Prescription of Physical Activity by General Practitioners in Type 2 Diabetes: Practice and Barriers in French Guiana

BackgroundGeneral practitioners (GPs) are the major primary healthcare players in the management of type 2 diabetes. In addition to a well-balanced diet, physical activity (PA) appears as a necessary non-medicinal therapy in the management of diabetic patients. However, GPs emphasize several obstacles to its prescription. The aim of this study is to evaluate the practices, barriers, and factors favoring the prescription of PA in type 2 diabetic patients by GPs in French Guiana.MethodWe conducted a cross-sectional descriptive study using a questionnaire, designed to interview 152 French Guiana GPs and describe their practice in prescribing PA in type 2 diabetic patients.ResultsOur results revealed that the prescription of PA as a non-medicinal therapeutic choice in the management of type 2 diabetes was practiced by 74% of the French Guiana GPs. However, only 37% of GPs responded that they implemented the recommendations; indeed, only one-third knew about them. The majority of GPs were interested in PA training, but only 11% were actually trained in this practice. The lack of structure adapted to the practice of PA and the lack of awareness of the benefits of PA in metabolic pathology appeared as the main obstacles to PA prescription.ConclusionThis study highlights the importance of improving the training of GPs in the prescription of PA, the development of adapted PA structures, and collaboration between the different actors within the framework of the sport-health system in type 2 diabetes in French Guiana.

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Physical activity on prescription by general practitioners in type 2 diabetes mellitus patients, practice and barriers in French Guiana.

10.21203/rs.2.18391/v1 ◽

2019 ◽

Author(s):

Stephanie Dranebois ◽

Marie Laure Lalanne-Mistrih ◽

Liliane Thelusme ◽

Rodolphe Priam ◽

Sandra Deungoue ◽

...

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

General Practitioners ◽

French Guiana ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Cross Sectional ◽

Balanced Diet ◽

Type 2 Diabetic

Abstract BACKGROUND General practitioners (GPs) are the major first-line care players of the management of type 2 diabetes, in France. In addition to a well-balanced diet, physical activity (PA) appears as a necessary non-medicinal therapy in its own right. However, GPs emphasize several obstacles to its prescription, in particular due to their lack of knowledge on its practical modalities. The aim of this study is to evaluate the practices, the barriers and the factors favoring the prescription of physical activity in type 2 diabetic patients by GPs in French Guiana.METHOD: A cross-sectional descriptive study was conducted in the form of a questionnaire, designed to interview 152 French Guiana GPs, to describe their practice in prescribing physical activity (PA) in type 2 diabetic patients. RESULTS: The oral or written prescription of physical activity as a non-medicated therapeutic choice in the management of type 2 diabetes is practiced by 74% of the French Guiana GPs, on an oral mode, for most of them. However, only 37% of doctors responded to apply the content of the recommendations of the French National Authority for Health and decree, indeed only one third knew about it. GPs convinced of the interest of PA and aware of its recommendations in this area, prescribed more PA than others. The majority of physicians are interested in PA training, but only 11% are actually trained in this practice. The lack of structure adapted to the practice of PA and of awareness of the interest of PA in their patients’ metabolic pathology appeared as the main obstacles to the prescription. According to 55% of physicians surveyed, a compensation by social security of the costs related to the prescription would improve the adherence to the practice of PA.CONCLUSIONS: It appears important to develop the training of the GPs, reception facilities adapted to where to refer patients, and collaborations between the various actors within the framework of a sport-health device. In addition, therapeutic patient education (TPE) is to be developed in order to improve patient compliance and adherence to sport-health programs.

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Dietary Diversity as a Risk Factor for Obesity in Algerian Patients with Type 2 Diabetes Mellitus

Healthcare ◽

10.3390/healthcare9091229 ◽

2021 ◽

Vol 9 (9) ◽

pp. 1229

Author(s):

Abdenour Bounihi ◽

Hamza Saidi ◽

Asma Bouazza ◽

Hassiba Benbaibeche ◽

Malha Azzouz ◽

...

