Negotiating exercise as medicine: Narratives from people with type 2 diabetes

The dominant notion that exercise is medicine puts a strong normative emphasis on individual responsibility for participation in sport and physical activity. The aim of this article was to explore how people with type 2 diabetes, a condition strongly linked to lifestyle behaviour both in origin and in management, translate this notion into their daily life. Based on a critical narrative analysis of stories of 18 Dutch people diagnosed with type 2 diabetes collected between 2012 and 2016, we found a range of meanings given to sport and physical activity. In addition, almost all respondents seemed to subscribe to the notion of exercise as medicine on a general level, either quite explicitly or in more subtle ways, for example, elicited by the interview setting. However, they employed different strategies to negotiate with the translation of this notion into their daily life, ranging from (almost) total acceptance to resistance. In addition, nearly all stories revealed mostly negative experiences with care and professional support regarding the uptake or continuation of sport or physical activity participation after diagnosis.

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I’m sleeping my day away. Improving diabetes self-management using CPAP treatment in patients with obstructive sleep apnea and type 2 diabetes: A qualitative explorative study (Preprint)

10.2196/preprints.27062 ◽

2021 ◽

Author(s):

Ditte Hjorth Laursen ◽

Gitte Rom ◽

Anne Margareta Banghoej ◽

Lise Tarnow ◽

Lone Schou

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Sleep Quality ◽

Daily Life ◽

Self Management ◽

Cpap Treatment ◽

Obstructive Sleep

BACKGROUND There is a high prevalence of unexplained and unexplored obstructive sleep apnea (OSA) in patients with type 2 diabetes. Daytime symptoms of OSA include severe fatigue, cognitive problems, decreased quality of life, and reduced motivation to provide self-care, which impairs the management of both diabetes and daily life. OSA may thereby cause negative implications for diabetes self-management. Treatment for OSA is offered through Continuous Positive Airway Pressure (CPAP) which has the potential to improve sleep quality, insulin resistance and glycemic control. Although the benefits of using CPAP as treatment for OSA are clear, noncompliance is high and there is poor evidence on the perceived effect of CPAP treatment in this group of patients. OBJECTIVE The purpose of this study is to explore the impact of comorbid diabetes and OSA on daily life among older adults, and to investigate the perceived effect of CPAP treatment for OSA on patients’ diabetes self-management. METHODS A qualitative follow-up study, with in-depth semi-structured dyad interviews with couples before and after an intervention with CPAP treatment (N=22). Patients were recruited from Hilleroed Hospital in Denmark and were all diagnosed with type 2 diabetes, age > 18 years and apnea-hypopnea index (AHI) ≥ 15. All interviews were coded and analyzed using thematic analysis. RESULTS Patients and partners do not consider OSA a serious disorder as they consider OSA symptoms similar to the process of aging. Patients experience poor nocturnal sleep, frequent daytime naps, reduced cognitive function, low levels of physical activity, and a high-calorie diet, that all negatively influence their diabetes self-management. Despite the immediate benefit of the CPAP treatment, most patients have technical challenges when using the CPAP. Only patients with severe OSA symptoms inflicting their daily life overcome the challenges of CPAP and thereby improve their diabetes self-management. Patients with less life inflicting symptoms rate the CPAP challenges as more burdensome than their symptoms. CONCLUSIONS If used correctly CPAP has the potential to improve OSA resulting in better sleep quality, improved physical activity, improved diet and a better diabetes self-management. But there are many barriers in CPAP treatment and only few patients manage to overcome the barriers and comply to correct treatment. CLINICALTRIAL The study was approved by the Danish Data Protection Agency (J.nr. 2012-58-0004).

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Daily Life Physical Activity, Quality of Life and Symptoms of Depression and Anxiety in Adult Patients with Type 2 Diabetes: A Preliminary Study

Psychology ◽

10.4236/psych.2021.128080 ◽

2021 ◽

Vol 12 (08) ◽

pp. 1277-1286

Author(s):

Ioannis D. Morres ◽

Evlalia Touloudi ◽

Antonis Hatzigeorgiadis ◽

Athanasios Z. Jamurtas ◽

Odysseas Androutsos ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Type 2 Diabetes ◽

Daily Life ◽

Depression And Anxiety ◽

Symptoms Of Depression ◽

Preliminary Study ◽

Daily Life Physical Activity

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A digital lifestyle behaviour change intervention for the prevention of type 2 diabetes: a qualitative study exploring intuitive engagement with real-time glucose and physical activity feedback

BMC Public Health ◽

10.1186/s12889-020-09740-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Maxine E. Whelan ◽

Francesca Denton ◽

Claire L. A. Bourne ◽

Andrew P. Kingsnorth ◽

Lauren B. Sherar ◽

...

