Self-Reported Diagnosis of Type 1 and Type 2 Diabetes and Lifestyle Change Among Uninsured Primary Care Patients

Introduction: The purpose of this study is to examine self-reported diagnosis of type 1 and type 2 diabetes and lifestyle change among uninsured primary care patients utilizing a free clinic. Methods: Free clinic patients participated in a self-administered survey in May and June 2016. Patients with the following self-reported diagnoses were analyzed: type 2 diabetes only (n = 84), and type 1 diabetes only or both (n = 43). Results: Participants who reported having type 2 diabetes only and/or were patients of the diabetes clinic were less likely to have modified diet and/or physical activity to manage diabetes compared to those with type 1 diabetes and/or those who were not patients of the diabetes clinic. Participants with hypertension were more likely to have changed diet and/or physical activity compared to those without hypertension. Conclusion: Uninsured primary care patients may not know whether they have type 1 or type 2 diabetes. This is problematic as type 1 and type 2 diabetes require different prevention and self-management strategies. Future studies should examine the impact of misunderstanding the 2 types of diabetes on health behaviors and outcomes and explore the context of the misunderstanding.

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Effects of Flash Glucose Monitoring on Dietary Variety, Physical Activity, and Self-Care Behaviors in Patients with Diabetes

Journal of Diabetes Research ◽

10.1155/2020/9463648 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Satoshi Ida ◽

Ryutaro Kaneko ◽

Kanako Imataka ◽

Kaoru Okubo ◽

Yoshitaka Shirakura ◽

...

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Type 1 Diabetes Mellitus ◽

Glucose Monitoring ◽

Flash Glucose Monitoring

The aim of this study was to evaluate the effects of flash glucose monitoring on dietary variety, physical activity, and self-care behavior in patients with diabetes. This study included outpatients with diabetes using insulin who presented at the Department of Diabetes and Metabolism of the Ise Red Cross Hospital. Before initiating flash glucose monitoring and 12 weeks after its initiation, blood glucose-related parameters were assessed and self-administered questionnaires were completed (Dietary Variety Score (DVS), the International Physical Activity Questionnaire (IPAQ), the Summary of Diabetes Self-Care Activities Measure (SDSCA), and the Diabetes Treatment Satisfaction Questionnaire (DTSQ)) and compared between the two time points. We analyzed 42 patients with type 1 diabetes mellitus and 48 patients with type 2 diabetes mellitus. In patients with type 2 diabetes mellitus, but not type 1 diabetes mellitus, there was an increase in moderate/high category scores for IPAQ (P<0.001) and for treatment satisfaction reported via DTSQ. Furthermore, in patients with type 2 diabetes mellitus, the glycemic excursion index improved significantly and HbA1c decreased significantly (from 7.7 (1.2) to 7.4 (0.8), P=0.025). Results showed that standard deviation and mean amplitude of glycemic excursions significantly decreased in patients with type 1 diabetes mellitus (from 71.2 (20.4) to 66.2 (17.5), P=0.033 and from 124.6 (31.9) to 108.1 (28.4), P<0.001, respectively). Flash glucose monitoring is a useful tool to improve physical activity in patients with type 2 diabetes.

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The Logan Healthy Living Program: A cluster randomized trial of a telephone-delivered physical activity and dietary behavior intervention for primary care patients with type 2 diabetes or hypertension from a socially disadvantaged community — Rationale, design and recruitment

Contemporary Clinical Trials ◽

10.1016/j.cct.2007.10.005 ◽

2008 ◽

Vol 29 (3) ◽

pp. 439-454 ◽

Cited By ~ 38

Author(s):

Elizabeth G. Eakin ◽

Marina M. Reeves ◽

Sheleigh P. Lawler ◽

Brian Oldenburg ◽

Chris Del Mar ◽

...

