measured via dual x-ray absorptiometry every 3 months. Percent body fat was calculated and used to differentiate between normal-fat, "overfat," and obese participants. At each measurement time point, participants reported engagement (min·wk) in aerobic exercise, resistance exercise, and other forms of exercise. RESULTS Most participants (93%) reported some exercise participation during the observation period. Total exercise or specific exercise types did not significantly affect subsequent body mass index after adjusting for sex, ethnicity, age, and baseline values of adiposity and exercise. Resistance exercise affected LM (P < 0.01) and FM (P < 0.01), whereas aerobic exercise only affected FM (P < 0.01). Any exercise type positively affected LM in normal-fat participants (P < 0.04). In overfat and obese participants, FM was reduced with increasing resistance exercise (P ≤ 0.02) but not with aerobic exercise (P ≥ 0.09). Additionally adjusting for objectively assessed total physical activity level did not change these results. CONCLUSIONS Despite the limited effects on body mass index, exercise was associated with beneficial changes in body composition. Exercise increased LM in normal-fat participants and reduced FM in overfat and obese adults. Adults with excess body fat may benefit particularly from resistance exercise.
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Affiliation(s)
- Clemens Drenowatz
- 1Department of Exercise Science, University of South Carolina, Columbia, SC; 2Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV; 3European Society of Lifestyle Medicine, Paris, FRANCE; 4Department of Kinesiology, Iowa State University, Ames, IA; 5College of Nursing, University of South Carolina, Columbia, SC; and 6Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
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30
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Mahady SE, George J. Exercise and diet in the management of nonalcoholic fatty liver disease. Metabolism 2016; 65:1172-82. [PMID: 26805014 DOI: 10.1016/j.metabol.2015.10.032] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 10/27/2015] [Accepted: 10/31/2015] [Indexed: 02/08/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver condition worldwide, and is projected to become the leading cause for liver transplantation in the United States as early as 2020. The mainstay of treatment remains lifestyle modification with diet and exercise recommendations, as although some pharmacological treatments such as glitazones and Vitamin E have shown benefit, there are concerns regarding long term safety. The evidence base for dietary interventions in NAFLD such as the Mediterranean diet, omega-3 polyunsaturated fatty acids and coffee is mainly derived from observational data with questionable validity. Where trials exist, they have shown benefit for surrogate outcomes such as hepatic steatosis and insulin resistance, but no trials have been conducted with salient clinical outcomes such as reduction in progression to chronic liver disease. Benefit in surrogate outcomes has also been seen for aerobic, anaerobic and combined modality exercise but it remains unclear if one type is superior. Furthermore, a reduction in sedentary time appears equally important. To provide a sound evidence base for lifestyle recommendations to people with NAFLD, longer duration trials of standardized dietary or exercise interventions, and testing various doses, types and with liver related outcomes, are essential.
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Affiliation(s)
- Suzanne E Mahady
- Storr Liver Centre, Westmead Millennium Institute for Medical Research and Westmead Hospital, the University of Sydney, NSW, Australia; Sydney School of Public Health, University of Sydney, NSW Australia.
| | - Jacob George
- Storr Liver Centre, Westmead Millennium Institute for Medical Research and Westmead Hospital, the University of Sydney, NSW, Australia
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Cuthbertson DJ, Bell JA, Ng SY, Kemp GJ, Kivimaki M, Hamer M. Dynapenic obesity and the risk of incident Type 2 diabetes: the English Longitudinal Study of Ageing. Diabet Med 2016; 33:1052-9. [PMID: 26479063 DOI: 10.1111/dme.12991] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/14/2015] [Indexed: 12/21/2022]
Abstract
AIM Obesity is a well-established risk factor for developing Type 2 diabetes. Evidence suggests that sarcopenia, the age-related decline in muscle mass and strength, may exacerbate diabetes risk in obese individuals. The aim of this study was to determine the combined effect of obesity and low muscle strength, dynapenia, on the risk of incident Type 2 diabetes in older adults. METHODS Participants were 5953 (1670 obese) men and women from the English Longitudinal Study of Ageing without known Type 2 diabetes at baseline and for whom handgrip strength, biochemical and other clinical data were collected. A diagnosis of Type 2 diabetes was recorded from self-reported physician diagnosis over 6 years. RESULTS For each unit increase in grip strength, there was a reduction in diabetes risk (age-, sex- and BMI adjusted HR; 0.98; 95% CI 0.96-0.99). The risk of Type 2 diabetes was elevated in all obese participants, but was greatest in those with low handgrip strength (HR = 4.93, 95% CI 2.85, 8.53) compared with non-obese individuals with high handgrip strength. Eleven per cent of the sample met the threshold for weakness (handgrip strength: men < 26 kg; women < 16 kg) that was associated with elevated Type 2 diabetes risk in obese (HR = 3.57, 95% CI 2.04, 6.24) but not in non-obese (HR = 0.86, 95% CI, 0.44, 1.68) compared with normal/non-obese participants. CONCLUSION Dynapenic obesity, determined by high BMI and low handgrip strength, is associated with increased risk of incident Type 2 diabetes in older people.