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Risk Factor ◽

Dietary Diversity ◽

Diabetic Patients ◽

Obese Patients ◽

Type 2 Diabetic Patients ◽

Cross Sectional ◽

Type 2 Diabetic

Although the incidence of “diabesity” (coexistence of type 2 diabetes and obesity) is alarmingly increasing in Algeria, the diet–diabesity link has not been well defined. This study aimed to explore the association between dietary diversity score (DDS) and obesity among Algerian type 2 diabetic patients. It was a cross-sectional observational study involving 390 type 2 diabetic patients. Anthropometric data were gathered, and dietary intake information was obtained through a 24-h dietary recall method, which was used to calculate DDS. Potential confounders such as age, sex, smoking, physical activity and energy intake were controlled for using multivariate logistic regression. A total of 160 patients (41.3%) were classified as obese. As expected, obese patients had a higher body mass index, waist circumference, hip circumference, body fat and fat mass index. Furthermore, obese patients more frequently met carbohydrate recommendations and had a higher intake of meat and protein. Female sex, hypertension, low physical activity and high meat and protein intake were positively associated with diabesity. Additionally, higher DDS was positively associated with diabesity after adjusting for confounders. Thus, a more diversified diet may be a risk factor for obesity among Algerian type 2 diabetic patients.

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Effects of Physical Training on Metabolic Control in Elderly Type 2 Diabetes Mellitus Patients

Clinical Science ◽

10.1042/cs0930127 ◽

1997 ◽

Vol 93 (2) ◽

pp. 127-135 ◽

Cited By ~ 64

Author(s):

P.C. Ligtenberg ◽

J.B.L. Hoekstra ◽

E. Bol ◽

M.L. Zonderland ◽

D.W. Erkelens

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Insulin Sensitivity ◽

Physical Training ◽

Training Group ◽

Control Group ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Type 2 Diabetic

1. The specific role of physical activity in the treatment of type 2 diabetes is still subject to discussion. A randomized prospective study was performed, investigating both the influence of physical training on metabolic control and the feasibility of physical training in the elderly. 2. A total of 58 patients (mean age: 62 ± 5 years; range: 55–75 years) with type 2 diabetes were randomized to either a physical training or a control programme. The training programme consisted of three sessions a week, aiming at 60–80% of the maximal oxygen uptake (VO2max). The 12 week supervised period was followed by a 14 week non-supervised one. The control group followed an educational programme. VO2max was assessed during exercise on a cycle ergometer. Glycosylated haemoglobin (HbA1c) was used as a measure for glucose control, and an insulin tolerance test was performed to test insulin sensitivity. Multivariate analysis of variance, with repeated measures design, was used to test differences between groups. 3. Fifty-one patients completed the study. VO2max was higher in the training group than in the control group both after 6 weeks (P ≤ 0.01 between groups) and after 26 weeks [training group: 1796 ± 419 ml/min (prestudy), 1880 ± 458 ml/min (6 weeks), 1786 ± 591 ml/min (26 weeks); control group: 1859 ± 455 ml/min (prestudy), 1742 ± 467 ml/min (6 weeks), 1629 ± 504 ml/min (26 weeks)]. Blood glucose control and insulin sensitivity did not change during the study. Levels of total triacyl-glycerols, very-low-density lipoprotein-triacyl-glycerols and apolipoprotein B were significantly lower after 6 weeks (P ≤ 0.01, P ≤ 0.05, P ≤ 0.05 between groups respectively), and so was the level of total cholesterol after 12 weeks of training (P ≤ 0.05 between groups). 4. Physical training in obese type 2 diabetic patients over 55 years of age does not change glycaemic control or insulin sensitivity in the short-term. Regular physical activity may lower triacylglycerol and cholesterol levels in this group of patients. 5. Finally, physical training in motivated elderly type 2 diabetic patients without major cardiovascular or musculoskeletal disorders is feasible, but only under supervision.

