All-cause and cardiovascular mortality risk in U.S. adults with and without type 2 diabetes: Influence of physical activity, pharmacological treatment and glycemic control

2014 ◽  
Vol 28 (3) ◽  
pp. 311-315 ◽  
Author(s):  
Ruth E. Brown ◽  
Michael C. Riddell ◽  
Alison K. Macpherson ◽  
Karissa L. Canning ◽  
Jennifer L. Kuk
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Mortality Risk ◽  
Cardiovascular Mortality ◽  
Pharmacological Treatment ◽  
Cardiovascular Mortality Risk

Psychometric Properties of the Korean Version of the Perceived Therapeutic Efficacy Scale for Physical Activity in Adults With Type 2 Diabetes

2021 ◽  
pp. 263501062110586
Author(s):  
Moonsun Kim ◽  
Chun-Ja Kim ◽  
Dae Jung Kim ◽  
Elizabeth A. Schlenk
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Factor Analysis ◽  
Glycemic Control ◽  
Confirmatory Factor Analysis ◽  
Therapeutic Efficacy ◽  
Cronbach’S Alpha ◽  
Cronbach's Alpha ◽  
Confirmatory Factor

Purpose: The purpose of this study is to translate the Perceived Therapeutic Efficacy Scale (PTES) into Korean and investigate its validity and reliability. Methods: The authors conducted a cross-sectional survey using baseline data from a randomized controlled study to psychometrically validate the PTES-Korean (PTES-K) among 108 adults with type 2 diabetes from an outpatient clinic at a university-affiliated hospital in Korea. The original PTES was forward-translated and back-translated to ensure translation equivalence of the PTES-K. Structured questionnaires were used for psychometric evaluation; exploratory and confirmatory factor analysis assessed validity, and Cronbach’s alpha coefficient and intraclass correlation coefficient (ICC) were used for reliability. Results: The interitem correlation analyses revealed that 5 items were redundant; thus, the scale was reduced to 5 items. A 1-factor model explained 76.85% of the variance; confirmatory factor analysis showed that this model adequately fit the data. The ICC for test-retest reliability was .78; Cronbach’s alpha was .92. The PTES-K showed significant associations with the scores of diabetes self-care activities for physical activity, quality of life, and depressive symptoms. Participants with good glycemic control and regular physical activity tended to have a higher score on the PTES-K than their counterparts, demonstrating known-groups validity. Conclusions: The cross-cultural applicability, reliability, and validity of the PTES-K were confirmed. The PTES-K may be used in clinical settings to examine the potential role of perceived therapeutic efficacy for physical activity in enhanced glycemic control among patients with diabetes.

scholarly journals En Balance: The Contribution of Physical Activity to the Efficacy of Spanish Diabetes Education of Hispanic Americans with Type 2 Diabetes

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Dequina A. Nicholas ◽  
Lorena M. Salto ◽  
Kristen Lavelle ◽  
Joy Wilson ◽  
W. Lawrence Beeson ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Weight Loss ◽  
Glycemic Control ◽  
Education Program ◽  
Mexican Americans ◽  
Diabetes Education ◽  
Fasting Blood Glucose ◽  
Active Group

Purpose. En Balance, a culturally sensitive diabetes education program, improves glycemic control in Hispanics with type 2 diabetes. The program emphasized diet, physical activity, and other factors important for glycemic control. However, the individual contributions of these education factors are unclear. The purpose of this study is to assess the contribution of physical activity to the success of En Balance in improving the health of Mexican Americans with type 2 diabetes. Methods. A retrospective study was conducted with plasma samples collected pre- and post-3-month study. Samples from 58 (18 males and 40 females) Hispanic subjects with type 2 diabetes were analyzed for the concentration of kynurenines, known to decrease in response to exercise. After three months, health outcomes for the active group (decreased kynurenines) and the rest of the cohort were evaluated by paired Wilcoxon signed-rank test. Results. Half of the subjects had increased kynurenine levels at the end of the educational program. We found that the subjects in the active group with decreased kynurenine concentrations displayed statistically greater improvements in fasting blood glucose, A1C, cholesterol, and triglycerides despite weight loss being higher in the group with increased kynurenine concentrations. Conclusions. En Balance participants with decreased kynurenine levels had significantly improved glycemic control. These data suggest that physical activity significantly contributes to the success of the En Balance education program. This analysis indicates that diabetes public health educators should emphasize the benefit of physical activity on glycemic control even in the absence of major weight loss.

scholarly journals Remotely Monitored Gamification and Social Incentives to Improve Glycemic Control Among Adults With Uncontrolled Type 2 Diabetes (iDiabetes): Protocol for a Randomized Controlled Trial