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Affiliation(s)
- D J Cuthbertson
- MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - J A Bell
- Department of Epidemiology & Public Health, University College London, London, UK
| | - S Y Ng
- MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - G J Kemp
- MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
- Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - M Kivimaki
- Department of Epidemiology & Public Health, University College London, London, UK
| | - M Hamer
- Department of Epidemiology & Public Health, University College London, London, UK
- The National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
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Nunes PRP, Barcelos LC, Oliveira AA, Furlanetto Júnior R, Martins FM, Orsatti CL, Resende EAMR, Orsatti FL. Effect of resistance training on muscular strength and indicators of abdominal adiposity, metabolic risk, and inflammation in postmenopausal women: controlled and randomized clinical trial of efficacy of training volume. AGE (DORDRECHT, NETHERLANDS) 2016; 38:40. [PMID: 26984105 PMCID: PMC5005909 DOI: 10.1007/s11357-016-9901-6] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 03/01/2016] [Indexed: 06/02/2023]
Abstract
This study evaluated the effect of resistance training (RT) volume on muscular strength and on indicators of abdominal adiposity, metabolic risk, and inflammation in post-menopausal women (PW). Thirty-two volunteers were randomly allocated into the following three groups: control (CT, no exercise, n = 11), low-volume RT (LV, three sets/exercise, n = 10), and high-volume RT (HV, six sets/exercise, n = 11). The LV and HV groups performed eight exercises at 70 % of one maximal repetition, three times a week, for 16 weeks. Muscular strength and indicators of abdominal adiposity, metabolic risk, and inflammation were measured at baseline and after 16 weeks. No differences were found in baseline measures between the groups. The PW showed excess weight and fat percentage (F%), large waist circumference (WC), high waist-hip ratio (WHR), and hypercholesterolemia and borderline values of glycated hemoglobin (HbA1c%). Following the RT, a similar increase in muscle strength and reduction in F% from baseline were found in both trained groups. In HV, a decrease in total cholesterol, LDL-c, WC, and WHR was noted. Moreover, the HV showed a lower change (delta%) of interleukin-6 (IL-6) when compared to CT (HV = 11.2 %, P 25-75 = -7.6-28.4 % vs. CT = 99.55 %, P 25-75 = 18.5-377.0 %, p = 0.049). In LV, a decrease was noted for HbA1c%. There were positive correlations (delta%) between WHR and IL-6 and between IL-6 and TC. These results suggest that while a low-volume RT improves HbA1c%, F%, and muscular strength, a high-volume RT is necessary to improve indicators of abdominal adiposity and lipid metabolism and also prevent IL-6 increases in PW.
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Affiliation(s)
- Paulo Ricardo Prado Nunes
- Postgraduate Course of Physical Education, Exercise Biology Laboratory (BioEx), Federal University of Triângulo Mineiro (UFTM), Avenue Tutunas, 490, Uberaba, MG, Brazil.