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Primary Care ◽

Cluster Randomized Trial ◽

Behavior Intervention ◽

Disadvantaged Community ◽

Socially Disadvantaged ◽

Primary Care Patients ◽

Cluster Randomized

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A comparison of physical activity-related social-cognitive factors between those with type 1 diabetes, type 2 diabetes and diabetes free adults

Psychology Health & Medicine ◽

10.1080/13548500903012863 ◽

2009 ◽

Vol 14 (5) ◽

pp. 536-544 ◽

Cited By ~ 6

Author(s):

Ronald C. Plotnikoff ◽

Nandini Karunamuni ◽

Stephanie Brunet

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Social Cognitive ◽

Diabetes Type 2 ◽

Diabetes Type ◽

Cognitive Factors

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NDUFB6 Polymorphism Is Associated With Physical Activity-Mediated Metabolic Changes in Type 2 Diabetes

Frontiers in Endocrinology ◽

10.3389/fendo.2021.693683 ◽

2021 ◽

Vol 12 ◽

Author(s):

Dominik Pesta ◽

Tomas Jelenik ◽

Oana-Patricia Zaharia ◽

Pavel Bobrov ◽

Sven Görgens ◽

...

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Insulin Sensitivity ◽

Mitochondrial Function ◽

Liver Fat ◽

C2c12 Myotubes ◽

Clinical Trial Registration

The rs540467 SNP in the NDUFB6 gene, encoding a mitochondrial complex I subunit, has been shown to modulate adaptations to exercise training. Interaction effects with diabetes mellitus remain unclear. We assessed associations of habitual physical activity (PA) levels with metabolic variables and examined a possible modifying effect of the rs540467 SNP. Volunteers with type 2 (n=242), type 1 diabetes (n=250) or normal glucose tolerance (control; n=139) were studied at diagnosis and subgroups with type 1 (n=96) and type 2 diabetes (n=95) after 5 years. Insulin sensitivity was measured by hyperinsulinemic-euglycemic clamps, oxygen uptake at the ventilator threshold (VO2AT) by spiroergometry and PA by questionnaires. Translational studies investigated insulin signaling and mitochondrial function in Ndufb6 siRNA-treated C2C12 myotubes, with electronic pulse stimulation (EPS) to simulate exercising. PA levels were 10 and 6%, VO2AT was 31% and 8% lower in type 2 and type 1 diabetes compared to control. Within 5 years, 36% of people with type 2 diabetes did not improve their insulin sensitivity despite increasing PA levels. The NDUFB6 rs540467 SNP modifies PA-mediated changes in insulin sensitivity, body composition and liver fat estimates in type 2 diabetes. Silencing Ndufb6 in myotubes reduced mitochondrial respiration and prevented rescue from palmitate-induced insulin resistance after EPS. A substantial proportion of humans with type 2 diabetes fails to respond to rising PA with increasing insulin sensitivity. This may at least partly relate to a polymorphism of the NDUFB6 gene, which may contribute to modulating mitochondrial function.Clinical Trial RegistrationClinicalTrials.gov, identifier NCT01055093. The trial was retrospectively registered on 25th of January 2010.

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Fatores Associados a Tensão Arterial Não Controlada em Pessoas com Diabetes Tipo 2 Seguidas nos Cuidados de Saúde Primários em Portugal

Acta Médica Portuguesa ◽

10.20344/amp.8321 ◽

2017 ◽

Vol 30 (3) ◽

pp. 197 ◽

Cited By ~ 2

Author(s):

Inês Rosendo ◽

Luiz Miguel Santiago ◽

Margarida Marques

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Type 2 Diabetes ◽

Primary Care ◽

Regression Analysis ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Primary Care Patients

Introduction: Determine whether socio-demographic, habits and risk factors are associated with a better tensional control in type 2 diabetes in primary care patients in order to identify a specific target population for compensatory interventions improving diabetes control and reducing its morbi-mortality.Material and Methods: Cross-sectional study in primary care. Randomized type 2 diabetes patient data collection by their volunteer family doctors, proportionally stratified from the 5 Portuguese continental regions. Variables: blood pressure, age, gender, education, diabetes duration, HbA1c, smoking habits, weight, waist circumference, physical activity and adherence to medication. Bivariate and logistic regression analysis to evaluate each measured variable’s independent association with uncontrolled blood pressure (≥ 140/90).Results: 709 patients were included in the study, 60.2% men, mean age 66.12 ± 10.47 years. In logistic regression analysis, the factors independently associated to uncontrolled BP were lower education (p = 0.014), shorter diabetes duration (p = 0.002), higher waist circumference (p < 0.001), higher pulse pressure (p < 0.001), higher physical activity level (p = 0.043) and being a smoker (p < 0.001).Discussion: The main limitations are the fact that the sample was not totaly random and included only primary care patients, a possible inter-observer bias and being a cross-sectional study, thus not providing information on temporal relation or causality.Conclusion: The sub-group of people with diabetes identified to have worse tensional control should have a different and more intensive approach in primary care. We recommend further longitudinal and population based confirmatory research.

