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Stefano Palermi, Anna M. Sacco, Immacolata Belviso, Nastasia Marino, Francesco Gambardella, Carlo Loiacono and Felice Sirico

to decreased socialization, autonomy, and overall quality of life ( Salkeld et al., 2000 ). This public health issue is even more serious in specific subsets of patients with specific diseases, such as patients with type 2 diabetes mellitus (DM). Indeed, these patients have a higher risk of falling

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Kin-Kit Li, Lorna Ng, Sheung-Tak Cheng and Helene H. Fung

. Accordingly, the effects should be validated across different populations and settings. This study examined the framing effect among older adults with type 2 diabetes (T2D). Message Framing in PA Promotion According to prospect theory ( Tversky & Kahneman, 1981 ), decisions are made based on the subjective

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Nele Huys, Vicky Van Stappen, Samyah Shadid, Marieke De Craemer, Odysseas Androutsos, Jaana Lindström, Konstantinos Makrilakis, Maria S. de Sabata, Luis Moreno, Pilar De Miguel-Etayo, Violeta Iotova, Imre Rurik, Yannis Manios, Greet Cardon and on behalf of the Feel4Diabetes-Study Group

form of diabetes, type 2 Diabetes Mellitus (T2DM), accounts for 91% of all diabetes cases. 3 The risk for T2DM is determined by several nonmodifiable (eg, ethnicity, family history of diabetes, older age) and also modifiable (eg, overweight and obesity, unhealthy diet, low physical activity [PA

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Saowaluck Suntraluck, Hirofumi Tanaka and Daroonwan Suksom

Diabetes mellitus is recognized as one of the leading causes of disability, morbidity, and premature mortality and has become an epidemic in many countries. Patients with type 2 diabetes demonstrate four times greater mortality from cardiovascular disease ( Almdal, Scharling, Jensen, & Vestergaard

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

Low levels of physical activity (PA) and high levels of sedentary behavior are independent, modifiable risk factors for the progression of insulin resistance, and poor health outcomes in adults with type 2 diabetes. 1 , 2 However, this cohort is substantially less likely to meet PA guidelines

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Susumu S. Sawada, I-Min Lee, Hisashi Naito, Koji Tsukamoto, Takashi Muto and Steven N. Blair

Background:

Limited data are available on the relationship between muscular and performance fitness (MPF) and the incidence of type 2 diabetes.

Methods:

A cohort of 3792 Japanese men completed a medical examination that included MPF and cardiorespiratory fitness tests. MPF index composite score was calculated using Z-scores from vertical jump, sit-ups, side step, and functional reach tests.

Results:

The mean follow-up period was 187 months (15.6 years). There were 240 patients who developed type 2 diabetes during follow-up. Relative risks and 95% confidence intervals (CI) for incidence of diabetes across baseline quartiles of MPF index composite score were obtained using the Cox proportional hazards model while adjusting for age, BMI, diastolic blood pressure, cigarette smoking, alcohol intake, and family history of diabetes. The relative risks for developing diabetes across quartiles of MPF index composite scores (lowest to highest) were 1.0 (referent), 1.15 (95% CI 0.83−1.60), 1.10 (0.78−1.55), and 0.57 (0.37−0.90) (P for trend = .061). These results were attenuated after adjustment for cardiorespiratory fitness (P for trend = .125).

Conclusions:

This prospective study suggests that MPF is a predictor of type 2 diabetes, although its predictive ability was attenuated after adjusting for cardiorespiratory fitness.

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Sae Young Jae, Kevin Heffernan, Bo Fernhall and Yoon-Ho Choi

Background:

We tested the hypothesis that higher levels of cardiorespiratory fitness are inversely associated with carotid artery intima media thickness in 746 (age 53 ± 7 yrs) men with type 2 diabetes.

Methods:

We measured common carotid intima media thickness and defined carotid atherosclerosis as a carotid intima media thickness > 1.0 mm. Cardiorespiratory fitness was directly measured by peak oxygen uptake using expired gases analysis during a standard treadmill test.

Results:

Cardiorespiratory fitness was independently associated with common carotid intima media thickness in multivariable regression (β = –0.15, P < .05). After adjusting for established risk factors, high and moderate cardiorespiratory fitness were associated with lower odds ratios for having carotid atherosclerosis—0.49 (95% CI, 0.30–0.81), and 0.59 (95% CI, 0.38–0.92), respectively—as compared with low cardiorespiratory fitness. Each 1 metabolic equivalent increment higher cardiorespiratory fitness was associated with 27% (OR = 0.73; 95% CI, 0.61–0.87) lower prevalence of carotid atherosclerosis.

