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Priscila M. Nakamura, Grégore I. Mielke, Bernardo L. Horta, Maria Cecília Assunção, Helen Gonçalves, Ana M.B. Menezes, Fernando C. Barros, Ulf Ekelund, Soren Brage, Fernando C. Wehrmeister, Isabel O. Oliveira and Pedro C. Hallal

Background:

Physical inactivity is responsible for 7% of diabetes deaths worldwide, but little is known whether low levels of physical activity (PA) during adolescence increase the risk of diabetes in early adulthood. We evaluated the cross-sectional and longitudinal associations between PA throughout adolescence and HbA1c concentration in early adulthood.

Methods:

HbA1c was measured by high performance liquid chromatography. PA was assessed by self-report at the ages of 11, 15, and 18 years and by accelerometry at the ages of 13 (subsample) and 18 years. The loss percentages of follow up were 12.5% at 11 years, 14.4% at 15 years, and 18.7% at 18 years.

Results:

At 18 years, boys showed higher HbA1c than girls. At age 18 years, accelerometrybased PA at 18 years was inversely related to HbA1c levels in boys. Self-reported leisure-time PA at ages 11, 15, and 18 were unrelated to HbA1c in both genders. PA at 13 years of age was unrelated to HbA1c among both genders. In trajectory analysis, PA and accelerometer PA trajectories were not associated with later HbA1c.

Conclusions:

Objectively measured PA at 18 years was cross-sectionally inversely associated with HbA1c in boys only. No prospective associations were identified.

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Ronald C. Plotnikoff, Michael A. Pickering, Nicole Glenn, Sandra L. Doze, Melissa L. Reinbold-Matthews, Laura J. McLeod, David C. W. Lau, Gordon H. Fick, Steven T. Johnson and Laura Flaman

Background:

Physical activity (PA) is a cornerstone in the management of type 2 diabetes (T2DM). This pilot investigation explores the effects of a standard diabetes education program compared with a supplemental PA intervention on diabetes-related health outcomes.

Methods:

Using a prospective 2-armed design, 96 adults with T2DM were randomly assigned to either standard care (diabetes education program; n = 49) or standard care supplemented with an 8-week, individualized-counseling and community-based PA component (n = 47). Measurements were taken at baseline, 3, 6, and 12 months. Primary outcomes were changes in PA (self-report) and HbA1c. Between group changes were compared using analysis of covariance (ANCOVA) and changes over time using repeated-measures ANOVA.

Results:

In comparison with standard care, the supplemental group demonstrated an increase in PA (Ps < 0.01) and cardiorespiratory fitness (Ps < 0.05) from baseline to all follow-up time-points. HbA1c levels declined (P < .05) from baseline to all time points in the standard care group. Reduction in cholesterol-ratio (P < .01), increase in HDL (P < .05), and reductions in blood pressure, resting heart rate and BMI (approaching statistical significance Ps < 0.10) were also reported for both groups.

Conclusions:

PA counseling in addition to standard care is effective for promoting PA behavior change and positive health-related outcomes among individuals with T2DM.

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Annie Fex, Jean-Philippe Leduc-Gaudet, Marie-Eve Filion, Antony D. Karelis and Mylène Aubertin-Leheudre

Objectives:

The purpose of the current study was to examine the impact of 12 weeks of elliptical high intensity interval training (HIIT) on metabolic risk factors and body composition in pre- and type 2 diabetes patients.

Methods:

Sixteen pre- (n = 8) and type 2 diabetes (n = 8) participants completed this study. Fasting blood glucose, HbA1c, anthropometric measurements, body composition (DXA), blood pressure, resting heart rate, VO2max, and dietary factors, as well as total and physical activity energy expenditure, were measured. The HIIT program on the elliptical was performed 3 times a week for 12 weeks.

Results:

After the intervention, we observed a significant improvement for fasting blood glucose, waist and hip circumference, appendicular fat mass, leg lean body mass and appendicular lean body mass, systolic blood pressure, resting heart rate, and VO2max (P < .05). In addition, we noted a lower tendency for leg fat mass (P = .06) and diastolic blood pressure (P = .05) as well as a higher tendency for total energy expenditure (P = .06) after the intervention.

Conclusions:

The current study indicates that elliptical HIIT seems to improve metabolic risk factors and body composition in pre- and type 2 diabetes patients.

