Associations of COVID-19 lockdown restrictions with longer-term activity levels of working adults with type 2 diabetes (Preprint)

BACKGROUND Lockdown restrictions reduce COVID-19 community transmission; however, they may pose challenges for non-communicable disease management. A 112-day hard lockdown in Victoria, Australia (commencing March 23, 2020), which affected an intervention trial of reducing and breaking up sitting time in desk workers with type 2 diabetes who were using a provided consumer grade activity tracker (Fitbit). OBJECTIVE To compare continuously recorded activity levels preceding and during COVID-19 lockdown restrictions among working adults with type 2 diabetes participating in a sitting less and moving more intervention. METHODS Eleven participants (8/11 male; mean [SD] age 52.8 [5.0] years) in Melbourne, Australia had Fitbit activity tracked before (mean [SD]: 122.7 [47.9] days) and during (99.7 [62.5] days) city-wide COVID-19 lockdown restrictions. Regression models compared device (Fitbit Inspire HR)-derived activity (steps; METs [metabolic equivalents], mean time in sedentary, lightly, fairly, and very active minutes, and usual bout durations) during restrictions, to pre-restriction. Relative rates (RR) <1.00 indicated a decline in activity levels following restrictions. RESULTS Total wear days were 2447. There was a decrease in steps (-1,584 steps; RR: 0.91; 95%CI: 0.89, 0.93), METs (-83 METs; RR: 0.95; 95%CI: 0.94, 0.95), lightly active (RR: 0.96; 95%CI: 0.92, 0.99), fairly active (RR: 0.82; 95%CI: 0.79, 0.85), very active (RR: 0.92; 95%CI: 0.89, 0.95) intensity minutes, and increases in sedentary minutes (RR: 1.03; 95%CI: 1.01, 1.06). Only very active (+5.1mins) and sedentary (+4.3mins) bout durations changed significantly. CONCLUSIONS In adults with type 2 diabetes, COVID-19 lockdown restrictions were associated with decreases in overall activity levels and increases in very active and sedentary bout durations. A Fitbit monitor provided meaningful continuous long term data in this context. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ANZCTRN12618001159246

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Re: Self-Reported Sitting Time and Prevalence of Erectile Dysfunction in Japanese Patients with Type 2 Diabetes Mellitus: The Dogo Study

The Journal of Urology ◽

10.1016/j.juro.2017.03.090 ◽

2017 ◽

Vol 197 (6) ◽

pp. 1534-1534

Author(s):

Allen D. Seftel

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Erectile Dysfunction ◽

Japanese Patients ◽

Sitting Time

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Population-Based Estimates of Physical Activity for Adults with Type 2 Diabetes: A Cautionary Tale of Potential Confounding by Weight Status

Journal of Obesity ◽

10.1155/2011/561432 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 8

Author(s):

Ronald C. Plotnikoff ◽

Steven T. Johnson ◽

Constantinos A. Loucaides ◽

Adrian E. Bauman ◽

Nandini D. Karunamuni ◽

...

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Weight Status ◽

Large Population ◽

Population Sample ◽

Population Level ◽

Activity Levels ◽

Healthy Weight ◽

Physical Activity Levels

At a population level, the method used to determine those meeting physical activity guidelines has important implications, as estimating “sufficient” physical activity might be confounded by weight status. The objective of this study was to test the difference between three methods in estimating the prevalence of “sufficient activity” among Canadian adults with type 2 diabetes in a large population sample (N=1614) while considering the role of weight status as a potential confounder. Our results revealed that estimates of physical activity levels vary by BMI categories, depending on the methods examined. Although physical activity levels were lower in the obese, their energy expenditure estimates were not different from those who were overweight or of a healthy weight. The implications of these findings are that biased estimates of physical activity at a population level may result in inappropriate classification of adults with type 2 diabetes as “sufficiently active” and that the inclusion of body weight in estimating physical activity prevalence should be approached with caution.

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Does Interrupting Prolonged Sitting With 10- or 20-Min Standing Attenuate Postprandial Glycemia and Blood Pressure in Middle-Aged and Older Adults With Type 2 Diabetes?

