scholarly journals Preliminary efficacy and feasibility of referral to exercise specialists, psychologists and provision of a technology-based behavior change support package to promote physical activity in school teachers ‘at risk' of, or diagnosed with, type 2 diabetes: The ‘SMART Health’ Pilot Study Protocol

2019 ◽  
Vol 78 ◽  
pp. 53-62
Author(s):  
Maria L. Murphy ◽  
David R. Lubans ◽  
Kristen E. Cohen ◽  
Sara L. Robards ◽  
Magdalena Wilczynska ◽  
...  
2021 ◽  
Vol 11 (22) ◽  
pp. 11046
Author(s):  
Han-Hung Huang ◽  
Brianna Gathright ◽  
Rachel Holik ◽  
Hannah Iverson ◽  
Emily Saville ◽  
...  

The objective of this study was to assess the effects of an active video game (AVG) program in physiological parameters, fitness levels, motivation to physical activity, and quality of life on people with type 2 diabetes (T2D). Eight T2D patients participated in the 8-week AVG program using Xbox Kinect and/or Nintendo Wii. Heart rate (HR) and rating of perceived exertion (RPE) were monitored during exercise. Physiological and fitness assessment included hemoglobin A1C (HbA1c), HR, blood pressure (BP), body mass index, body composition, aerobic and muscular endurance, muscular strength, and flexibility. Psychological outcome measures included the Physical Activity Measure-Revised (MPAM-R), Situational Motivation Scale (SIMS), and World Health Organization Quality of Life (WHOQOL)-BREF. Participants demonstrated a moderate level of exercise intensity during AVG based on average HR and RPE. HbA1c, BP, and lower extremity muscle strength were improved, but were not statistically significant. The changes on psychological assessment were not significant. However, most participants demonstrated positive behavior and attitudes toward health and physical activity at one-month follow-up. This pilot study demonstrated that the AVG program might be an effective and alternative way of exercise for people with T2D. A future RCT is warranted to determine the physical and psychological effects of AVG on T2D population.


2016 ◽  
Vol 85 (2) ◽  
pp. 26-28
Author(s):  
Andrew D Hanna ◽  
Natalie V Scime

Global rates of type 2 diabetes (T2D) among children and adolescents are steadily rising. As such, an increasing amount of attention and research has begun to focus on strategies to prevent this chronic and burdensome disease in pediatric populations. The purpose of this article is to briefly review current evidence pertaining to the effectiveness of physical activity versus metformin in improving insulin sensitivity of children at-risk (ie, obese and/or insulin resistant) for developing T2D. Potential barriers to each preventative intervention will also be discussed. Physical activity, both aerobic and resistance, has demonstrated effectiveness in a moderate number of demographically diverse pediatric studies. However, the pediatric population is already alarmingly sedentary with barriers such as lack of motivation, social stigma and discomfort presenting a challenge. A small number of studies have demonstrated the beneficial effects of metformin in children and adolescents for improved insulin sensitivity. However, longer and larger studies are required to confirm these findings and elucidate upon the long-term safety and efficacy of this pharmaceutical in pediatric populations. While no head-to-head studies examining physical activity and metformin exist in pediatric populations and more research is needed, current evidence seems to favour the use of physical activity given the larger quantity of studies and generalizability of its beneficial effects. Thus, physical activity should be emphasized in clinical and public health practice when targeting at-risk children and adolescents to prevent a T2D diagnosis.


2017 ◽  
Author(s):  
James Weatherall ◽  
Yurek Paprocki ◽  
Theresa M Meyer ◽  
Ian Kudel ◽  
Edward A Witt

BACKGROUND Few studies assessing the correlation between patient-reported outcomes and patient-generated health data from wearable devices exist. OBJECTIVE The aim of this study was to determine the direction and magnitude of associations between patient-generated health data (from the Fitbit Charge HR) and patient-reported outcomes for sleep patterns and physical activity in patients with type 2 diabetes mellitus (T2DM). METHODS This was a pilot study conducted with adults diagnosed with T2DM (n=86). All participants wore a Fitbit Charge HR for 14 consecutive days and completed internet-based surveys at 3 time points: day 1, day 7, and day 14. Patient-generated health data included minutes asleep and number of steps taken. Questionnaires assessed the number of days of exercise and nights of sleep problems per week. Means and SDs were calculated for all data, and Pearson correlations were used to examine associations between patient-reported outcomes and patient-generated health data. All respondents provided informed consent before participating. RESULTS The participants were predominantly middle-aged (mean 54.3, SD 13.3 years), white (80/86, 93%), and female (50/86, 58%). Use of oral T2DM medication correlated with the number of mean steps taken (r=.35, P=.001), whereas being unaware of the glycated hemoglobin level correlated with the number of minutes asleep (r=−.24, P=.04). On the basis of the Fitbit data, participants walked an average of 4955 steps and slept 6.7 hours per day. They self-reported an average of 2.0 days of exercise and 2.3 nights of sleep problems per week. The association between the number of days exercised and steps walked was strong (r=.60, P<.001), whereas the association between the number of troubled sleep nights and minutes asleep was weaker (r=.28, P=.02). CONCLUSIONS Fitbit and patient-reported data were positively associated for physical activity as well as sleep, with the former more strongly correlated than the latter. As extensive patient monitoring can guide clinical decisions regarding T2DM therapy, passive, objective data collection through wearables could potentially enhance patient care, resulting in better patient-reported outcomes.


