The Association between time spent in performing physical activity and physical function in outpatients with type 2 diabetes who may have diabetic neuropathy

AimsTo determine the relationship between physical activity time and physical function according to the Japanese Clinical Practice Guideline for Diabetes, which recommended 150 min of activity for outpatients with type 2 diabetes who may have diabetic neuropathy.MethodsWe examined a cross-sectional study with 79 outpatients with Type 2 diabetes participated. A short version, Japanese language edition of the International Physical Activity Questionnaire (IPAQ) was used to evaluate physical activity. Isometric knee extensor strength, grip strength, maximum 10-m walking speed, the Michigan Neuropathy Screening Instrument score, and the Short Physical Performance Battery (SPPB). Each evaluation item was compared between time spent performing physical activity ≥150 min group and <150 min group, and multiple regression analysis was performed to determine the factors associated with time spent performing physical activity. Further, the correlation between time spent performing physical activity and isometric knee extensor strength was examined.ResultsThe ≥150 min group had significantly higher isometric knee extensor strength than the <150 min group. In addition, the ≥150 min group had significantly faster maximum 10-m walking speed and sit-to-stand time than the <150 min group. Isometric knee extensor strength was determined to be an independent factor associated with the IPAQ score. A positive correlation was found between the IPAQ score and isometric knee extensor strength.ConclusionsAmong the patients with type 2 diabetes who may have diabetic neuropathy, those who performed physical activity for ≥150 min per week were suggested to have higher physical function than those with <150 min of activity.     

Application of health concern and activity model on cognition in the elderly

The aim of this study was to examine the effects of physical, mental, social activity, and health concern on cognition in the elderly by means of the health concern and activity (HCA) model. Data were obtained from 3157 subjects aged 60 years and above. The subjects were divided into four groups according to the HCA model. Cognitive function was assessed by the Korean version of the mini-mental state examination (K-MMSE). A cross-sectional, factorial design was used in which the K-MMSE score was the dependent variable, with physical, mental, and social activity as one factor and health concern as the other. Analysis of covariance revealed significant differences in the K-MMSE score between all four groups after adjusting for age, sex, education, current smoking, and alcohol consumption for all subjects. The results suggest that having health concerns as well as physical, mental, or social activity is associated with cognitive function in the elderly.     

我国血吸虫病消除阶段健康教育与健康促进面临的挑战及对策

健康教育与健康促进是我国血吸虫病综合防控的重要措施之一,可提高流行区居民参与血防工作的依从性,有效避免或减少人群血吸虫感染。近年来,我国血吸虫病综合防控成效显著,已实现了传播控制目标,正向传播阻断乃至消除目标迈进。本文就健康教育与健康促进在我国血吸虫病防控中的作用及当前面临的挑战进行了分析,并就如何在消除阶段推进血吸虫病健康教育与健康促进工作提出针对性建议。     

Review of general suggestions on physical activity to prevent and treat gestational and pre-existing diabetes during pregnancy and in postpartum

The aim of this review is to provide general suggestions on physical activity (PA) in pre-gestational and gestational diabetes mellitus (GDM) and encourage women to take part in safe and effective activities throughout pregnancy, in the absence of other contraindications. PA before and during pregnancy and in postpartum has many positive effects on the mother, as it could reduce the risk of GDM, excessive weight gain and lower back pain and also prevents, in the postpartum, diabetes mellitus. It may also reduce the duration of labour and complications at childbirth, fatigue, stress, anxiety and depression, thereby leading to an improved sense of wellbeing. Clinically, it is thought to help prevent preeclampsia and premature birth even though RCTs provide conflicting evidence with regard to the prevention of GDM. The main reason for this rests on the fact that the majority of clinical trials have not been able to replicate the preventive effect of PA on the onset of GDM, such as the different adherence of the patient to PA. Herein, we survey the literature regarding exercise and PA on GDM prevention and treatment as well as on clinical outcomes in pre-GDM in pregnancy. On the basis of the current literature, we also present a series of general recommendations and suggestions on PA and exercise training in pregnancy among both diabetic patients and those at risk for GDM.     

