Epidemiological studies of exercise in diabetes prevention

2007 ◽  
Vol 32 (3) ◽  
pp. 583-595 ◽  
Author(s):  
Gang Hu ◽  
Timo A. Lakka ◽  
Tuomas O. Kilpeläinen ◽  
Jaakko Tuomilehto
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Clinical Trials ◽  
Physical Fitness ◽  
Prospective Studies ◽  
Scientific Evidence ◽  
Total Mortality ◽  
Epidemiological Studies ◽  
Glucose Levels

Type 2 diabetes is one of the fastest growing public health problems in both developed and developing countries. It is estimated that the number of people with diabetes in the world will double in coming years, from 171 million in 2000 to 366 million in 2030. Cardiovascular disease accounts for more than 70% of total mortality among patients with type 2 diabetes. The associations of physical activity, physical fitness, and changes in the lifestyle with the risk of type 2 diabetes have been assessed by a number of prospective studies and clinical trials in the past decade. Several studies have also evaluated the joint associations of physical activity, body mass index, and glucose levels with the risk of type 2 diabetes. Prospective studies and clinical trials have shown that moderate or high levels of physical activity or physical fitness and changes in the lifestyle (dietary modification and increase in physical activity) can prevent type 2 diabetes. Our review of the scientific evidence confirms that 30 min/d of moderate- or high-level physical activity is an effective and safe way to prevent type 2 diabetes in all populations.

Exercise, genetics and prevention of type 2 diabetes

2006 ◽  
Vol 42 ◽  
pp. 177-192 ◽  
Author(s):  
Gang Hu ◽  
Jesús Rico-Sanz ◽  
Timo A. Lakka ◽  
Jaakko Tuomilehto
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Clinical Trials ◽  
Physical Fitness ◽  
Prospective Studies ◽  
Dietary Modification ◽  
Glucose Levels ◽  
The Past ◽  
Joint Associations

Type 2 diabetes is one of the fastest growing public health problems in both developed and developing countries. Cardiovascular disease is the most prevalent complication of type 2 diabetes. In the past decade, the associations of physical activity, physical fitness and changes in the lifestyle with the risk of type 2 diabetes have been assessed by a number of prospective studies and clinical trials. A few studies have also evaluated the joint associations of physical activity, body mass index and glucose levels with the risk of type~2 diabetes. The results based on prospective studies and clinical trials have shown that moderate or high levels of physical activity or physical fitness and changes in the lifestyle (dietary modification and increase in physical activity) can prevent type 2 diabetes.

scholarly journals Type 2 diabetes patients’ views on prevention of hypoglycaemia – a mixed methods study investigating self-management issues and self-identified causes of hypoglycaemia

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Stijn Crutzen ◽  
Tessa van den Born-Bondt ◽  
Petra Denig ◽  
Katja Taxis
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Mixed Methods ◽  
Food Intake ◽  
Mixed Methods Study ◽  
Self Management ◽  
Hypoglycaemic Event ◽  
Glucose Levels ◽  
Management Issues

Abstract Background Hypoglycaemia is a common and potentially avoidable adverse event in people with type 2 diabetes (T2D). It can reduce quality of life, increase healthcare costs, and reduce treatment success. We investigated self-management issues associated with hypoglycaemia and self-identified causes of hypoglycaemia in these patients. Methods In this mixed methods study qualitative semi-structured interviews were performed, which informed a subsequent quantitative survey in T2D patients. All interviews were audio recorded, transcribed verbatim and coded independently by two coders using directed content analysis, guided by the Theoretical Domains Framework. Descriptive statistics were used to quantify the self-management issues and causes of hypoglycaemia collected in the survey for the respondents that had experienced at least one hypoglycaemic event in the past. Results Sixteen participants were interviewed, aged 59–84 years. Participants perceived difficulties in managing deviations from routine, and they sometimes lacked procedural knowledge to adjust medication, nutrition or physical activity to manage their glucose levels. Grief and loss of support due to the loss of a partner interfered with self-management and lead to hypoglycaemic events. Work ethic lead some participant to overexerting themselves, which in turn lead to hypoglycaemic events. The participants had difficulties preventing hypoglycaemic events, because they did not know the cause, suffered from impaired hypoglycaemia awareness and/or did not want to regularly measure their blood glucose. When they did recognise a cause, they identified issues with nutrition, physical activity, stress or medication. In total, 40% of respondents reported regular stress as an issue, 24% reported that they regularly overestimated their physical abilities, and 22% indicated they did not always know how to adjust their medication. Around 16% of patients could not always remember whether they took their medication, and 42% always took their medication at regular times. Among the 83 respondents with at least one hypoglycaemic event, common causes for hypoglycaemia mentioned were related to physical activity (67%), low food intake (52%), deviations from routine (35%) and emotional burden (28%). Accidental overuse of medication was reported by 10%. Conclusion People with T2D experience various issues with self-managing their glucose levels. This study underlines the importance of daily routine and being able to adjust medication in relation to more physical activity or less food intake as well as the ability to reduce and manage stress to prevent hypoglycaemic events.

