The association between physical activity, diabetes mellitus (DM), and long-term acute coronary syndrome (ACS) prognosis was evaluated. The GREECS study included 2,172 consecutive ACS patients from six Greek hospitals (2003–2004). In 2013–2014, a 10-year follow up was performed with 1,918 patients. Physical activity was categorized in never, rarely (monthly basis), 1–2 and ≥ 3 times/week. Multi-adjusted analysis revealed that 1–2 and ≥ 3 times/week vs. no physical activity had a protective effect on ACS incidence (OR = 0.63 95% CI 0.38, 1.05) and (OR = 0.63 95% CI 0.40, 0.99) respectively, only in patients without prior baseline CVD event. In a subgroup analysis, with DM as strata in these patients, engagement in physical activity (i.e., 1–2 times/week) had a significant protective effect among patients with diabetes (OR = 0.51, 95% CI 0.27, 0.96, p = .037). These findings revealed the beneficial role of exercise in secondary ACS prevention, even in DM patients. Public health-oriented policies should incorporate regular physical activity as a key protective factor in disease prognosis.
Evangelos Papataxiarchis, Demosthenes B. Panagiotakos, Venetia Notara, Matina Kouvari, Yannis Kogias, Petros Stravopodis, George Papanagnou, Spyros Zombolos, Yannis Mantas, Christos Pitsavos and for the GREECS Study Investigators, Greece
Robert Kertzer, Ron Croce, Richard Hinkle and Collette Janson-Sand
Few studies have investigated the fitness levels of children and adolescents with insulin-dependent diabetes mellitus (IDDM), with no data presently available on such children’s level of motor proficiency. The present investigation was prompted by this lack of information. Twenty-one girls (mean age = 11.0 years, range = 7-14) and 23 boys (mean age =11.5 years, range = 8-15) with IDDM were tested on selected fitness and motor behavior parameters. Results indicated that children and adolescents with IDDM follow similar fitness and motor behavior profiles of their nondiabetic peers: Boys tended to be in better physical condition than girls of similar ages, particularly in the 12-15 year range. In the areas of body composition and abdominal strength/endurance, subjects displayed values below those obtained in studies of nondiabetic subjects. Subjects’ scores on the Bruininks-Oseretsky Test of Motor Proficiency for each age grouping were relatively high, indicating that children and adolescents with IDDM need not have diminished psychomotor skills.
Joan Kelly, Katrina Edney, Chris Moran, Velandai Srikanth and Michele Callisaya
Physical activity (PA) is important in managing Type 2 Diabetes Mellitus (T2DM). This study aimed to determine 1) the number of daily steps taken by older people with T2DM, 2) if T2DM is associated with taking fewer steps per day and less likelihood of meeting PA guidelines, and 3) whether these associations are modified by age or gender.
PA was obtained by pedometer from 2 cohorts of older adults with and without T2DM. Multivariable regression was used to determine associations between T2DM, mean steps per day and meeting a guideline equivalent (7 100 steps per day).
There were 293 participants with T2DM (mean age 67.6 ± 6.8 years) and 336 without T2DM (mean age 72.1 ± 7.1 years). In women, T2DM was associated with fewer mean steps per day (β = –1306.4; 95% CI –2052.5, –560.3; P = .001) and not meeting the PA guidelines (OR 0.51; 95% CI 0.28, 0.92; P = .03). Associations were not significant in men (P > .05). Only 29.7% of those with T2DM and 33.3% of those without T2DM met PA guidelines.
Greater focus is needed on how to maintain and increase PA in older age with particular focus on women with T2DM.
Christian Lackinger, Sandra Haider, Lana Kosi, Juergen Harreiter, Yvonne Winhofer and Alexandra Kautzky-Willer
Although the infrastructure of Austrians’ sports clubs is well developed, exercise classes for people suffering from type II diabetes mellitus (T2DM) do not exist. This feasibility study evaluates factors for participating in target group specific exercise courses (TGSEC) and changes in physical activity.
This intervention study was performed in 22 communities of Austria. Initial TGSEC were offered to T2DM patients over 2 months. Participants were surveyed at 4 time points with a questionnaire: before the program, 2, 6 and 12 months after the initial questionnaire.
881 patients aged 59.0 (SD: 9.6) years took part in TGSEC. At baseline a lack of suitable exercise groups prevented 51% from being active. 58% were encouraged by the medical sector. After 12 months the weekly time spent on exercise training was increased from 1.40 (SD: 2.55) hours to 2.15 (SD: 3.00) hours (P < .001). The dropout rate during the first 2 months was 12.9%. The rate of return for the 12 months questionnaire was 42%.
TGSEC provided by sports clubs attract people suffering from T2DM and effectively enhance physical activity.