| | - Larissa Corrêa Barcelos
- Postgraduate Course of Physical Education, Exercise Biology Laboratory (BioEx), Federal University of Triângulo Mineiro (UFTM), Avenue Tutunas, 490, Uberaba, MG, Brazil
| | - Anselmo Alves Oliveira
- Postgraduate Course of Physical Education, Exercise Biology Laboratory (BioEx), Federal University of Triângulo Mineiro (UFTM), Avenue Tutunas, 490, Uberaba, MG, Brazil
| | - Roberto Furlanetto Júnior
- Postgraduate Course of Physical Education, Exercise Biology Laboratory (BioEx), Federal University of Triângulo Mineiro (UFTM), Avenue Tutunas, 490, Uberaba, MG, Brazil
| | - Fernanda Maria Martins
- Postgraduate Course of Physical Education, Exercise Biology Laboratory (BioEx), Federal University of Triângulo Mineiro (UFTM), Avenue Tutunas, 490, Uberaba, MG, Brazil
| | - Cláudio Lera Orsatti
- Postgraduate Course of Physical Education, Exercise Biology Laboratory (BioEx), Federal University of Triângulo Mineiro (UFTM), Avenue Tutunas, 490, Uberaba, MG, Brazil
| | | | - Fábio Lera Orsatti
- Postgraduate Course of Physical Education, Exercise Biology Laboratory (BioEx), Federal University of Triângulo Mineiro (UFTM), Avenue Tutunas, 490, Uberaba, MG, Brazil
- Department of Sport Sciences, Health Science Institute, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
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Tükel HC, Alptekin Ö, Turan B, Delilbaşı E. Effects of metabolic syndrome on masseter muscle of male Wistar rats. Eur J Oral Sci 2015; 123:432-8. [DOI: 10.1111/eos.12226] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2015] [Indexed: 01/21/2023]
Affiliation(s)
- H. Can Tükel
- Department of Oral and Maxillofacial Surgery; Faculty of Dentistry; University of Cukurova; Adana Turkey
| | - Özlem Alptekin
- Department of Biochemistry; Faculty of Pharmacy; University of Cukurova; Adana Turkey
| | - Belma Turan
- Department of Biophysics; Faculty of Medicine; University of Ankara; Ankara Turkey
| | - Ertan Delilbaşı
- Department of Oral and Maxillofacial Surgery; Faculty of Dentistry; University of Gazi; Ankara Turkey
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Koo BK, Roh E, Yang YS, Moon MK. Difference between old and young adults in contribution of β-cell function and sarcopenia in developing diabetes mellitus. J Diabetes Investig 2015; 7:233-40. [PMID: 27042276 PMCID: PMC4773679 DOI: 10.1111/jdi.12392] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 06/03/2015] [Accepted: 06/21/2015] [Indexed: 11/28/2022] Open
Abstract
AIMS/INTRODUCTION To investigate the difference in contributing factors in developing diabetes between old and young adults. MATERIALS AND METHODS Subjects with recent-onset diabetes were selected from a nationwide survey data and classified according to age: elderly (age ≥75 years), middle-age (age 45-64 years) and young (age 25-39 years). The homeostasis model assessment of insulin resistance and β-cell function were calculated. Sarcopenia was assessed using dual-energy X-ray absorptiometry. RESULTS The prevalence of recent-onset diabetes was 13.5%, 8.0%, and 1.4% in patients aged ≥75 years (unweighted n = 1,082), 45-64 years (unweighted n = 6,532), and 25-39 years (unweighted n = 5,178), respectively. Homeostasis model assessment of β-cell function along with homeostasis model assessment of insulin resistance showed increasing trends as onset age increased in recent-onset diabetes (P for trend < 0.001 in both). Elderly-onset diabetic patients had significantly higher homeostasis model assessment of β-cell function and homeostasis model assessment of insulin resistance compared with the middle-age-onset group (P < 0.001 and 0.014, respectively). Multivariate analysis showed that sarcopenia was significantly associated with recent-onset diabetes only in patients aged ≥75 years (odds ratio [OR] 2.478, 95% confidence interval [CI] 1.379-4.452) but not in patients aged 45-64 years. In the middle-age group, abdominal obesity (OR 2.933, 95% CI 2.086-4.122), hypertriglyceridemia (OR 1.529, 95% CI 1.078-2.169]) and low high-density lipoprotein cholesterolemia (OR 1.930, 95% CI 1.383-2.695) were associated with recent-onset diabetes. CONCLUSIONS Elderly-onset diabetic patients had higher insulin resistance and relatively preserved β-cell function compared with middle-age-onset patients. Sarcopenia might play a more important role in developing diabetes in the elderly population.
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Affiliation(s)
- Bo Kyung Koo
- Department of Internal Medicine Seoul National University College of Medicine Seoul Korea; Department of Internal Medicine Boramae Medical Center Seoul Korea
| | - Eun Roh
- Department of Internal Medicine Seoul National University College of Medicine Seoul Korea; Department of Medicine University of Ulsan College of Medicine Seoul Korea
| | - Ye Seul Yang
- Department of Internal Medicine Seoul National University College of Medicine Seoul Korea
| | - Min Kyong Moon
- Department of Internal Medicine Seoul National University College of Medicine Seoul Korea; Department of Internal Medicine Boramae Medical Center Seoul Korea
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Food and addiction among the ageing population. Ageing Res Rev 2015; 20:79-85. [PMID: 25449527 DOI: 10.1016/j.arr.2014.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 08/25/2014] [Accepted: 10/06/2014] [Indexed: 12/25/2022]
Abstract
Obesity among the elderly is a growing public health concern. Among the various factors that may contribute to the current rates of obesity is the rewarding aspect of highly palatable foods and beverages, which may lead to overconsumption and excess caloric intake. The present review describes recent research supporting the hypothesis that, for some individuals, the consumption these highly palatable foods and beverages may lead to the development of addictive-like behaviors. In particular, the authors consider the relevance of this hypothesis to the ageing population.