SLEEP ◽  
2012 ◽  
Vol 35 (7) ◽  
pp. 977-984 ◽  
Author(s):  
Lindsay E. Bromley ◽  
John N. Booth ◽  
Jennifer M. Kilkus ◽  
Jacqueline G. Imperial ◽  
Plamen D. Penev

2008 ◽  
Vol 88 (11) ◽  
pp. 1355-1364 ◽  
Author(s):  
Chiao-Nan Chen ◽  
Lee-Ming Chuang ◽  
Ying-Tai Wu

Background and Purpose Physical inactivity has been well documented as a risk factor for type 2 diabetes. Previous studies measured the level of physical activity either with questionnaires or with direct measurements of maximum oxygen uptake. However, questionnaires are patient-report measures, and methods for obtaining direct maximum oxygen uptake measurements often are not available clinically. The purpose of this study was to investigate whether clinical measurement of health-related physical fitness with a simple test battery can predict insulin resistance, a precursor of type 2 diabetes, in people at risk for diabetes. Subjects and Methods A total of 151 volunteers with at least one diabetes risk factor (overweight, hypertension, dyslipidemia, family history, impaired glucose tolerance, gestational diabetes, or delivering a baby weighing more than 4.0 kg) were recruited. Insulin resistance (as determined with the homeostasis model assessment of insulin resistance [HOMA-IR]), physical fitness (including body composition, as determined with the body mass index and waist circumference), muscle strength (handgrip strength [force-generating capacity]), muscle endurance (sit-up test), flexibility (sit-and-reach test), and cardiorespiratory endurance (step test) were measured, and a physical activity questionnaire was administered. Backward regression analysis was used to build the prediction models for insulin resistance from components of physical fitness and physical activity. Results Body mass index, muscle strength, and cardiorespiratory fitness predicted HOMA-IR in men (adjusted R2=.264). In women, age, waist circumference, and cardiorespiratory fitness were the predictors of HOMA-IR (adjusted R2=.438). Discussion and Conclusion Clinical measures of physical fitness can predict insulin resistance in people at risk for diabetes. The findings support the validity of clinical measures of physical fitness for predicting insulin resistance in people at risk for diabetes.


Folia Medica ◽  
2013 ◽  
Vol 55 (2) ◽  
pp. 33-42 ◽  
Author(s):  
Theodora Temelkova-Kurktschiev ◽  
Tsvetan Stefanov ◽  
Carsta Koehler ◽  
Elena Henkel ◽  
Frank Schaper ◽  
...  

ABSTRACT AIM: To examine the relationship between physical activity (PA) and various cardiometabolic risk factors during an oral glucose tolerance test (OGTT), including glycemic spikes (PGS) in individuals at risk for type 2 diabetes. SUBJECTS AND METHODS: A total of 949 middle-aged subjects from the Risk factors in Impaired Glucose Tolerance for Atherosclerosis and Diabetes (RIAD) trial aged 40-70 years were included in the present cross-sectional analysis. Standard 75 g OGTT was performed and blood was collected every 30 min for 2 hours for measurements of plasma glucose (PG) and other cardiometabolic risk factors. PA was assessed using interviewer-administered questionnaire. RESULTS: Post-challenge PGS and maximal PG (PGmax) during OGTT were significantly lower in individuals with high PA vs. individuals with low PA even after body mass index (BMI) adjustment (p = 0.026 and p = 0.035, respectively). In univariate analysis post-challenge PG 30, 60, 90, and 120 minutes, PGS and PGmax during OGTT were significantly inversely correlated to PA. This correlation was attenuated but remained significant after adjustment for BMI. Fasting PG and glycosylated hemoglobin were not correlated to PA. Significantly higher fasting and post-challenge insulin levels were found among subjects with low vs. subjects with medium (p < 0.05) and high PA (p < 0.05). Post-challenge C-peptide and proinsulin levels were significantly lower in participants with high vs. participants with low PA (p < 0.05 for all). The relationship between 2-h PG and PA was observed also in lean subjects and in subjects with normal fasting glucose. In multivariate analysis PA was a significant independent determinant of 2-h PG. CONCLUSION: We found a strong inverse relationship between PA and various post-challenge cardiometabolic parameters during OGTT, including glycemic spikes, in a population at risk for diabetes. This relationship was only partially dependent on BMI.