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Real Time ◽

Behaviour Change ◽

Structured Interviews ◽

Lifestyle Behaviour ◽

Health Technologies ◽

Freestyle Libre ◽

Physiological Feedback

Abstract Background Mobile health technologies have advanced to now allow monitoring of the acute physiological responses to lifestyle behaviours. Our aim was to explore how people engaged with real-time feedback on their physical activity and glucose levels over several weeks. Methods Semi-structured interviews with 26 participants (61.5% female, 56.6 years) at moderate-to-high risk of developing type 2 diabetes were conducted. Interviews were completed after participants took part in an intervention comprising a flash glucose monitor (Freestyle Libre) and a physical activity monitor (Fitbit Charge 2). Purposive sampling ensured representation of ages, genders and group allocations. Results Inductive thematic analysis revealed how individuals intuitively used, interpreted and acted on feedback from wearable technologies. Six key themes emerged: triggers of engagement with the technologies, links between behaviour and health, lack of confidence, changes to movement behaviours, changes to diet and barriers to lifestyle behaviour change. Conclusions Our findings demonstrate that accessing behavioural and physiological feedback can increase self-awareness of how lifestyle impacts short-term health. Some participants noticed a link between the feedback presented by the two devices and changed their behaviour but many did not. Training and educational support, as well as efforts to optimize how feedback is presented to users, are needed to sustain engagement and behaviour change. Extensions of this work to involve people with diabetes are also warranted to explore whether behavioural and physiological feedback in parallel can encourage better diabetes self-management. Trial registration ISRCTN Registry, ISRCTN17545949, 12/05/2017, prospectively registered.

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Abstract #217: Combined Predictability of Physical Activity and Bodyweight on Healthrelated Quality of Life Among Nigerian Type 2 Diabetes Mellitus

Endocrine Practice ◽

10.1016/s1530-891x(20)42523-6 ◽

2015 ◽

Vol 21 ◽

pp. 31

Author(s):

Akolade Idowu ◽

Adeyinka Idowu ◽

Adesoji Tade

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Healthrelated Quality Of Life

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How to Maintain a Healthy Body Weight

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831.76.4.208 ◽

2006 ◽

Vol 76 (4) ◽

pp. 208-215 ◽

Cited By ~ 10

Author(s):

Astrup

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Weight Loss ◽

Body Weight ◽

Glycemic Index ◽

Dairy Products ◽

Weight Control ◽

Healthy Body Weight ◽

Healthy Body

The epidemic of both obesity and type 2 diabetes is due to environmental factors, but the individuals developing the conditions possess a strong genetic predisposition. Observational surveys and intervention studies have shown that excess body fatness is the major environmental cause of type 2 diabetes, and that even a minor weight loss can prevent its development in high-risk subjects. Maintenance of a healthy body weight in susceptible individuals requires 45–60 minutes physical activity daily, a fat-reduced diet with plenty of fruit, vegetables, whole grain, and lean meat and dairy products, and moderate consumption of calorie containing beverages. The use of table values to predict the glycemic index of meals is of little – if any – value, and the role of a low-glycemic index diet for body weight control is controversial. The replacement of starchy carbohydrates with protein from lean meat and lean dairy products enhances satiety, and facilitate weight control. It is possible that dairy calcium also promotes weight loss, although the mechanism of action remains unclear. A weight loss of 5–10% can be induced in almost all obese patients providing treatment is offered by a professional team consisting of a physician and dieticians or nurses trained to focus on weight loss and maintenance. Whereas increasing daily physical activity and regular exercise does not significantly effect the rate of weight loss in the induction phase, it plays an important role in the weight maintenance phase due to an impact on daily energy expenditure and also to a direct enhancement of insulin sensitivity.

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