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Awotidebe TO, Adedoyin RA, Yusuf AO, Mbada CE, Opiyo R, Maseko FC. Comparative functional exercise capacity of patients with type 2-diabetes and healthy controls: a case control study. Pan Afr Med J 2014; 19:257. [PMID: 25852800 PMCID: PMC4382056 DOI: 10.11604/pamj.2014.19.257.4798] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 10/21/2014] [Indexed: 11/28/2022] Open
Abstract
Introduction Functional Exercise Capacity (FEC) is a valid measure of physical fitness in health and disease. However, there is paucity of studies on FEC in African patients with Type-2 Diabetes (T2D). This study compared FEC between patients with T2D and healthy controls. Methods Thirty five patients with T2D (18 men, 17 women) and 35 (16 men, 19 women) age-sex matched healthy controls participated in this case-control study. Anthropometric and demographic characteristics and cardiovascular parameters were measured following standard procedures. A glucometer was used to determine the Fasting Blood Glucose (FBG) level following at least 8 hours of overnight fasting. FEC was assessed using the Six-Minute Walk Test (6MWT) while Hand Grip Strength (HGS) test was measured with an electronic dynamometer. Data were analyzed using descriptive and inferential statistics. Alpha level was set at p< 0.05. Results Patients with T2D and controls were similar in age (p > 0.05). There were significant differences in the distance covered during 6MWT between patients and controls (t= 0.329; p =0.03), exercise capacity (t = 0.329; p = 0.03), FBG (t = 7.403; p = 0.001), systolic and diastolic blood pressure (t = 12.56; p = 0.001 and t = 27.23; p = 0.001) respectively. There were significant inverse relationships between 6MWD and Body mass index (r = -0.39; p = 0.02) and FBS(r = -0.51; p = 0.02) in patients with type-2 respectively. No significant association was found between exercise capacity and HGS (p > 0.05). Conclusion Patients with type-2 diabetes demonstrated lower functional exercise capacity than healthy controls. High body mass index and fasting blood glucose were significantly associated with lower functional exercise capacity.
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Affiliation(s)
- Taofeek Oluwole Awotidebe
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile - Ife, Nigeria
| | - Rufus Adesoji Adedoyin
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile - Ife, Nigeria
| | - Abraar Olalakan Yusuf
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile - Ife, Nigeria
| | - Chidozie Emmanuel Mbada
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile - Ife, Nigeria
| | - Rose Opiyo
- Department of Nutrition, School of Public Health, University of Nairobi, Nairobi, Kenya
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Nadeau DA. Management of type 2 diabetes mellitus in self-motivated patients: optimized diet, exercise, and medication for weight loss and cardiometabolic fitness. PHYSICIAN SPORTSMED 2014; 42:49-59. [PMID: 25419888 DOI: 10.3810/psm.2014.11.2091] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is a growing public health problem with significant lifetime health care costs. The majority of Americans do not achieve minimal targets for exercise, and individuals with T2DM typically engage in less exercise than the general adult population. However, those patients with T2DM who are sufficiently self-motivated to manage their condition have the potential to reverse diabetes and prevent its complications through behavioral and pharmacologic interventions. Marked improvements are possible through increased awareness and selection of healthy eating options, a willingness to incorporate vigorous exercise into their lifestyle, and the use of newer medications that essentially eliminate the risk of hypoglycemia while facilitating weight loss and the achievement of ideal glucose targets. For self-motivated patients, daily aerobic activity of 45 to 60 minutes per day may be a suitable target. For those who have cardiovascular clearance, high-intensity interval training accomplishes high levels of cardiometabolic fitness with shorter training periods by alternating moderate and intense exertion. Suitable medications that have a low risk of hypoglycemia during exercise include metformin, glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors, and sodium-glucose linked transporter-2 inhibitors. Specific daily caloric goals and incorporation of a mainly plant-based diet should be considered as a primary target for diabetes management. Self-management is important to achieving diabetes treatment goals, and mobile applications can be useful tools to support lifestyle changes in patients with T2DM.
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Affiliation(s)
- Daniel A Nadeau
- Kris V. Iyer Endowed Chair in Diabetes Care, Mary and Dick Allen Diabetes Center, Hoag Hospital, Newport Beach, CA.