2019 ◽  
Vol 16 (12) ◽  
pp. 1105-1112 ◽  
Author(s):  
Nele Huys ◽  
Vicky Van Stappen ◽  
Samyah Shadid ◽  
Marieke De Craemer ◽  
Odysseas Androutsos ◽  
...  

Background: This study aimed to investigate whether the relationship between psychosocial and perceived environmental factors and physical activity (PA) in adults at risk for type 2 diabetes is influenced by educational level. Methods: Based on the Finnish Diabetes Risk Score questionnaire, this study selected 164 adults (Mage: 38 (5.34) y, 13.4% men) at type 2 diabetes risk from 11 low socioeconomic neighborhoods in Flanders (Belgium). Participants filled out questionnaires on psychosocial and perceived environmental factors and wore an ActiGraph accelerometer for 5 consecutive days. Statistical analyses were performed using analysis of covariance in SPSS. Results: Educational level significantly influenced the association between perception of body weight and light PA (P = .01) and total PA (P = .03) on weekend days. Educational level did not influence the associations between other psychosocial and perceived environmental factors (ie, perceived social influence; environmental, time and attitudinal barriers, perceived self-efficacy; knowledge and fatalism) and PA. Conclusions: Educational level did not influence the relationship between most psychosocial and perceived environmental factors and PA in this sample of adults at type 2 diabetes risk. This suggests that addressing different psychosocial and perceived environmental correlates in lower and higher educated participants might not be necessary. However, more research in this specific population is needed.


2021 ◽  
Author(s):  
Fabio Araujo Almeida ◽  
Wen You ◽  
Fabiana Almeida Brito ◽  
Thais Favero Alves ◽  
Cody L Goessl ◽  
...  

BACKGROUND Lifestyle interventions targeting physical activity and improved eating habits have demonstrated that modest weight loss can prevent or delay the onset of type-2 diabetes. However, translation of these interventions into typical clinical programs remains a challenge. OBJECTIVE To evaluate the effectiveness of two technology-enhanced interventions for diabetes prevention among adults at risk for developing diabetes in a primary care setting. METHODS The DiaBEAT-it study employed a hybrid 2-group preference (Choice) and 3-group randomized controlled (RCT) design. This paper presents the weight related primary outcomes of the RCT arm. Patients from Southwest Virginia were identified through the Carilion Clinic electronic health records. Eligible participants (18 and older, BMI≥25, no Type 2 Diabetes) were randomized to either Choice (n=264) or RCT (n=334). RCT individuals were further randomized to one of three groups: (1) a 2-hour small group class to help patients develop a personal action plan to prevent diabetes (SC, n=117); (2) a 2-hour small group class plus automated telephone calls using an interactive voice response system (IVR) to help participants initiate weight loss through a healthful diet and regular physical activity (Class/IVR, n=110); or (3) a DVD with same content as the class plus the same IVR calls over a period of 12 months (DVD/IVR, n=107). Height was assessed with a calibrated stadiometer, weight with a calibrated Health-O-Meter stand-on scale. RESULTS Intention to treat analyses, controlling for gender, race, age and baseline BMI, showed that DVD/IVR and Class/IVR led to reductions in BMI at 6 (DVD/IVR -0.94, p<.001; Class/IVR -0.70, p<.01), 12 (DVD/IVR -0.88, p<.001; Class/IVR-0.82, p<.001) and 18 (DVD/IVR -0.78, p<.001; Class/IVR -0.58, p<.01) months. All three groups showed a significant number of participants losing at least 5% of their body weight at 12 months (DVD/IVR 26.87%; Class/IVR 21.62%; SC 16.85%). When comparing groups, DVD/IVR were significantly more likely to decrease BMI at 6 months (p<.05) and maintain the reduction at 18 months (p<.05) when compared to SC. There were no differences between the other groups. CONCLUSIONS These findings suggest that both IVR delivered interventions were effective in reducing and maintaining weight reduction in a group of primary care patients at risk for developing type 2 diabetes. The DiaBEAT-it interventions show promise in responding to the need for scalable, effective methods to manage obesity and prevent diabetes in primary care settings that do not over burden primary care clinics and providers. CLINICALTRIAL clinicaltrials.gov NCT02162901, https://clinicaltrials.gov/ct2/show/NCT02162901 INTERNATIONAL REGISTERED REPORT RR2-doi: 10.1016/j.cct.2014.06.010


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