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A Reimbursable Counseling Intervention Improves Physical Activity and Function for Primary Care Patients with Type 2 Diabetes

Diabetes ◽

10.2337/db18-879-p ◽

2018 ◽

Vol 67 (Supplement 1) ◽

pp. 879-P

Author(s):

AMY G. HUEBSCHMANN ◽

IAN M. LEAVITT ◽

RUSSELL GLASGOW ◽

JUDITH G. REGENSTEINER ◽

ANDREA L. DUNN

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Primary Care ◽

Counseling Intervention ◽

Primary Care Patients ◽

And Function

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Trends in Factors Affecting Pregnancy Outcomes Among Women With Type 1 or Type 2 Diabetes of Childbearing Age (2004–2017)

Frontiers in Endocrinology ◽

10.3389/fendo.2020.596633 ◽

2021 ◽

Vol 11 ◽

Author(s):

Mariangela Gaudio ◽

Nicoletta Dozio ◽

Michael Feher ◽

Marina Scavini ◽

Amelia Caretto ◽

...

Keyword(s):

Type 2 Diabetes ◽

Primary Care ◽

Type 1 Diabetes ◽

Glycaemic Control ◽

Pregnancy Outcomes ◽

Childbearing Age ◽

Factors Affecting ◽

Over Time

AimTo describe trends in modifiable and non-modifiable unfavorable factors affecting pregnancy outcomes, over time (years 2004–2017), in women with diabetes of childbearing age from an English primary care perspective.MethodsWe identified women with diabetes aged 16–45 years from the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) network, an English primary care sentinel database. Repeated annual cross-sectional analyses (2004–2017) assessed the prevalence of unfavorable factors for pregnancy, such as obesity, poor glycaemic control, microalbuminuria, hypertension, use of medications for treating diabetes, and associated comorbidities not recommended for pregnancy.ResultsWe identified 3,218 women (61.5% with Type 2 diabetes) in 2004 and 6,657 (65.0% with Type 2 diabetes) in 2017. The proportion of women with ideal glycaemic control for conception (HbA1c<6.5%) increased over time, in patients with Type 1 diabetes from 9.0% (7.1%–11.0%) to 19.1% (17.2%–21.1%), and in those with Type 2 diabetes from 27.2% (24.6%–29.9%) to 35.4% (33.6%–37.1%). The proportion of women with Type 2 diabetes prescribed medications different from insulin and metformin rose from 22.3% (20.5%–24.2%) to 27.3% (26.0%–28.6%).In 2017, 14.0% (12.6%–15.4%) of women with Type 1 and 30.7% (29.3%–32.0%) with Type 2 diabetes were prescribed angiotensin-modulating antihypertensives or statins. We captured at least one unfavorable factor for pregnancy in 50.9% (48.8%–52.9%) of women with Type 1 diabetes and 70.7% (69.3%–72.0%) of women with Type 2 diabetes. Only one third of women with Type 1 diabetes (32.2%, 30.3%–34.0%) and a quarter of those with Type 2 diabetes (23.1%, 21.9%–24.4%) were prescribed hormonal contraception. Contraception was prescribed more frequently to women with unfavorable factors for pregnancy compared to those without, however, the difference was significant only for women with Type 1 diabetes.ConclusionsDespite significant improvements in general diabetes care, the majority of women with Type 1 or Type 2 diabetes have unfavorable, although mostly modifiable, factors for the start of pregnancy. Good diabetes care for women of childbearing age should include taking into consideration a possible pregnancy.

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