scholarly journals Legume consumption and its association with fasting glucose, insulin resistance and type 2 diabetes in the Indian Migration Study

2016 ◽  
Vol 19 (16) ◽  
pp. 3017-3026 ◽  
Author(s):  
Preet K Dhillon ◽  
Liza Bowen ◽  
Sanjay Kinra ◽  
Ankalmadugu Venkatsubbareddy Bharathi ◽  
Sutapa Agrawal ◽  
...  
Keyword(s):  
Physical Activity ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Large Scale ◽  
Fasting Glucose ◽  
Epidemiological Studies ◽  
Model Assessment ◽  
Dietary Intakes ◽  
Migration Status

AbstractObjectiveLegume consumption is associated with lower fasting glucose (FG) and insulin levels in nutrition trials and lower CVD mortality in large-scale epidemiological studies. In India, legumes are widely consumed in various preparations, yet no epidemiological study has evaluated the association of legumes with FG levels, insulin resistance and diabetes risk. The present study aimed to fill this gap.DesignFasting blood samples, in-person interviews to obtain information on demographic/socio-economic factors, physical activity, alcohol and tobacco use, and anthropometric measurements were collected. Dietary intakes were assessed by an interviewer-administered, validated, semi-quantitative FFQ.SettingLucknow, Nagpur, Hyderabad and Bangalore, India.SubjectsMen and women (n 6367) aged 15–76 years – urban residents, urban migrants and their rural siblings.ResultsIn multivariate random-effects models adjusted for age, BMI, total energy intake, macronutrients, physical activity and rural/migration status, daily legume consumption was not associated with FG (P-for-trend=0·78), insulin resistance (homeostasis model assessment score; P-for-trend=0·73) or the prevalence of type 2 diabetes mellitus (P-for-trend=0·41). Stratified analyses by vegetarian diet and migration status did not change the findings. Inverse associations between legumes and FG emerged for participants with lower BMI and higher carbohydrate, protein, fat and sugar intakes.ConclusionsAlthough legumes are essential in traditional Indian diets, as well as in prudent and Mediterranean diets in the West, we did not find an association between legumes and markers of glycaemic control, insulin resistance or diabetes, except for subgroups based on BMI and macronutrient intake. The ubiquitous presence and complexity of legume preparations in Indian diets may contribute to these findings.

Coffee consumption and type 2 diabetes — An extensive review

Open Medicine ◽  
2008 ◽  
Vol 3 (1) ◽  
pp. 9-19 ◽  
Author(s):  
Siamak Bidel ◽  
Gang Hu ◽  
Jaakko Tuomilehto
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trials ◽  
Insulin Sensitivity ◽  
Fasting Glucose ◽  
Complex Mixture ◽  
Coffee Consumption ◽  
Epidemiological Studies ◽  
Extensive Review

AbstractCoffee is a complex mixture of potentially active chemicals. It contains significant amounts of phenolic polymers, chlorogenic acid and also caffeine. Agricultural factors, roasting, blending, and brewing determine coffee’s chemical composition. Recent epidemiological studies suggest that habitual coffee consumption may help to prevent some chronic diseases including type 2 diabetes. Despite reports from the clinical trials of the effect of caffeine on decreasing insulin sensitivity, long-term prospective studies revealed that coffee may improve fasting glucose, glucose tolerance and insulin sensitivity as well. In the most recent publication habitual coffee drinkers have a lower total and cardiovascular mortality rate among diabetic subjects.

scholarly journals Physical Activity in Relation to Cardiovascular Disease and Total Mortality Among Men With Type 2 Diabetes

Circulation ◽  
2003 ◽  
Vol 107 (19) ◽  
pp. 2435-2439 ◽  
Author(s):  
Mihaela Tanasescu ◽  
Michael F. Leitzmann ◽  
Eric B. Rimm ◽  
Frank B. Hu
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Total Mortality

scholarly journals Clinical Measures of Physical Fitness Predict Insulin Resistance in People at Risk for Diabetes