10.2196/14180 ◽  
2019 ◽  
Vol 8 (11) ◽  
pp. e14180 ◽  
Author(s):  
Michael Fortunato ◽  
Joseph Harrison ◽  
Ai Leen Oon ◽  
Dylan Small ◽  
Victoria Hilbert ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Randomized Controlled Trial ◽  
Glycemic Control ◽  
Behavioral Economics ◽  
Hba1c Level ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Social Incentives

Background Type 2 diabetes is a significant cause of morbidity and mortality in the United States. Lifestyle modifications including increasing physical activity and losing weight have been demonstrated to improve glycemic control. However, most patients struggle to make these changes. Many stakeholders are interested in using gamification and social incentives to increase engagement in healthy behaviors. However, these approaches often do not appropriately leverage insights from behavioral economics that could be used to address predictable barriers to behavior change. Objective This study aimed to describe the protocol for the Influencing DIabetics to Adapt Behaviors related to Exercise and weighT by Enhancing Social incentives (iDiabetes) trial, which aimed to evaluate the effectiveness of gamification interventions that leverage insights from behavioral economics to enhance supportive, competitive, or collaborative social incentives to improve glycemic control, promote weight loss, and increase physical activity among overweight and obese adults with type 2 diabetes. Methods We are conducting a one-year four-arm randomized controlled trial of 361 overweight and obese patients with type 2 diabetes and a glycated hemoglobin (HbA1c) level ≥8.0. Wireless weight scales and wearable devices are provided to remotely monitor weight and physical activity and transmit data to the study team. Patients are recruited by email, following which they establish a baseline measure of weight, daily step count, HbA1c level, and low-density lipoprotein cholesterol level and then repeat these measures at 6 and 12 months. The control arm receives no other interventions. Patients randomized to one of the three intervention arms are entered into a game designed using insights from behavioral economics to enhance supportive, competitive, or collaborative social incentives. To examine predictors of strong or poor performance, participants completed validated questionnaires on a range of areas including their personality, risk preferences, and social network. Results Enrollment of 361 patients was completed in January 2019. Results are expected in 2020. Conclusions The iDiabetes trial represents a scalable model to remotely monitor the daily health behaviors of adults with type 2 diabetes. Results from this trial will help provide insights into how to improve management of patients with type 2 diabetes. Trial Registration ClinicalTrials.gov NCT02961192; https://clinicaltrials.gov/ct2/show/NCT02961192 International Registered Report Identifier (IRRID) DERR1-10.2196/14180

scholarly journals Muscle Strength and Glycaemic Control among Patients with Type 2 Diabetes

2020 ◽  
Author(s):  
Haya Abduhijleh ◽  
Joud Alalwani ◽  
Dana Alkhatib ◽  
Hiba Bawadi
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Muscle Strength ◽  
Glycaemic Control ◽  
Handgrip Strength ◽  
Poor Glycaemic Control ◽  
Patients With Diabetes ◽  
Insulin Use

Background: The prevalence of diabetes has been rising sharply since 1980, reaching 422 million cases worldwide in 2014. Physical activity and handgrip strength may be associated with good glycaemic control among patients with diabetes Objective: We tested the association between handgrip strength and glycemic control in type 2 diabetes patients, from National Health and Nutritional Examination Survey NHANES 2011-2014 and the contribution of the study covariates to this association. Hypothesis: Muscle strength is positively associated with glycemic control in type two diabetes. Methodology: This cross-sectional study examined the association between handgrip strength and glycaemic control among patients with diabetes. Data on 1058 participants aged 40 and older were collected from the NHANES. Muscle strength was assessed using a handgrip dynamometer, and blood samples were obtained to observe the glycaemic control values. Height, body weight, physical activity, insulin use, smoking status, alcohol use, participant demographics, and income-to-poverty ratio were all considered in the study. Results: logistic regression analysis was used to assess the association between handgrip strength and poor glycaemic control among participants with diabetes. Three models were used, each model adjusted to include different variables. OR values revealed no association between handgrip strength and glycaemic control. However, model 2, which was adjusted for sedentary activity, income-topoverty ratio, education, and smoking, shows a trend towards an association. Patients in quartile 4 of handgrip had 0.59 odds of poor glycaemic control, OR = 0.59 (95% CI: 0.34–1.02). However, in model 3 this effect was diluted when further adjusted for insulin use, OR = 0.81 (95% CI: 0.47– 1.38). Further analysis was performed to examine the mean decline in handgrip strength among non-insulin and insulin users. Non-insulin users, both men and women, have higher handgrip strength as compared to insulin users. Conclusion: There was no association found between handgrip and glycaemic control among patients with diabetes.

scholarly journals Influence of social determinants, diabetes knowledge, health behaviors, and glycemic control in type 2 diabetes: An analysis from real-world evidence