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Drenowatz C, Hand GA, Shook RP, Jakicic JM, Hebert JR, Burgess S, Blair SN. The association between different types of exercise and energy expenditure in young nonoverweight and overweight adults. Appl Physiol Nutr Metab 2014; 40:211-7. [PMID: 25647557 DOI: 10.1139/apnm-2014-0310] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
With decades of trends for decreasing activity during work and travel, exercise becomes an important contributor to total physical activity (PA) and energy expenditure. The purpose of this study was to examine the contribution of different types of exercise to the variability in energy expenditure and time spent at different PA intensities in young adults. Four hundred and seventeen adults (49.9% male; 46.2 overweight/obese) between 21 and 36 years of age provided valid objective PA and energy expenditure data, assessed via the SenseWear Armband (BodyMedia Inc.). Frequency and duration of participation in various exercise types was self-reported. Weight status was based on body mass index (BMI) (kg/m(2)) with body weight and height being measured according to standard procedures. Eighty-four percent of the participants reported regular exercise engagement with no difference in participation rate by sex or BMI category. Exercise time along with sex and ethnicity explained roughly 60% of the variability in total daily energy expenditure (TDEE) while the association between exercise and time spent in moderate to vigorous PA or being sedentary was low or nonsignificant. Engagement in endurance exercise and sports contributed predominantly to the variability in energy expenditure and PA in nonoverweight participants. In overweight/obese participants engagement in resistance exercise and swimming contributed significantly to variability in TDEE. Current exercise recommendations focus primarily on aerobic exercise, but results of the present study suggest that nonweight-bearing exercises, such as resistance exercise and swimming, contribute significantly to the variability in TDEE in overweight/obese adults, which would make these types of activities viable options for exercise interventions.
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Affiliation(s)
- Clemens Drenowatz
- Department of Exercise Science, University of South Carolina, Public Health Research Center, 921 Assembly Street, Columbia, SC 29208, USA
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Sukala WR, Page RA, Rowlands DS, Lys I, Krebs JD, Leikis MJ, Cheema BS. Exercise intervention in New Zealand Polynesian peoples with type 2 diabetes: Cultural considerations and clinical trial recommendations. Australas Med J 2012; 5:429-35. [PMID: 23024717 PMCID: PMC3442187 DOI: 10.4066/amj.2012.1311] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The Maori and Pacific Islands peoples of New Zealand suffer a greater burden of type 2 diabetes mellitus (T2DM) and associated comorbidities than their European counterparts. Empirical evidence supports the clinical application of aerobic and resistance training for effective diabetes management and potential remission, but few studies have investigated the effectiveness of these interventions in specific ethnic cohorts. We recently conducted the first trial to investigate the effect of prescribed exercise training in Polynesian people with T2DM. This article presents the cultural considerations undertaken to successfully implement the study. The research procedures were accepted and approved by cultural liaisons and potential participants. The approved methodology involved a trial evaluating and comparing the effects of two, 16-week exercise regimens (i.e. aerobic training and resistance training) on glycosylated haemoglobin (HbA1c), related diabetes markers (i.e. insulin resistance, blood lipids, relevant cytokines and anthropometric and hemodynamic indices) and health-related quality of life. Future exercise-related research or implementation strategies in this cohort should focus on cultural awareness and techniques to enhance participation and compliance. Our approach to cultural consultation could be considered by researchers undertaking trials in this and other ethnic populations suffering an extreme burden of T2DM, including indigenous Australians and Americans.