Conclusions:

These results suggest that high cardiorespiratory fitness is inversely associated with common carotid intima media thickness in men with type 2 diabetes.

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James Dziura, Stanislav V. Kasl and Loretta Di Pietro

Background:

It is not clear whether physical activity can exert a protective role on diabetes risk in older people that is independent of the changes in body weight that occur with both aging and disuse. The purpose of this analysis was to determine the relation between current physical activity, 3-year change in body weight, and the subsequent risk of type 2 diabetes in an older cohort.

Methods:

We studied prospectively 2,135 older (≥65 years) persons living in New Haven, CT, between 1982 and 1994. Physical activity was self-reported in 1982 and again in 1985; body weight and diabetes were self-reported annually over 12 years. Data were analyzed using multivariable Cox Proportional Hazards modeling with adjustments for age, sex, race, education, body mass index (BMI), smoking, chronic conditions, physical function, and alcohol intake.

Results:

Although an inverse graded relation was observed between level of activity and rate of diabetes, this dose–response relation did not reach statistical significance. However, older people who reported at least some activity at baseline experienced a significantly lower rate of diabetes between 1983 and 1994 compared to those reporting no activity (RR = 0.55; 95%CI = 0.35, 0.87). When 3-year changes in physical activity and body weight between 1982 and 1985 were added to the model, the relation between physical activity and reduced diabetes risk was unchanged (RR = 0.49; 95%CI = 0.24, 0.99).

Conclusions:

Even in advanced age, physical activity exerts an important and independent role in the prevention of type 2 diabetes. Continued physician counseling on the health effects of physical activity and referrals to community-based exercise programs should be encouraged among older people.

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Jane E. Yardley, Jacqueline Hay, Freya MacMillan, Kristy Wittmeier, Brandy Wicklow, Andrea MacIntosh and Jonathan McGavock

Type 2 diabetes is associated with hypertension and an increased risk of cardiovascular disease. In adults, blood pressure (BP) responses to exercise are predictive of these complications. To determine if the hemodynamic response to exercise is exaggerated in youth with dysglycemia (DG) compared with normoglycemic overweight/obese (OB) and healthy weight (HW) controls a cross-sectional comparison of BP and heart rate (HR) responses to graded exercise to exhaustion in participants was performed. DG and OB youth were matched for age, BMI z-score, height and sex. Systolic (SBP) and diastolic BP (DBP) were measured every 2 min, and HR was measured every 1 min. SBP was higher in OB and DG compared with HW youth at rest (p > .001). Despite working at lower relative workloads compared with HW, the BP response was elevated during exercise in OB and DG. For similar HR and oxygen consumption rates, BP responses to exercise were slightly higher in OB and DG compared with HW. OB and DG youth both display elevated resting and exercise BP relative to HW peers. Obesity may play a greater role than dysglycemia in the exaggerated BP response to exercise in youth.

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William R. Sukala, Rachel Page, Chris Lonsdale, Isabelle Lys, David Rowlands, Jeremy Krebs, Murray Leikis and Birinder Singh Cheema

Background:

To evaluate the differential effect of 2, group-based exercise modalities on quality of life (QoL) in indigenous Polynesian peoples with type 2 diabetes (T2DM) and visceral obesity.

Methods:

Participants were randomized to resistance training or aerobic training performed 3 times per for 16 weeks. The Short-Form 36 was administered at baseline and post intervention to assess 8 domains and physical and mental component scales (PCS and MCS) of QoL.

Results:

With the exception of Mental Health and MCS, all scores were lower at baseline than general population norms. Significant improvements were documented in several QoL scores in each group post intervention. No group × time interactions were noted. Pooled analyses of the total cohort indicated significantly improved Physical Functioning, Role-Physical, Bodily Pain, General Health, Vitality, Role-Emotional, PCS and MCS. Adaptation ranged from 5%−22%, and demonstrated a moderate-to-large effect (Cohen’s d = 0.64−1.29). All measures of QoL increased to near equivalent, or greater than general norms.

Conclusion:

Exercise, regardless of specific modality, can improve many aspects of QoL in this population. Robust trials are required to investigate factors mediating improvements in QoL, and create greater advocacy for exercise as a QoL intervention in this and other indigenous populations with T2DM.