2020 ◽  
Author(s):  
Rubén Silva-Tinoco ◽  
Teresa Cuatecontzi-Xochitiotzi ◽  
Viridiana De la Torre-Saldaña ◽  
Enrique León-García ◽  
Javier Serna-Alvarado ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Glycemic Control ◽  
Mexico City ◽  
Low Income ◽  
Self Care ◽  
Diabetes Knowledge ◽  
Care Behavior

Abstract Background Although important achievements have been done in type 2 diabetes mellitus (T2D) treatment and glycemic control, new strategies may take advantage of non-pharmacological approaches and of other potential determinants of health (e.g., socioeconomic status, education, diabetes knowledge, physical activity, and self-care behavior). However, the relationships between these factors are not totally clear and have not been studied in the context of large urban settings. This study aimed to explore the relationship between these determinants of glycemic control (GC) in a low-income urban population from Mexico City, focused in exploring potential the mediation of self-care behaviors in the association between diabetes knowledge and GC.Methods A multicenter cross-sectional study was conducted in patients with type 2 diabetes (T2D) from 28 primary care outpatient centers located in Mexico City. Using multivariable-adjusted models, we determined the associations between diabetes knowledge, self-care behaviors, and GC. The mediation analyses to determine the pathways on glycemic control were done using linear regression models, where the significance of indirect effects was calculated with bootstrapping.Results The population (N=513) had a mean age of 53.8 years (standard deviation: 11.3 yrs.), and 65.9% were women. Both socioeconomic status and level of education were directly associated with diabetes knowledge. Using multivariable-adjusted linear models, we found that diabetes knowledge was associated with GC (β: -0.102, 95% Confidence Interval [95% CI] -0.189, -0.014). Diabetes knowledge was also independently associated with self-care behavior (for physical activity: β: 0.181, 95% CI 0.088, 0.273), and self-care behavior was associated with GC (for physical activity: β: -0.112, 95% CI -0.194, -0.029). The association between diabetes knowledge and GC was not observed after adjustment for self-care behaviors, especially physical activity (β: -0.084, 95% CI -0.182, 0.014, p-value: 0.062). Finally, the mediation models showed that the effect of diabetes knowledge on GC was 17% independently mediated by physical activity (p-value: 0.049). Conclusions Socioeconomic and educational gradients influence diabetes knowledge among primary care patients with type 2 diabetes. Self-care activities, particularly physical activity, mediated the effect of diabetes knowledge on GC. Our results indicate that diabetes knowledge should be reinforced in low-income T2D patients, with an emphasis on the benefits physical activity has on improving GC.

scholarly journals Determinants of Glycemic Control among Urban Patients with Type 2 Diabetes: A mediation analysis from real-world evidence

2020 ◽  
Author(s):  
Rubén Silva-Tinoco ◽  
Teresa Cuatecontzi-Xochitiotzi ◽  
Viridiana De la Torre-Saldaña ◽  
Enrique León-García ◽  
Javier Serna-Alvarado ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Low Income ◽  
Self Care ◽  
P Value ◽  
Diabetes Knowledge ◽  
Linear Regression Models ◽  
Care Behavior

Abstract Aims To explore the determinants of glycemic control (GC) among patients with type 2 diabetes (PwD) to provide insight into the pathways of the effect of diabetes knowledge on GC.Methods A multicenter cross-sectional study was conducted in PwD from 28 primary outpatient centers located in Mexico City. Using the multivariable-adjusted models, we determined the associations between diabetes knowledge, self-care behaviors, and glycemic control. The mediation analyses used linear regression models, where the significance of indirect effects was calculated with bootstrapping.Results The population (N=513) had a mean age of 53.8 years (standard deviation: 11.3 yrs.), and 65.9% were women. Using multivariable-adjusted linear models, we found that diabetes knowledge was associated with glycemic control (β: -0.102, 95% Confidence Interval [95% CI] -0.189, -0.014). Diabetes knowledge was also independently associated with self-care behavior (for physical activity: β: 0.181, 95% CI 0.088, 0.273), and self-care behavior was associated with glycemic control (for physical activity: β: -0.112, 95% CI -0.194, -0.029).The association between diabetes knowledge and glycemic control was lost after adjustment for self-care behaviors, especially physical activity (β: -0.084, 95% CI -0.182, 0.014, p -value: 0.062). Finally, the mediation models showed that the effect of diabetes knowledge on glycemic control was 17% independently mediated by physical activity ( p -value: 0.049).Conclusions Self-care activities, particularly physical activity, mediated the effect of diabetes knowledge on glycemic control. Our results indicate that diabetes knowledge should be reinforced in low-income PwD, with an emphasis on the benefits physical activity has on improving GC.