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Marjan Mosalman Haghighi, Yorgi Mavros and Maria A. Fiatarone Singh

-regression analyses were used to determine: (1) the association between intervention characteristics (eg, study duration, contacts) and change in PA behavior; (2) the association between participant characteristics and change in PA behavior; and (3) the association between change in PA behavior and change in HbA 1c

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Cristiane Petra Miculis, Wagner De Campos and Margaret Cristina da Silva Boguszewski

Background:

The aim of this study was to correlate glycemic control (GC) and variables of physical activity levels (PAL) in children with type 1 diabetes mellitus (T1DM).

Methods:

Fifty children and adolescents with T1DM were selected. Personal and medical data for the patients were collected. Physical evaluations of body weight and sexual maturation were undertaken. Bouchard’s questionnaire was applied to evaluate PAL as well as for time spent on physical activities.

Results:

Sixty-four percent of the subjects were sexually mature. Differences were observed between females and males in insulin dose, duration of light physical activity, and sleeping time (P < .05). Ninety percent presented poor GC and 80% had a low PAL. Fasting blood glucose (FBG) was significantly correlated with PAL, with sedentary time, and with sleeping time. Glycated hemoglobin (HbA1c) was significantly correlated with sedentary time and sleeping time. Among the three groups of PAL (insufficient × moderate × active) there were differences in HbA1c (%), FBG (mg/dL), duration of disease (years), and insulin dose (UI/kg/day) (P < 0.001).

Conclusion:

GC was significantly correlated with PAL. Among the three groups of physical activity level, the most active group was seen to have the best GC.

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Valderi Abreu de Lima, Luis Paulo Gomes Mascarenhas, Juliana Pereira Decimo, William Cordeiro de Souza, Anna Louise Stellfeld Monteiro, Ian Lahart, Suzana Nesi França and Neiva Leite

The aim of this study was to evaluate the level of physical activity and cardiorespiratory fitness in teenagers with type 1 diabetes mellitus (T1D) in comparison with healthy scholar participants. Total of 154 teenagers (T1D = 45 and CON = 109). Height, weight, cardiorespiratory fitness (VO2max), and the level of physical activity by the Bouchard’s Physical Activity Record were measured, and glycated hemoglobin (HbA1c) in T1D. The VO2max was lower in the T1D (38.38 ± 7.54) in comparison with the CON (42.44 ± 4.65; p < .05). The VO2max had correlation with the amount of time of moderate-to-vigorous physical activity (r = .63; p = .0001) and an inverse correlation with sedentary activities (r= -0.46; p = .006). In the T1D the levels of HbA1c had an inverse correlation with the amount of time of moderate-to-vigorous physical activity (r= -0.34; p = .041) and correlation with the BMI z-score (r = .43; p = .017). Only 37,8% of the participants in the T1D reached the adequate amount of daily moderate-to-vigorous intensity physical activity, in the CON 81,7% reached the WHO’s recommendation. Conclusion: T1D had less cardiorespiratory capacity then healthy controls, the teenagers of T1D with lower BMI z-score and that dedicated a greater time in moderate-to-vigorous intensity physical activity demonstrated a better glycemic control.

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Radhika Aditya Jadhav, Animesh Hazari, Ashma Monterio, Sampath Kumar and Arun G. Maiya

Background:

Prediabetes is a strong risk factor for the development of Type2 Diabetes Mellitus (T2DM). Modification in lifestyle plays an important role to avoid the prognosis of T2DM and its complications in future. The aim of our study was to focus on the effectiveness of physical activity (PA) intervention program on different outcome measures in individuals with prediabetes. The effort of the present review was to contribute to the existing literature by strengthening the evidence pointing toward the positive impact of physical activity in individuals with prediabetes.

Methods:

Studies have been identified through database like PubMed, Scopus, and ProQuest. Randomized and nonrandomized controlled trials have been included. Nineteen articles have been selected for the qualitative analysis and 08 for meta-analysis.

Results:

PA intervention showed a favorable effect on improving oral glucose tolerance (Risk ratio [RR] –0.26, 95% CI –0.06 to 0.07) and fasting blood sugar (RR –0.05, 95% CI –0.14 to 0.04). It also showed the favorable effect on glycated hemoglobin (HbA1C), maximum oxygen uptake (VO2max), and body composition.