2008 ◽  
Vol 88 (11) ◽  
pp. 1355-1364 ◽  
Author(s):  
Chiao-Nan Chen ◽  
Lee-Ming Chuang ◽  
Ying-Tai Wu
Keyword(s):  
Physical Activity ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Body Mass Index ◽  
At Risk ◽  
Risk Factor ◽  
Waist Circumference ◽  
Physical Fitness ◽  
Clinical Measures

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.

scholarly journals Relationships of Changes in Physical Activity and Sedentary Behavior With Changes in Physical Fitness and Cardiometabolic Risk Profile in Individuals With Type 2 Diabetes: The Italian Diabetes and Exercise Study 2 (IDES_2)

2021 ◽  
Author(s):  
Stefano Balducci ◽  
Jonida Haxhi ◽  
Massimo Sacchetti ◽  
Giorgio Orlando ◽  
Patrizia Cardelli ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Risk ◽  
Physical Fitness ◽  
Cardiovascular Risk Factors ◽  
Risk Profile ◽  
Risk Scores ◽  
Metabolic Equivalents

<a><strong>Objective.</strong></a> In the Italian Diabetes and Exercise Study_2, a behavioral counseling <a>promoted</a> a sustained increase in physical activity (PA) volume (+3.3 metabolic equivalents-hour·week<sup>-1</sup>), moderate-to-vigorous-intensity PA (MVPA, +6.4 min·day<sup>-1</sup>), and light-intensity PA (LPA, +0.8 hours·day<sup>-1</sup>) and decrease in sedentary time (SED-time, -0.8 hours·day<sup>-1</sup>). Here, we investigated <a>the relationships of changes in PA/SED-time with changes in physical fitness and cardio-metabolic risk profile in individuals with type 2 diabetes</a>. <p><b>Research Design and Methods. </b><a>In this 3-year randomized clinical trial, 300 physically inactive and sedentary patients were randomized 1:1 to receive one-month theoretical and practical counseling once-a-year or standard care. </a>Changes in physical fitness and cardiovascular risk factors/scores according to quartiles of accelerometer-measured changes in PA/SED-time were assessed, together with univariate and multivariable associations between these parameters<a>, in the whole cohort and by study arm</a>.</p> <p><b>Results. </b>Physical fitness increased and HbA<sub>1c</sub> and coronary heart disease 10-year risk scores decreased with quartiles of MVPA and SED-time change. In quartile IV of MVPA increase and SED-time decrease, cardiorespiratory fitness increased by 5.23 and 4.49 ml·min<sup>-1</sup>·kg<sup>-1</sup> and HbA<sub>1c</sub> decreased by 0.73 and 0.85%, respectively. Univariate correlations confirmed these relationships and mean changes in both MPVA and SED-time predicted changes in physical fitness and cardiovascular risk factors/scores independently of one another and of other confounders. Similar findings were observed with LPA and PA volume and in each group separately.</p> <p><b>Conclusions. </b>Even modest increments in MVPA may have a clinically meaningful impact and reallocating SED-time to LPA may also contribute to improve outcomes, possibly by increasing total energy expenditure.</p>

Epidemiological evidence for the role of physical activity in reducing risk of type 2 diabetes and cardiovascular disease

2005 ◽  
Vol 99 (3) ◽  
pp. 1193-1204 ◽  
Author(s):  
Shari S. Bassuk ◽  
JoAnn E. Manson
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Cardiovascular Health ◽  
Disease Risk ◽  
Epidemiological Studies ◽  
Moderate Intensity ◽  
Atherogenic Dyslipidemia ◽  
Protective Mechanisms ◽  
Physically Active

Epidemiological studies suggest that physically active individuals have a 30–50% lower risk of developing type 2 diabetes than do sedentary persons and that physical activity confers a similar risk reduction for coronary heart disease. Risk reductions are observed with as little as 30 min of moderate-intensity activity per day. Protective mechanisms of physical activity include the regulation of body weight; the reduction of insulin resistance, hypertension, atherogenic dyslipidemia, and inflammation; and the enhancement of insulin sensitivity, glycemic control, and fibrinolytic and endothelial function. Public health initiatives promoting moderate increases in physical activity may offer the best balance between efficacy and feasibility to improve metabolic and cardiovascular health in largely sedentary populations.

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