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FVC, FEV1 and FEV1/FVC% in Type 2 Diabetes and Their Relationships with Duration of the Disease

Journal of Bangladesh Society of Physiologist ◽

10.3329/jbsp.v4i2.4178 ◽

1970 ◽

Vol 4 (2) ◽

pp. 81-87 ◽

Cited By ~ 3

Author(s):

Md Omar Ali ◽

Shelina Begum ◽

Noorzahan Begum ◽

Taskina Ali ◽

Sultana Ferdousi ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Metabolic Diseases ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Cross Sectional ◽

Duration Of Diabetes ◽

Group A ◽

Type 2 Diabetic

Background: Diabetes mellitus is a chronic debilitating disease affecting various organs including lungs. The magnitude of the complications of this disease is related to its duration. Objective: To observe FVC, FEV1 and FEV1/FVC% in type 2 diabetic patients and their relationship with duration of the disease. Methods: This cross-sectional study was carried out in the Department of Physiology, BSMMU, Dhaka, from July 2007 to June 2008 on 60 type 2 diabetic male patients of age 40-60 years (Group B). For comparison, 30 age and BMI matched apparently healthy non diabetic subjects (Group A) were also studied. Patients were selected from the out patient department of Bangladesh Institute of research on diabetes, endocrine and metabolic diseases. Based on duration of diabetes, diabetic patients were divided into B1 (5-10 years) and B2 (10-20 years). FVC, FEV1 and FEV1/FVC% of all the subjects were measured by a digital microspirometer. Data were analyzed by One way ANOVA test, Unpaired Student's 't' test and Pearson's correlation coefficient test as applicable. Results: Mean of the percentage of the predicted values of FVC and FEV1, were significantly (p<0.001) lower in both those of Gr. B1 and B2 than that in A and were also significantly (p<0.001) lower in Gr. B2 when compared with Gr. B1. Again, FEV1/FVC% was significantly (p<0.01) higher in Gr. B2 than those in Gr. B1 and A whereas this value was lower in Gr. B1 than those of group A but it was not statistically significant. However, FVC and FEV1 showed negative and FEV1/FVC% showed positive correlations with duration of diabetes. All these correlations were statistically non significant. Conclusion: From the result of this study it can be concluded that the ventilatory function of lung may be reduced in type 2 diabetes which may be related to the duration of the disease. Key words: FVC, FEV1, diabetes mellitus DOI: 10.3329/jbsp.v4i2.4178 J Bangladesh Soc Physiol. 2009 Dec;4(2): 81-87

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Faktor Risiko yang Berpengaruh terhadap Terjadinya Hipertensi pada Penderita Diabetes Melitus Tipe II di Wilayah Puskesmas Kabupaten Pati

Jurnal Epidemiologi Kesehatan Komunitas ◽

10.14710/j.e.k.k.v2i2.3996 ◽

2017 ◽

Vol 2 (2) ◽

pp. 54

Author(s):

Gracilaria Puspa Sari ◽

Shofa Chasani ◽

Tjokorda Gde Dalem Pemayun ◽

Suharyo Hadisaputro ◽

Heri Nugroho

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Type 2 Diabetes ◽

Medication Adherence ◽

Coffee Consumption ◽

Diabetes Duration ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Type 2 Diabetic