Journal of Aging and Physical Activity ◽

10.1123/japa.2020-0418 ◽

2020 ◽

pp. 1-8

Author(s):

Yuri A. Freire ◽

Carlos A. Silva ◽

Geovani A. D. Macêdo ◽

Rodrigo A. V. Browne ◽

Bruno M. de Oliveira ◽

...

Keyword(s):

Blood Pressure ◽

Type 2 Diabetes ◽

Older Adults ◽

Area Under The Curve ◽

Acute Effect ◽

Sitting Time ◽

Middle Aged ◽

Postprandial Glycemia ◽

Prolonged Sitting

We carried out three types of 2-hr experimental sessions with middle-aged and older adults with Type 2 diabetes in order to examine the acute effect of interrupting prolonged sitting with varying periods of standing on postprandial glycemia and blood pressure (BP): (a) prolonged sitting after breakfast; (b) standing for 10 min, 30 min after breakfast; and (c) standing for 20 min, 30 min after breakfast. Glucose and BP were assessed before and after breakfast. A generalized linear model revealed no significant differences for the incremental area under the curve of glucose between standing for 10 min, 30 min after breakfast, versus prolonged sitting after breakfast (β = –4.5 mg/dl/2 hr, 95% CI [–17.3, 8.4]) and standing for 20 min, 30 min after breakfast, versus prolonged sitting after breakfast (β = 0.9 mg/dl/2 hr, 95% CI [–11.9, 13.7]). There was no difference in area under the curve of systolic and diastolic BP among the sessions. Interrupting prolonged sitting time with 10 or 20 min of standing 30 min after breakfast does not attenuate postprandial glycemia or BP in middle-aged and older adults with Type 2 diabetes.

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A non-exercise method to determine cardiorespiratory fitness identifies females predicted to be at ‘high risk’ of type 2 diabetes

Diabetes and Vascular Disease Research ◽

10.1177/1479164116666476 ◽

2016 ◽

Vol 14 (1) ◽

pp. 47-54 ◽

Cited By ~ 2

Author(s):

Benjamin J Gray ◽

Jeffrey W Stephens ◽

Daniel Turner ◽

Michael Thomas ◽

Sally P Williams ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

High Risk ◽

Risk Score ◽

Exercise Testing ◽

Diabetes Risk ◽

Testing Method ◽

Metabolic Equivalents

This study examined the relationship between cardiorespiratory fitness determined by a non-exercise testing method for estimating fitness and predicted risk of developing type 2 diabetes mellitus using five risk assessments/questionnaires (Leicester Diabetes Risk Score, QDiabetes, Cambridge Risk Score, Finnish Diabetes Risk Score and American Diabetes Association Diabetes Risk Test). Retrospective analysis was performed on 330 female individuals with no prior diagnosis of cardiovascular disease or type 2 diabetes mellitus who participated in the Prosiect Sir Gâr workplace initiative in Carmarthenshire, South Wales. Non-exercise testing method for estimating fitness (expressed as metabolic equivalents) was calculated using a validated algorithm, and females were grouped accordingly into fitness quintiles <6.8 metabolic equivalents (Quintile 1), 6.8–7.6 metabolic equivalents (Quintile 2), 7.6–8.6 metabolic equivalents (Quintile 3), 8.6–9.5 metabolic equivalents (Quintile 4), >9.5 metabolic equivalents (Quintile 5). Body mass index, waist circumference, and HbA1c all decreased between increasing non-exercise testing method for estimating fitness quintiles ( p < 0.05), as did risk prediction scores in each of the five assessments/questionnaires ( p < 0.05). The proportion of females in Quintile 1 predicted at ‘high risk’ was between 20.9% and 81.4%, depending on diabetes risk assessment used, compared to none of the females in Quintile 5. A calculated non-exercise testing method for estimating fitness <6.8 metabolic equivalents could help to identify females at ‘high risk’ of developing type 2 diabetes mellitus as predicted using five risk assessments/questionnaires.

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Factors associated with physical activity levels in African-American women with type 2 diabetes

Journal of the American Academy of Nurse Practitioners ◽

10.1111/j.1745-7599.2011.00674.x ◽

2011 ◽

Vol 24 (4) ◽

pp. 209-217 ◽

Cited By ~ 22

Author(s):

Melanie Komar-Samardzija ◽

Lynne T. Braun ◽

Joyce K. Keithley ◽

Lauretta T. Quinn

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

African American ◽

African American Women ◽

Activity Levels ◽

American Women ◽

Factors Associated ◽

Physical Activity Levels

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Self-reported and objectively measured physical activity levels among Hispanic/Latino adults with type 2 diabetes

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2019-000893 ◽

2020 ◽

Vol 8 (1) ◽

pp. e000893

Author(s):

Wendy Bevier ◽

Namino Glantz ◽

Charis Hoppe ◽

Jessikah Morales Glass ◽

Arianna Larez ◽

...