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Affiliation(s)
- William R. Sukala
- Institute of Food, Nutrition & Human Health, Massey University, Wellington, New Zealand
- School of Health and Human Sciences, Southern Cross University, Lismore, Australia
| | - Rachel A. Page
- Institute of Food, Nutrition & Human Health, Massey University, Wellington, New Zealand
| | - David S. Rowlands
- School of Sport and Exercise, Massey University, Wellington, New Zealand
| | - Isabelle Lys
- Faculty of Engineering, Health, Science and the Environment, Charles Darwin University, Australia
| | - Jeremy D. Krebs
- Faculty of Medicine, University of Otago, Wellington, New Zealand
| | - Murray J. Leikis
- Wellington Hospital, Capital and Coast District Health Board, Wellington, New Zealand
| | - Birinder S. Cheema
- School of Science and Health, University of Western Sydney, Campbelltown, Australia
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40
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Hovanec N, Sawant A, Overend TJ, Petrella RJ, Vandervoort AA. Resistance training and older adults with type 2 diabetes mellitus: strength of the evidence. J Aging Res 2012; 2012:284635. [PMID: 22988507 PMCID: PMC3440926 DOI: 10.1155/2012/284635] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 07/05/2012] [Accepted: 07/12/2012] [Indexed: 12/25/2022] Open
Abstract
Objective. This paper analyzes the effects of resistance training (RT) on metabolic, neuromuscular, and cardiovascular functions in older adults (mean age ≥ 65 years) with type 2 diabetes (T2DM). Research Design and Methods. A systematic review conducted by two reviewers of the published literature produced 3 records based on 2 randomized controlled trials that assessed the effect of RT on disease process measures and musculoskeletal/body composition measures. Statistical, Comprehensive Meta-Analysis (version 2) software was used to compute Hedge's g, and results were calculated using the random effects model to account for methodological differences amongst studies. Results. Largest effect of RT was seen on muscle strength; especially lower body strength, while the point estimate effect on body composition was small and not statistically significant. The cumulative point estimate for the T2DM disease process measures was moderate and statistically significant. Conclusions. RT generally had a positive effect on musculoskeletal, body composition, and T2DM disease processes measures, with tentative conclusions based on a low number of completed RCTs. Thus, more research is needed on such programs for older adults (≥65 years) with T2DM.
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Affiliation(s)
- Nina Hovanec
- Health and Rehabilitation Sciences Graduate Program, Western University, London, ON, Canada N6G 1H1
| | - Anuradha Sawant
- School of Physical Therapy and Center for Physical Activity and Aging, Faculty of Health Sciences, Western University, London, ON, Canada N6G 1H1
| | - Tom J. Overend
- School of Physical Therapy and Center for Physical Activity and Aging, Faculty of Health Sciences, Western University, London, ON, Canada N6G 1H1
| | - Robert J. Petrella
- Department of Family Medicine, Western University, London, ON, Canada N6G 1H1
| | - Anthony A. Vandervoort
- School of Physical Therapy and Center for Physical Activity and Aging, Faculty of Health Sciences, Western University, London, ON, Canada N6G 1H1
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Effects of an aerobic and resistance training program on functional capacity and glucose regulation in patients with heart failure and diabetes. Cardiovasc Endocrinol 2012. [DOI: 10.1097/xce.0b013e32835a2147] [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] Open
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van Dijk JW, Manders RJF, Tummers K, Bonomi AG, Stehouwer CDA, Hartgens F, van Loon LJC. Both resistance- and endurance-type exercise reduce the prevalence of hyperglycaemia in individuals with impaired glucose tolerance and in insulin-treated and non-insulin-treated type 2 diabetic patients. Diabetologia 2012; 55:1273-82. [PMID: 22124605 PMCID: PMC3331783 DOI: 10.1007/s00125-011-2380-5] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2011] [Accepted: 10/26/2011] [Indexed: 12/25/2022]
Abstract
AIMS/HYPOTHESIS The present study compares the impact of endurance- vs resistance-type exercise on subsequent 24 h blood glucose homeostasis in individuals with impaired glucose tolerance (IGT) and type 2 diabetes. METHODS Fifteen individuals with IGT, 15 type 2 diabetic patients treated with exogenous insulin (INS), and 15 type 2 diabetic patients treated with oral glucose-lowering medication (OGLM) participated in a randomised crossover experiment. Participants were studied on three occasions for 3 days under strict dietary standardisation, but otherwise free-living conditions. Blood glucose homeostasis was assessed by ambulatory continuous glucose monitoring over the 24 h period following a 45 min session of resistance-type exercise (75% one repetition maximum), endurance-type exercise (50% maximum workload capacity) or no exercise at all. RESULTS Average 24 h blood glucose concentrations were reduced from 7.4 ± 0.2, 9.6 ± 0.5 and 9.2 ± 0.7 mmol/l during the control experiment to 6.9 ± 0.2, 8.6 ± 0.4 and 8.1 ± 0.5 mmol/l (resistance-type exercise) and 6.8 ± 0.2, 8.6 ± 0.5 and 8.5 ± 0.5 mmol/l (endurance-type exercise) over the 24 h period following a single bout of exercise in the IGT, OGLM and INS groups, respectively (p < 0.001 for both treatments). The prevalence of hyperglycaemia (blood glucose >10 mmol/l) was reduced by 35 ± 7 and 33 ± 11% over the 24 h period following a single session of resistance- and endurance-type exercise, respectively (p < 0.001 for both treatments). CONCLUSIONS/INTERPRETATION A single session of resistance- or endurance-type exercise substantially reduces the prevalence of hyperglycaemia during the subsequent 24 h period in individuals with IGT, and in insulin-treated and non-insulin-treated type 2 diabetic patients. Both resistance- and endurance-type exercise can be integrated in exercise intervention programmes designed to improve glycaemic control. TRIAL REGISTRATION Clinicaltrials.gov NCT00945165. FUNDING The Netherlands Organization for Health Research and Development (ZonMw, the Netherlands).