Conclusion:

Present review suggests that the PA promotion and participation can help to slow down the progression of disease in individuals with prediabetes and thus reduces the morbidity and mortality associated with T2DM.

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Emily Read

Background:

Rural Canadians are at increased risk of metabolic syndrome. Physical inactivity is a primary target for preventing and reversing metabolic syndrome. Adherence to lifestyle interventions may be enhanced using cell phones and self-monitoring technologies. This study investigated the feasibility of a physical activity and self-monitoring intervention targeting high-risk adults in rural Ontario.

Methods:

Rural adults (n = 25, mean = 57.0 ± 8.7 years) with ≥ 2 criteria for metabolic syndrome participated in an 8-week stage-matched physical activity and self-monitoring intervention. Participants monitored blood glucose, blood pressure, weight, and physical activity using self-monitoring devices and Blackberry Smart phones. VO2max, stage of change, waist circumference, weight, blood lipids, and HbA1c were measured at weeks 1, 4, and 8.

Results:

Adherence to self-monitoring was > 94%. Participants’ experiences and perceptions of the technology were positive. Mean stage of change increased 1 stage, physical activity increased 26%, and predicted VO2max increased 17% (P < .05). Significant changes in weight, waist circumference, diastolic blood pressure, LDL cholesterol, and total cholesterol were found.

Conclusions:

This stage-matched technology intervention for increased physical activity was feasible and effective.

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Lise Crinière, Claire Lhommet, Agnès Caille, Bruno Giraudeau, Pierre Lecomte, Charles Couet, Jean-Michel Oppert and David Jacobi

Background:

Increasing physical activity and decreasing sedentary time are cornerstones in the management of type 2 diabetes (T2DM). However, there are few instruments available to measure physical activity in this population. We translated the long version of the International Physical Activity Questionnaire (IPAQ-L) into French and studied its reproducibility and validity in patients with T2DM.

Methods:

Reproducibility was studied by 2 telephone administrations, 8 days apart. Concurrent validity was tested against pedometry for 7 days during habitual life.

Results:

One-hundred forty-three patients with T2DM were recruited (59% males; age: 60.9 ± 10.5 years; BMI: 31.2 ± 5.2 kg/m2; HbA1c: 7.4 ± 1.2%). Intraclass correlation coefficients (95% CI) for repeated administration (n = 126) were 0.74 (0.61−0.83) for total physical activity, 0.72 (0.57−0.82) for walking, and 0.65 (0.51−0.78) for sitting time. Total physical activity and walking (MET-min·week-1) correlated with daily steps (Spearman r = .24 and r = .23, respectively, P < .05). Sitting time (min·week-1) correlated negatively with daily steps in women (r = −0.33; P < .05).

Conclusion:

Our French version of the IPAQ-L appears reliable to assess habitual physical activity and sedentary time in patients with T2DM, confirming previous data in nonclinical populations.

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Sarah Edmunds, Denise Roche and Gareth Stratton

Background:

The current study objectively assessed physical activity (PA) levels and patterns in children and adolescents with type 1 diabetes and compared the metabolic and physiologic health profiles of those achieving and those not achieving the current recommendation of 60 minutes a day (minutes·D−1) of at least moderate intensity PA.

Method:

37 children and adolescents (20 boys, 17 girls) aged 12.7 ± 2.1 years (mean ± SD), disease duration 5.9 ± 3.0 years participated. PA was assessed using heart rate monitoring. Peak VO2, BMI, sum of 5 skinfolds, HbA1c, and daily insulin dosage were also determined.

Results:

Mean accumulated time in moderate-to-vigorous intensity PA was 53.6 ± 31.4 minutes·D−1. Levels of vigorous-intensity PA were low, mean 8.3 ± 10.2 minutes·D−1. When controlling for age, no differences in metabolic or physiologic health outcomes were evident between those individuals achieving, and those not achieving, 60 minutes·D−1 of moderate-to-vigorous intensity PA. PA predominantly occurred in short bouts lasting 5 minutes or less.

Conclusion:

The efficacy of accumulating 60 minutes·D−1 of moderate-to-vigorous intensity PA, in the form of short duration, intermittent bouts of largely unplanned PA, to promote health gains in children and adolescents with type 1 diabetes is questionable.