Background: The prevalence of hypertension in type 2 diabetic patients is 1,5-3 times higher than it is in nondiabetic individuals This chronic condition accelerates macrovascular complications. Research about risk factors of hypertension in type 2 diabetic patients is still rare because its causes multifactorial. The objectives of this research is to explain the risk factors affecting hypertension in type 2 diabetic patients.Methods: An observational studies with case-control study design in Primary Healthcare Centers patients in Pati District. Patients with hypertension in type 2 diabetes are the case, while the type 2 diabetes patients without hypertension are the control. There were 57 cases and 57 controls included. Data were obtained from medical records and qualitative interviews. Chi-square test in bivariate and multiple logistic regression in multivariate analysis.Results: Factors that influence hypertension in type 2 diabetic patients were physical activity (OR=6,4; 95% CI: 2,18 - 18,77; p=0,001), diabetes duration ≥ 5 years (OR=5,4; 95% CI: 1,97 - 14,704; p=0,001), and medication adherence (OR=3,6; 95% CI: 1,32 - 9,83; p=0,012). Other risk factors i.e age ≥45 years, male, diet compliance, history of hypertension, smoking, salt consumption, coffee consumption, and sleep duration were not significantly influenced.Conclusion: In this study, physical activity, diabetes duration, and DM medication adherence are risk factors that influence of hypertension in type 2 diabetic patients.

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Serum Free Triiodothyronine Is Inversely Associated With Diabetic Peripheral Neuropathy but Not With Carotid Atherosclerotic Lesions in Type 2 Diabetic Patients With Euthyroid Function

10.21203/rs.3.rs-773386/v1 ◽

2021 ◽

Author(s):

Mei-Fang Li ◽

Jiang-Feng Ke ◽

Shuai Li ◽

Jun-Wei Wang ◽

Zhi-Hui Zhu ◽

...

Keyword(s):

Type 2 Diabetes ◽

Peripheral Neuropathy ◽

Diabetic Patients ◽

Free Triiodothyronine ◽

Type 2 Diabetic Patients ◽

Cross Sectional ◽

Serum Free ◽

Atherosclerotic Lesions ◽

Type 2 Diabetic

Abstract Background: The associations between serum free triiodothyronine (FT3) and diabetic peripheral neuropatprohy (DPN) / carotid atherosclerotic lesions in type 2 diabetic patients with normal thyroid function is still unclear. The purpose of our study was to explore the relationships of FT3 with DPN and carotid atherosclerotic lesions in Chinese type 2 diabetes inpatients with euthyroid function.Methods: A total of 2477 type 2 diabetes inpatients with euthyroid function were recruited in this cross-sectional study, and they were stratified into quartiles by FT3 levels. Peripheral neuropathy was assessed by neurological symptoms and signs as well as nerve conduction velocity tests. Carotid atherosclerotic lesions, including carotid intima-media thickness, plaque and stenosis, were evaluated by Doppler ultrasound. Results: After adjusting for potential confounders, there was a significant decrease in the prevalence of DPN in the patients with type 2 diabetes across the FT3 quartiles (23.5%, 20.9%, 18.9%, and 11.2%, respectively, p < 0.001). Logistical regression analysis further revealed that FT3 quartiles were significantly and inversely associated with DPN. Compared with the subjects in the highest FT3 quartile, the adjusted odds ratios (95% confidence interval) of DPN in the first to third FT3 quartile were successively 2.338 (1.407-3.884), 1.903 (1.134-3.194) and 1.598 (0.960-1.125). The patients with DPN had significantly higher prevalence of carotid plaques (55.8%) and carotid stenosis (1.3%) than non-DPN patients (44.8%; 0.5%). However, no statistical association was observed between FT3 quartiles and carotid atherosclerotic lesions.Conclusions: Lower FT3 within the normal range was independently associated with DPN, but not with carotid atherosclerotic lesions in Chinese type 2 diabetes inpatients with euthyroid function.