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Affiliation(s)
- J.-W. van Dijk
- Department of Human Movement Sciences, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre+, PO Box 616, 6200 MD Maastricht, the Netherlands
| | - R. J. F. Manders
- Department of Human Movement Sciences, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre+, PO Box 616, 6200 MD Maastricht, the Netherlands
| | - K. Tummers
- Department of Human Movement Sciences, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre+, PO Box 616, 6200 MD Maastricht, the Netherlands
| | - A. G. Bonomi
- Department of Human Biology, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - C. D. A. Stehouwer
- Department of Internal Medicine, CARIM Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - F. Hartgens
- Departments of Epidemiology and Surgery, Research School CAPHRI, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - L. J. C. van Loon
- Department of Human Movement Sciences, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre+, PO Box 616, 6200 MD Maastricht, the Netherlands
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Abstract
The frailty syndrome is defined as unintentional weight and muscle loss, exhaustion, and declines in grip strength, gait speed, and activity. Evidence with respect to the clinical definition, epidemiology, mechanisms, interactions, assessment, prevention, and treatment of frailty in the older adult is reviewed.
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Affiliation(s)
- Roschelle A Heuberger
- Department of Human Environmental Studies, Central Michigan University, Mt. Pleasant, Michigan 48859, USA.
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Otterman NM, van der Schaaf M, Busch-Westbroek TE, van Schie CHM, Nollet F. The use and safety of combined resistance and aerobic training in a patient with complications related to type 2 diabetes: a case report. Disabil Rehabil 2012; 34:1495-500. [DOI: 10.3109/09638288.2011.650312] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Resistance Training in Type II Diabetes Mellitus: Impact on Areas of Metabolic Dysfunction in Skeletal Muscle and Potential Impact on Bone. J Nutr Metab 2012; 2012:268197. [PMID: 22474580 PMCID: PMC3306910 DOI: 10.1155/2012/268197] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Revised: 10/24/2011] [Accepted: 11/24/2011] [Indexed: 12/25/2022] Open
Abstract
The prevalence of Type II Diabetes mellitus (T2DM) is increasing rapidly and will continue to be a major healthcare expenditure burden. As such, identification of effective lifestyle treatments is paramount. Skeletal muscle and bone display metabolic and functional disruption in T2DM. Skeletal muscle in T2DM is characterized by insulin resistance, impaired glycogen synthesis, impairments in mitochondria, and lipid accumulation. Bone quality in T2DM is decreased, potentially due to the effects of advanced glycation endproducts on collagen, impaired osteoblast activity, and lipid accumulation. Although exercise is widely recognized as an important component of treatment for T2DM, the focus has largely been on aerobic exercise. Emerging research suggests that resistance training (strength training) may impose potent and unique benefits in T2DM. The purpose of this review is to examine the role of resistance training in treating the dysfunction in skeletal muscle and the potential role for resistance training in treating the associated dysfunction in bone.
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Colberg SR. Physical activity: the forgotten tool for type 2 diabetes management. Front Endocrinol (Lausanne) 2012; 3:70. [PMID: 22649427 PMCID: PMC3355983 DOI: 10.3389/fendo.2012.00070] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Accepted: 05/02/2012] [Indexed: 11/13/2022] Open
Abstract
Individuals who are currently sedentary, unfit, or overweight can benefit metabolically from simply taking breaks from sitting. Since avoidance of sedentary behavior appears to have a large impact on glycemic management, all individuals with type 2 diabetes should be encouraged to minimally engage in greater daily movement to better manage their diabetes and body weight. In addition, engaging in physical activity of any intensity (including low-intensity ones) likely positively impacts insulin action and blood glucose control acutely. Moreover, as long as total caloric expenditure during exercise is matched (i.e., total exercise dose), daily exercise may be done every other day instead with the same glycemic results, although at least 150 min of weekly physical activity is recommended. Both aerobic and resistance training are important for individuals with diabetes, and ideally a program that combines the two types of training should be undertaken to achieve maximal glycemic and other benefits. Once individuals have successfully implemented more daily movement into their lifestyle, they will be more likely to participate in structured forms of physical activity to gain additional benefits. All clinicians working with individuals with either type 2 diabetes or prediabetes should consider incorporating these suggestions into care plans to improve their patients' glycemic management.