Differences and similarities of physical activity determinants between older adults who have and have not experienced a fall: Testing an extended health belief model

PurposeExperiencing a fall can be a detrimental experience for older adults and may affect an individual’s beliefs about participating in future physical activity (PA) behavior. The purpose of this study was to identify if determinants of PA differ between older adults who have a history of a fall (HF) and those with no history of a fall (NHF) within the Health Belief Model (HBM), expanded through the constructs of intention and habit.Materials and MethodsParticipants (N = 667) were community-dwelling older adults who completed online measures of original HBM determinants (beliefs, barriers, self-efficacy, cues, and perceived threat variables) related to participating in PA in addition to past PA behavior and intention.ResultsNovel findings include perceived barriers significantly predicted intention to participate in PA among those with a HF but not among those with NHF, and past PA behavior predicted decreased perceived threat of falling among both groups. The model also supported cues to predict physical activity habit.ConclusionsPerceived barriers (time constraints and bodily pain) deterred PA intentions among those with a HF, suggesting the importance of intervention planning to reduce/resolve these barriers for this group. Past PA was negatively associated with perceived threat of falling, which signposts the importance of providing a safe environment for older adults to engage in PA. The study also provides formative notes for interpreting and further investigating perceived threat and its antecedents (susceptibility and seriousness) in addition to cues, which generally have been omitted in previous studies that employ the HBM.     

Effects of a 12-month physical activity counselling intervention on glycaemic control and on the status of cardiovascular risk factors in people with Type 2 diabetes

Aims/hypothesis The aim of this study was to investigate the effectiveness of physical activity counselling in promoting physical activity in people with Type 2 diabetes and to evaluate resultant physiological and biochemical effects.Methods A total of 70 inactive people with Type 2 diabetes were given standard exercise information and randomised to receive physical activity counselling (n=35, experimental) or not (n=35, control). Physical activity consultations were delivered at baseline and after 6 months, with follow-up phone calls after 1, 3, 6 and 9 months. Changes from baseline after 6 and 12 months were assessed for physical activity (7-day recall and accelerometer), for physiological characteristics (body mass index and blood pressure) and for biochemical variables (HbA₁c, lipid profile, fibrinogen, tissue plasminogen activator and microalbuminuria).Results Significant differences between groups were recorded for physical activity after 6 and 12 months (p<0.01). The experimental group had increased levels of physical activity from baseline to 6 months (p<0.01), with no decrease from 6 to 12 months (p>0.05). In the control group, accelerometer counts per week decreased from baseline to 12 months (p=0.03). Between-group differences (p<0.05) were recorded for the change in HbA₁c (experimental: 0.26% decrease; control: 0.15% increase), for systolic blood pressure (experimental: 7.7 mm Hg decrease; control: 5.6 mm Hg increase) and for fibrinogen (experimental: 0.28 mmol/l decrease; control: 1.43 mmol/l increase) from baseline to 6 months, and for total cholesterol (experimental: 0.33 mmol/l decrease; control: 0.04 mmol/l increase) from baseline to 12 months (p<0.05). No significant differences were recorded in other measured variables.Conclusions/interpretations Physical activity counselling was effective in promoting physical activity in people with Type 2 diabetes. The counselling improved glycaemic control as well as the status of cardiovascular risk factors in these patients.Abbreviations CSA Computer Science and Applications - t-PA tissue plasminogen activator antigen - UKPDS United Kingdom Prospective Diabetes Study     

Impacts of self-management education on glycaemic control in patients with type 2 diabetes mellitus

Objectives

Dietary and physical activity advice have been considered to be seminal ingredients in prevention and management of type 2 diabetes mellitus. In this regard, the impacts of a three-month self-management intervention on glycemic control in patients with type 2 diabetes were examined in the present study.

Effect of educational intervention based on PRECEDE-PROCEED model combined with self-management theory on self-care behaviors in type 2 diabetic patients

Aims

Diabetes mellitus is a chronic and progressive disease which requires ongoing medical care as well as patient’s self-care skills to prevent acute complications. The purpose of this study is to determine the effect of the PRECEDE-PROCEED model combined with self-management theory on self-care behaviors in type 2 diabetic patients.