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Urinary tract Infection among type 2 diabetic patients admitted in a multispecialty hospital in South Chennai, Tamil Nadu

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20190628 ◽

2019 ◽

Vol 6 (3) ◽

pp. 1295 ◽

Cited By ~ 1

Author(s):

P. S. Vignesh ◽

T. T. Gopinath ◽

D. K. Sriram

Keyword(s):

Type 2 Diabetes ◽

Tamil Nadu ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Cross Sectional ◽

Gram Negative ◽

Hospital Patients ◽

Type 2 Diabetic

Background: Diabetes mellitus (DM) is a chronic and potentially disabling disease which is reaching an epidemic proportion in many parts of the world. UTI is a common infection observed in diabetic patients. The objectives of this study was to determine the prevalence of UTI among hospitalized type 2 diabetic patients, the frequent bacteria responsible for UTI and most susceptible antibiotics among the diabetic patients.Methods: A hospital-based study involving type 2 diabetes patients admitted with diagnosis of UTI between 2017- 2018 (July - June). The study was a cross sectional study and was approved by the Ethics Committee of the hospital. Patients fitting study inclusion and exclusion criteria took part in the study with informed written consent obtained. A validated pilot-tested questionnaire was used as a tool for data collection.Results: Total of 126 subjects were identified. Prevalence of UTI was around 25% higher in women with type 2 diabetes than in men. UTI was found to be significantly associated with age, creatinine (p<0.05) and Escherichia coli was the commonly isolated micro-organism. The gram negative pathogens were highly sensitive to cefoperazone-sulbactum and amikacin was found to be the most sensitive antibiotic for both gram positive and gram negative pathogens.Conclusions: UTIs are frequent in diabetic patients. Improved glycemic control in diabetics may help in controlling the UTIs. Accurate screening for UTI in diabetic patients is also critical to enable the appropriate treatment and avoiding related complications.

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Faktor Risiko yang Berpengaruh terhadap Terjadinya Hipertensi pada Penderita Diabetes Melitus Tipe II di Wilayah Puskesmas Kabupaten Pati

Jurnal Epidemiologi Kesehatan Komunitas ◽

10.14710/jekk.v2i2.3996 ◽

2017 ◽

Vol 2 (2) ◽

pp. 54

Author(s):

Gracilaria Puspa Sari ◽

Shofa Chasani ◽

Tjokorda Gde Dalem Pemayun ◽

Suharyo Hadisaputro ◽

Heri Nugroho

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Type 2 Diabetes ◽

Medication Adherence ◽

Coffee Consumption ◽

Diabetes Duration ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Type 2 Diabetic

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Diabetic nephropathy: early markers for monitoring and prevention

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20210443 ◽

2021 ◽

Vol 9 (2) ◽

pp. 565

Author(s):

Vijayashree S. Gokhale ◽

Kshithija R. Sajjan ◽

Rupesh Parati ◽

Keyuri Mehta

Keyword(s):

Type 2 Diabetes ◽

Diabetic Nephropathy ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Cross Sectional ◽

Albumin Creatinine Ratio ◽

Early Markers ◽

Function Test ◽

Type 2 Diabetic

Background: Type 2 diabetes, with its complications is perpetually on the rise more so in India .Diabetic Nephropathy progresses silently, and manifests at a stage where, patient can be offered only renal replacement. This study was undertaken to detect early markers of Diabetic Nephropathy. Aims and objective of the study was to study early nephropathy by UACR (urinary albumin/creatinine ratio), RFT (renal function test) and e-GFR in Type 2 diabetic patients of more than 2 years duration, with and without hypertension.Methods: A hospital based cross-sectional observational study, of 100 patients, 18-60 years of age, of type 2 Diabetes of 2 year duration and above, of which 50 were only diabetic and 50 had diabetes and hypertension. Patients who had an established renal disease were excluded from study.Results: Our study of 100 patients, 18-60 years of age, had 23 male and 77 female patients. Maximum patients were in age group 41-50 years, and 52% had diabetes of 2-4 years duration. Of the renal parameters studied, BUN was normal in 72% and S. Creatinine normal in 67%. UACR was normal in only 38%, and e-GFR was normal in 49%.Conclusions: In our study age and sex, duration of Diabetes and HbA1c did not have any bearing on renal parameters. UACR followed by e-GFR, were deranged early. UACR was more deranged in diabetics with hypertension.

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