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Affiliation(s)
- Sheri R Colberg
- Human Movement Sciences Department, Old Dominion University, Norfolk, VA, USA.
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Colberg SR, Albright AL, Blissmer BJ, Braun B, Chasan-Taber L, Fernhall B, Regensteiner JG, Rubin RR, Sigal RJ. Exercise and type 2 diabetes: American College of Sports Medicine and the American Diabetes Association: joint position statement. Exercise and type 2 diabetes. Med Sci Sports Exerc 2011; 42:2282-303. [PMID: 21084931 DOI: 10.1249/mss.0b013e3181eeb61c] [Citation(s) in RCA: 341] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Although physical activity (PA) is a key element in the prevention and management of type 2 diabetes mellitus (T2DM), many with this chronic disease do not become or remain regularly active. High-quality studies establishing the importance of exercise and fitness in diabetes were lacking until recently, but it is now well established that participation in regular PA improves blood glucose control and can prevent or delay T2DM, along with positively affecting lipids, blood pressure, cardiovascular events, mortality, and quality of life. Structured interventions combining PA and modest weight loss have been shown to lower T2DM risk by up to 58% in high-risk populations. Most benefits of PA on diabetes management are realized through acute and chronic improvements in insulin action, accomplished with both aerobic and resistance training. The benefits of physical training are discussed, along with recommendations for varying activities, PA-associated blood glucose management, diabetes prevention, gestational diabetes, and safe and effective practices for PA with diabetes-related complications.
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Recruitment of patients with type 2 diabetes for target group specific exercise programs at an Outpatient Department of a Medical University: A factor analysis. Wien Klin Wochenschr 2011; 123:350-3. [DOI: 10.1007/s00508-011-1576-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Accepted: 03/18/2011] [Indexed: 01/01/2023]
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49
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Colberg SR, Sigal RJ. Prescribing exercise for individuals with type 2 diabetes: recommendations and precautions. PHYSICIAN SPORTSMED 2011; 39:13-26. [PMID: 21673482 DOI: 10.3810/psm.2011.05.1909] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
An increasing prevalence of obesity and sedentary behavior has strongly contributed to the epidemic of type 2 diabetes mellitus. Although regular exercise improves glycemic control and is associated with reduced morbidity and mortality, many physicians fail to prescribe it. This article highlights the recommended types and quantities of physical activities that can (and should) be undertaken by individuals with type 2 diabetes, along with precautions required to maximize the safety of exercise in those using various medications and in the presence of diabetes-related complications. This article assesses the need for pre-exercise stress testing, reviews the latest exercise prescription recommendations for individuals with type 2 diabetes, and recommends strategies to assist individuals in adopting and maintaining an active lifestyle.
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Affiliation(s)
- Sheri R Colberg
- Human Movement Sciences Department, Old Dominion University, Norfolk, VA, USA.
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Otterman NM, van Schie CHM, van der Schaaf M, van Bon AC, Busch-Westbroek TE, Nollet F. An exercise programme for patients with diabetic complications: a study on feasibility and preliminary effectiveness. Diabet Med 2011; 28:212-7. [PMID: 21219432 DOI: 10.1111/j.1464-5491.2010.03128.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To investigate the feasibility and preliminary effectiveness of an exercise programme for patients with diabetic complications. METHODS In this pre-post design study, 22 patients from a diabetic foot outpatient clinic participated in a 12-week individualized exercise programme, consisting of aerobic and resistance exercise, with specific safety precautions. Feasibility was assessed on the basis of programme adherence, adverse events, achievement of the target training intensity and patient satisfaction. Preliminary effectiveness was evaluated with pre-post-changes in blood glucose regulation (HbA(1c) ), muscle strength (isometric peak torque) and perceived limitations in functioning (Patient Specific Function Scale with visual analogue scale). RESULTS Twenty patients completed the exercise programme with a high mean attendance (85%). No training-related severe adverse events occurred. The target training intensity was achieved by 70% of the participants. Patient satisfaction was high. HbA(1c) decreased from 8.2% before to 7.8% after the programme (P=0.005), muscle strength increased from 136.4 to 150.4 Nm (P = 0.046) and perceived limitations in functioning decreased from 7.2 to 5.8 mm (P=0.003). CONCLUSIONS The prescribed exercise programme had a potentially positive effect on blood glucose regulation, muscle strength and perceived limitations in functioning in patients with diabetic complications.
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Affiliation(s)
- N M Otterman
- Department of Rehabilitation, Academic Medical Center Amsterdam, University of Amsterdam, Amsterdam, the Netherlands.
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