离退休干部体格检查结果分析及健康教育对策

目的总结离退休干部体格检查资料,分析其疾病谱,探讨相应健康教育对策,以期干预其疾病发展。方法采用相应检测方法进行检番,统计2007年体格检查结果的前10位疾病检出情况以及恶性肿瘤检出情况。结果本次体检1411例离退休干部患病种类22种,总患病例数为6053例次,排在前6位的患病率依次为前列腺增生74％,甲状腺结节68％,高血压58％,高血脂52％,脂肪肝33％,冠心病27％。结论离退休干部的患病率处于较高的水平,采用适当的健康教育方法有助于降低患病率,以期延年益寿。     

Trends in leisure time physical activity,smoking, body mass index and alcohol consumption in Danish adults with and without diabetes: A repeat cross-sectional national survey covering the years 2000 to 2010

Aims

In recent decades there has been an increased focus on non-pharmacological treatment of diabetes. The aim of this study was to investigate trends in leisure time physical activity (PA), smoking, body mass index (BMI), and alcohol consumption reported in 2000, 2005 and 2010 by Danish subjects with diabetes.

Methods

Data comprised level of leisure time PA (inactive; moderate active; medium active; high active); smoking; BMI; and alcohol consumption, provided by The Danish Health and Morbidity Surveys. Participants older than 45 years with or without diabetes were included from cross-sectional analyses from 2000, 2005 and 2010.

Results

In participants with diabetes, leisure time PA levels increased from 2000 to 2010: The percentage of those that were physically active increased from 53.5% to 78.2% (p < 0.001; women) and from 67.8% to 79.1% (p = 0.01; men). The prevalence of daily smokers was reduced from 27.2% to 16.4%, p = 0.015, in women with diabetes. In men with diabetes, BMI increased from 27.2 ± 4.0 to 28.6 ± 5.1 kg m⁻², p = 0.003, and men who exceeded the maximum recommendation for alcohol consumption increased from 9.4% to 19.0%, p = 0.007. The leisure time PA level was reduced in participants with diabetes compared to participants without diabetes throughout the study.

Conclusions

The percentage of physically active Danish participants older than 45 years with diabetes increased from 2000 to 2010, and the most beneficial trends in life style were observed among the women. These trends may have serious implications for cardiovascular risk in Danish patients with diabetes.     

基因、体力活动及其交互作用与2型糖尿病

2型糖尿病是目前威胁人类健康,发病率迅速增长的疾病之一.2007年以来,全基因组关联分析研究发现一系列包括SLC30A8、LOC387761、IDE-KIF11-HHEX和EXT2-ALX4等新的糖尿病基因.基因及体力活动不足与2型糖尿病患病风险相关,且两个因素可能有交互影响,本文就基因、体力活动及其交互作用与2型糖尿病间的关系作一综述.     

一种新型的艾滋病健康促进活动模式

在艾滋病健康促进行动中,策划、运用了一种新型模式。组织构架 以卫生防疫站与政府机关报构成联合主体,辅以支持性、协作性机构。组织策略 充分取得各级领导的支持、专家的帮助和积极分子的参与。组织艺术 既体现政策性、科学性、密集性,又体现人性、爱心。传播手段 以报纸为主,辅以电视、电话、网络。行动内容 全方位,多角度。行动对象既有“面”（普通大众）,又有“点”（中学生）。行动时间 持续半个月。该模式的运作收到了卫生防疫站、报社和群众“三赢”的效果。     

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

AimTo examine the association between leisure time physical activity (LTPA) and metabolic control, in adults with diabetes mellitus (DM).MethodsA cross-sectional study was conducted in two hospitals (Santiago, Chile) with 101 type 1 (mean 34.4 ± 12.3 years) and 100 type 2 DM (mean 57.8 ± 5.2 years) adults. Glycated hemoglobin level (A1C) was obtained, and LTPA levels were estimated through the Global Physical Activity Questionnaire.Multiple linear regression models were fitted evaluating the independent effect of LTPA, sociodemographic, cardiovascular risk factors and other types of physical activity (PA) on metabolic control.ResultsDM participants which reported no LTPA had higher levels of A1C (type 1 mean A1C: 8.8 ± 1.5% and type 2 mean A1C: 9.2 ± 1.4%) compared to those who fulfilled PA recommendations of ≥150 min/week (type 1 mean A1C: 8.0 ± 1.6% and type 2 mean A1C: 8.1 ± 1.4%).Regression analysis showed that A1C levels were negatively associated with ≥150 min/week on LTPA in type 1 (b = ?0.25; 95%CI ?0.16 to ?0.01) and type 2 DM (b = ?0.24; 95%CI ?0.29 to ?0.02) participants.ConclusionLeisure time physical activity may be considered as an efficient and inexpensive non-pharmacological tool for DM treatment. Hence, healthcare professionals should educate and promote PA since primary-care diagnosis in addition to prevent disease-related complications.     