Kian Peng Goh, Hwei Yee Lee, Dawn Pingxi Lau, Wilma Supaat, Yiong Huak Chan and Angela Fang Yung Koh
The primary aims of the study were to examine the effect of resveratrol on skeletal muscle SIRT1 expression and energy expenditure in subjects with Type 2 diabetes mellitus (T2DM).
Animal and in vivo studies indicate that resveratrol increases SIRT1 expression that stimulates PGC1α activity. Subsequent upregulation of AMPK and GLUT4 expression are associated with improved insulin sensitivity in peripheral tissues.
Ten subjects with T2DM were randomized in a double-blind fashion to receive 3g resveratrol or placebo daily for 12 weeks. Secondary outcomes include measures of AMPK, p-AMPK and GLUT4 expression levels, energy expenditure, physical activity levels, distribution of abdominal adipose tissue and skeletal muscle fiber type composition, body weight, HbA1c, plasma lipid subfraction, adiponectin levels, and insulin sensitivity.
There was a significant increase in both SIRT1 expression (2.01 vs. 0.86 arbitrary units [AU], p = .016) and p-AMPK to AMPK expression ratio (2.04 vs. 0.79 AU, p = .032) in the resveratrol group compared with the placebo group. Although the percentage of absolute change (8.6 vs. –13.9%, p = .033) and percentage of predicted resting metabolic rate (RMR; 7.8 vs. –13.9%, p = .013) were increased following resveratrol, there was a significant reduction in average daily activity (–38 vs. 43.2%, p = .028) and step counts (–39.5 vs. 11.8%, p = .047) when compared with placebo.
In patients with T2DM, treatment with resveratrol regulates energy expenditure through increased skeletal muscle SIRT1 and AMPK expression. These findings indicate that resveratrol may have beneficial exercise-mimetic effects in patients with T2DM.
Denise Rodrigues Bueno, Maria de Fátima Nunes Marucci, Clara Suemi da Costa Rosa, Rômulo Araújo Fernandes, Yeda Aparecida de Oliveira Duarte and Maria Lucia Lebão
prevalence of both arterial hypertension (HBP) and diabetes mellitus (DM) ( Nascimento et al., 2015 ). An insufficient physical activity level (PAL) can result in unfavorable control of these diseases, leading to a significant economic impact related to the associated complications ( Bertoldi et al., 2013
Debra M. Vinci
Column-editor : Susan M. Kleiner
Binh Nguyen, Adrian Bauman and Ding Ding
To examine the combined effects of body mass index (BMI), physical activity (PA) and sitting on incident type 2 diabetes mellitus (T2DM) among Australian adults.
A sample of 29,572 adults aged ≥45 years from New South Wales, Australia, completed baseline (2006–2008) and follow-up (2010) questionnaires. Incident T2DM was defined as self-reported, physician-diagnosed diabetes at follow-up. BMI was categorized as normal/overweight/obese. PA was tertiled into low/medium/ high. Sitting was dichotomized as higher/lower sitting (≥ 8 hours/day or < 8 hours/day). Odds ratios (OR) were estimated for developing T2DM using logistics regression for individual and combined risk factors, and data stratified by BMI categories.
During a mean 2.7 (SD: 0.9) years of follow-up, 611 (2.1%) participants developed T2DM. In fully adjusted models, BMI was the only independent risk factor for incident T2DM. In stratified analyses, the association between BMI and T2DM did not differ significantly across sitting or PA categories. Overweight/obese individuals with high PA and lower sitting had higher odds of incident T2DM than normal counterparts with low PA and higher sitting.
High PA/low sitting did not attenuate the risk of T2DM associated with overweight/obesity. Maintaining a healthy weight, by adopting healthy lifestyle behaviors, is critical for T2DM prevention.
Barbara N. Campaigne, Kyle W. Landt, Frederick W. James, Joan Reimar, Wayne Mays and Mark A. Sperling
Systolic time intervals (STI) were measured before and after exercise in 18 diabetic adolescents (D) and 18 age- and sex-matched nondiabetic controls (C). At similar heart rates, pre-exercise pre-ejection period (PEP) and left ventricular ejection time (LVET) were significantly shorter in D compared to C (p<0.05). There was no difference between the two groups in the PEP/LVET ratio. Following exercise there were no differences in STIs between groups. However, the change in PEP and LVET from pre- to postexercise was significantly less in D compared to C (delta PEP 38 vs. 53±3 msec, p<0.01; delta LVET 120 vs. 134±4 msec, p<0.05). These data suggest a hypercontractile state at rest in D and a blunted response to exercise when compared to C. This study provides data that may be relevant to the early identification of individuals at risk for premature diabetic cardiomyopathy.