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

English Language ◽

Spanish Language ◽

Activity Levels ◽

Cross Sectional ◽

The Usa ◽

Latino Adults ◽

Objectively Measured

ObjectiveIn the USA, minority populations face a disproportionate burden from type 2 diabetes (T2D), in whom physical activity (PA) is recommended. The aim of this study was to determine levels of PA among a community of free-living Hispanic/Latino adults with T2D using a research accelerometer, a consumer device and a pictogram self-assessment questionnaire.Research design and methodsThis was a cross-sectional, observational study. Participants (57 women and 31 men, body mass index (kg/m2) 32.2±7.9 and 29.9±4.5, waist circumference 97.1±30.1 and 93.7±33.0 cm and hemoglobin A1c 8.0±2.0 and 8.1%±1.8%, respectively) wore an ActiGraph (AG) on the hip and a Fitbit (FB) on the wrist for 1 week to estimate daily steps and energy expenditure (EE). Participants reported type and intensity of PA using English-language or Spanish-language pictograms and a 10-point Likert scale (1=‘not active’ to 10=‘very, very active’).ResultsSteps per day were not normally distributed; AG median steps/weekday (Monday–Friday) was 6990 (range 1091–25 884) compared with 9329 (288–31 669) using FB (p≤0.01). Both devices recorded significantly more steps on weekdays versus weekends (p≤0.05). EE was also higher during the week. AG and FB were highly correlated to each other (p<0.01). Men were more active than women and maintained their PA throughout the week, whereas women decreased theirs on weekends. Spanish-language pictograms were preferred and self-reported PA matched objective assessments by both devices. Participants perceived themselves to be active (7.1±2.0) due to work.ConclusionsBoth objectively measured and self-reported levels of PA in Hispanic/Latino adults with T2D challenge the assumption that lack of PA may be commonplace for this group. AG and FB are different in their measurement of PA but are significantly correlated. New strategies, including use of pictograms, for interventions need to be considered if further increases or changes in PA are to be used as T2D therapy.Trial registration numberNCT03736486

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Increasing Knowledge, Attitudes, Skills, and Glucose Control in Type-2 Diabetic Patients through EMAS Interventions

Nurse Media Journal of Nursing ◽

10.14710/nmjn.v9i2.22989 ◽

2019 ◽

Vol 9 (2) ◽

pp. 141-150

Author(s):

Arief Andriyanto ◽

Etty Rekawati ◽

Dwi Cahya Rahmadiyah

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Glucose Control ◽

Communicable Disease ◽

Sampling Technique ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Management Interventions ◽

Quasi Experimental

Background: Diabetes Mellitus (DM) is a chronic and non-communicable disease that has serious impacts. Previous studies have focused on a single intervention in the management of DM. Therefore, EMAS (education, nutrition management, physical activities, and stress management) interventions are proposed to convey the pillars of diabetes mellitus as endorsed by the Indonesian Ministry of Health.Purpose: This study aimed to analyze the effects of EMAS interventions on the knowledge, attitudes, skills, and glucose control in patients with type-2 DM.Methods: This study used a pretest-posttest quasi-experimental design without control groups. The samples were 86 diabetic patients recruited using a purposive sampling technique. The EMAS interventions were conducted for six months and eight sessions (October 2018 to March 2019). The EuroQoLfive-dimensional (EQ-5D) questionnaire was used to collect the data, and the paired t-test was used for data analysis. Results: The results showed that there were significant differences in the knowledge, attitudes, skills (p=0.001), and glucose control (p=0.04) of type 2 diabetes mellitus after the implementation of EMAS interventions. Conclusion: EMAS interventions significantly increased the knowledge, attitudes, and skills in patients with type 2 diabetes to behave healthier to control their blood sugar. Community nurses can use EMAS intervention for the management of DM among diabetic patients.

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