A structural equation model of the relation between socioeconomic status,physical activity level,independence and health status in older Iranian people

Background and aimHealth status is an independent predictor of mortality, morbidity and functioning in older people. The present study was designed to evaluate the link between socioeconomic status (SES), physical activity (PA), independence (I) and the health status (HS) of older people in Iran, using structural equation modelling.MethodsUsing computerized randomly selection, a representative sample of 851 75-year-olds living in Tehran (2007–2008), Iran, was included. Participants answered questions regarding indicators of HS, SES and also PA and I through interviews. Both measurement and conceptual models of our hypotheses were tested using Mplus 5. Maximum-likelihood estimation with robust standard errors (MLR estimator), chi-square tests, the goodness of fit index (and degrees of freedom), as well as the Comparative Fit Index (CFI), and the Root Mean Square Error of Approximation (RSMEA) were used to evaluate the model fit.ResultsThe measurement model yielded a reasonable fit to the data, χ2 = 110.93, df = 38; CFI = 0.97; RMSEA = 0.047, with 90% C.I. = 0.037–0.058. The model fit for the conceptual model was acceptable; χ2 = 271.64, df = 39; CFI = 0.91; RMSEA = 0.084, with 90% C.I. = 0.074–0.093. SES itself was not a direct predictor of HS (β = 0.13, p = 0.059) but it was a predictor of HS either through affecting PA (β = 0.31, p < 0.001) or I (β = 0.57, p < 0.001).ConclusionSocioeconomic status appeared to influence health status, not directly but through mediating some behavioral and self-confidence aspects including physical activity and independence in ADL.     

我国棘球蚴病防治工作中健康素养提升策略之探讨

本文分析了我国棘球蚴病主要流行区健康教育与健康促进工作最新进展,指出当前流行区内人群棘球蚴病防治知识匮乏、居民健康素养水平较低、健康促进工作模式尚未完全建立、实现全民健康目标亟需努力的现状。同时,根据《“健康中国2030”规划纲要》,探讨了现阶段棘球蚴病健康促进工作需紧密结合全民健康素养提升战略要求的可行措施与策略。     

Effect of tele-rehabilitation on glucose control,exercise capacity,physical fitness,muscle strength and psychosocial status in patients with type 2 diabetes: A double blind randomized controlled trial

AimTo determine the effect of a tele-rehabilitation (TR) program on glucose control, exercise capacity, physical fitness, muscle strength and psychosocial status in patients with type 2 diabetes mellitus (DM).MethodFifty type 2 DM participants were enrolled in the study and divided randomly into two groups; TR (n = 25, mean age: 52.82 ± 11.86) or control (n = 25, mean age: 53.04 ± 10.45) group. Participants in the TR group performed breathing and callisthenic exercises, three times a week, for 6 weeks, at home by internet based video conferences. Outcome measures including, HbA1c level, 6 min walk testing, physical fitness and muscle strength dynamometer measurement, Beck Depression Inventory were performed before and after the 6 weeks.ResultsHbA1c (p = 0.00), 6 min walking distance (p = 0.00), physical fitness subparameters; sit-up (p = 0.00), sit-and-reach (p = 0.04), back scratch (p = 0.00), lateral flexion right (p = 0.04), left (p = 0.00) and time up go tests (p = 0.00), muscles strength (p = 0.00); deltoideus-anterior, middle, quadriceps femoris and gluteus maximus, and depression levels (p = 0.00) changed significantly (p = 0.00) in TR groups. There were no significant improvements in control group (p > 0.05).ConclusionOur findings suggest that TR interventions found to be safe and effective, and may be an alternative treatment model for type 2 DM management. In addition to these health benefits, patients and rehabilitation team may save time, labor and treatment costs by using TR.     

Lower objectively measured physical activity is linked with perceived risk of hypoglycemia in type 1 diabetes

Aims

Compare physical activity (PA) levels in adults with and without type 1 diabetes and identify diabetes-specific barriers to PA.