scholarly journals Empowering Patients for Healthy Nutrition, Physical Activity, and Self-Care Using the Diabetes Score Questionnaire

2021 ◽  
Vol 27 (4) ◽  
pp. 131-136
Author(s):  
Muhammad Jawad Hashim ◽  
Halla Mustafa
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Lifestyle Change ◽  
Lifestyle Factors ◽  
Health Care Center ◽  
Healthy Nutrition ◽  
Patients With Diabetes

<b><i>Objectives:</i></b> Lifestyle factors such as nutrition and physical activity play an important role in the management of diabetes mellitus. Unfortunately, adherence to lifestyle change remains low among patients with diabetes. The aim of this study was to evaluate the effectiveness of the Diabetes Score questionnaire in a clinical setting. <b><i>Methods:</i></b> The Diabetes Score is a 10-item shared decision-making tool designed to empower lifestyle change in individuals with diabetes. It yields an intuitive score from 0 to 100 based on a patient’s adherence to lifestyle recommendations. An observational study was conducted at an ambulatory health care center. After obtaining written informed consent, adult patients with type 2 diabetes mellitus were interviewed by a trained researcher using the Diabetes Score questionnaire. Patients’ Diabetes Score values were analyzed in reference to their glycemic control and other clinical and demographic factors. <b><i>Results:</i></b> A total of 60 individuals with type 2 diabetes participated in the study. The mean age was 56 years (minimum 43 years, maximum 70 years) with 60% being males. Higher Diabetes Scores correlated with better glycemic control (hemoglobin A1C; <i>r</i> = −0.23, <i>p</i> = 0.044) indicating the effect of lifestyle factors such as healthy nutrition, smaller portion sizes, active lifestyle, and aerobic exercise. The questionnaire showed internal consistency (alpha 0.66), construct validity, and high patient satisfaction (98%). <b><i>Conclusion:</i></b> Diabetes Score, a behavioral lifestyle questionnaire, correlates with glycemic control in type 2 diabetes. Diabetes Score can be used in clinical settings for measuring, discussing, and setting targets for lifestyle change among patients with diabetes.

scholarly journals Remotely Monitored Gamification and Social Incentives to Improve Glycemic Control Among Adults With Uncontrolled Type 2 Diabetes (iDiabetes): Protocol for a Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Michael Fortunato ◽  
Joseph Harrison ◽  
Ai Leen Oon ◽  
Dylan Small ◽  
Victoria Hilbert ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Randomized Controlled Trial ◽  
Glycemic Control ◽  
Behavioral Economics ◽  
Controlled Trial ◽  
The United States ◽  
Randomized Controlled ◽  
Social Incentives

BACKGROUND Type 2 diabetes is a significant cause of morbidity and mortality in the United States. Lifestyle modifications including increasing physical activity and losing weight have been demonstrated to improve glycemic control. However, most patients struggle to make these changes. Many stakeholders are interested in using gamification and social incentives to increase engagement in healthy behaviors. However, these approaches often do not appropriately leverage insights from behavioral economics that could be used to address predictable barriers to behavior change. OBJECTIVE This study aimed to describe the protocol for the <italic>Influencing DIabetics to Adapt Behaviors related to Exercise and weighT by Enhancing Social incentives</italic> (iDiabetes) trial, which aimed to evaluate the effectiveness of gamification interventions that leverage insights from behavioral economics to enhance supportive, competitive, or collaborative social incentives to improve glycemic control, promote weight loss, and increase physical activity among overweight and obese adults with type 2 diabetes. METHODS We are conducting a one-year four-arm randomized controlled trial of 361 overweight and obese patients with type 2 diabetes and a glycated hemoglobin (HbA<sub>1c</sub>) level ≥8.0. Wireless weight scales and wearable devices are provided to remotely monitor weight and physical activity and transmit data to the study team. Patients are recruited by email, following which they establish a baseline measure of weight, daily step count, HbA<sub>1c</sub> level, and low-density lipoprotein cholesterol level and then repeat these measures at 6 and 12 months. The control arm receives no other interventions. Patients randomized to one of the three intervention arms are entered into a game designed using insights from behavioral economics to enhance supportive, competitive, or collaborative social incentives. To examine predictors of strong or poor performance, participants completed validated questionnaires on a range of areas including their personality, risk preferences, and social network. RESULTS Enrollment of 361 patients was completed in January 2019. Results are expected in 2020. CONCLUSIONS The iDiabetes trial represents a scalable model to remotely monitor the daily health behaviors of adults with type 2 diabetes. Results from this trial will help provide insights into how to improve management of patients with type 2 diabetes. CLINICALTRIAL ClinicalTrials.gov NCT02961192; https://clinicaltrials.gov/ct2/show/NCT02961192

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