Assessment of energy expenditure using doubly labeled water,physical activity by accelerometer and reported dietary intake in Japanese men with type 2 diabetes: A preliminary study

The aim of the present study was to determine the total energy expenditure, physical activity and dietary intake of men with type 2 diabetes mellitus and control participants without type 2 diabetes mellitus who were matched for age and body mass index. The participants in the present study were 12 well‐controlled type 2 diabetes mellitus patients and 10 controls, aged 40–75 years, with a body mass index <30 kg/m². Total energy expenditure under free‐living conditions was assessed using the doubly labeled water method, and physical activity was measured using a triaxial accelerometer. Dietary intake was assessed using a self‐recorded food intake diary during the measurement period. Participants were instructed to record their dietary intake over 3 days, including 2 weekdays. Total energy expenditure was not significantly different between the groups (P = 0.153), nor were energy (P = 0.969) or macronutrient intakes. In conclusion, when age and body mass index are matched, total energy expenditure and self‐reported energy intake are not significantly different between type 2 diabetes mellitus patients and healthy controls.     

Irisin levels are associated with urotensin II levels in diabetic patients

Aims/Introduction

Irisin is a newly identified myokine that can promote energy expenditure. Previous studies showed that circulating urotensin II (UII) levels were increased in diabetes, and UII could inhibit the glucose transport in skeletal muscle in diabetic mice and aggravated insulin resistance. We presumed that irisin levels are associated with UII in diabetic patients.

Materials and Methods

A total of 71 patients with type 2 diabetes and 40 healthy subjects were recruited. Blood and urinary irisin concentrations were measured by using enzyme-linked immunosorbent assay, and UII concentrations were measured by bioelectrical impedance analysis. Every participant''s body composition was analyzed by bioelectrical impedance.

Results

The serum irisin levels were significantly lower in diabetic patients than that of controls, whereas serum UII levels were significantly higher in diabetic patients than that in that of controls. Serum irisin levels were negatively associated with circulating UII, hemoglobin A1c and the natural logarithm transformation of urinary albumin excretion, whereas serum irisin was positively associated with estimated glomerular filtration rate, and low-density lipoprotein cholesterol and urinary irisin were positively associated with urinary UII. Furthermore, circulating irisin is positively associated with muscle mass, whereas circulating UII is negatively associated with muscle mass in diabetic patients. Hemoglobin A1c and circulating UII are independent determinants of circulating irisin by multiple regression analysis.

Conclusions

The present results provide the clinical evidence of an association between irisin and UII in diabetic patients. Hemoglobin A1c and circulating UII are independent determinants of circulating irisin. Our results hint that UII and high glucose might inhibit the release of irisin from skeletal muscle in diabetic patients.     

Leisure time physical activity and the risk of type 2 diabetes in men and women from the general population

Aims/hypothesis The aim of this study was to examine sex-specific associations between leisure time physical activity and incident type 2 diabetes in a representative population sample in Germany.Methods The study was based on 4,069 men and 4,034 women (aged 25 to 74 years) who participated in one of the three MONICA Augsburg surveys between 1984 and 1995. Subjects were free of diabetes at baseline. Incident cases of type 2 diabetes were assessed in 1998 using a follow-up questionnaire. Sex-specific hazard ratios (HRs) were estimated from Cox proportional hazard models.Results A total of 145 cases of incident type 2 diabetes among men and 82 among women were registered during the mean follow-up period of 7.4 years. In both sexes, a high leisure time physical activity level was associated with a reduced risk of incident type 2 diabetes. After adjustment for confounding factors, the HR in highly active men (more than 2 h physical activity per week in summer and winter) was 0.83 (95% CI: 0.50–1.36). In contrast, highly active women had the lowest risk of type 2 diabetes even after multivariable adjustment (HR 0.24; 95% CI: 0.06–0.98). In subgroup analyses, after multivariable adjustment, the protective effect of moderate to high physical activity was significant in women with a BMI below 30 kg/m² (HR 0.24; 95% CI: 0.09–0.65) but not in women with a BMI of 30 kg/m² or higher (HR 0.97; 95% CI: 0.44–2.11).Conclusions/interpretation Leisure time physical activity is effective in preventing type 2 diabetes, especially in nonobese women, in the general population.