Exercise, genetics and prevention of type 2 diabetes

2006 ◽  
Vol 42 ◽  
pp. 177-192 ◽  
Author(s):  
Gang Hu ◽  
Jesús Rico-Sanz ◽  
Timo A. Lakka ◽  
Jaakko Tuomilehto
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Clinical Trials ◽  
Physical Fitness ◽  
Prospective Studies ◽  
Dietary Modification ◽  
Glucose Levels ◽  
The Past ◽  
Joint Associations

Type 2 diabetes is one of the fastest growing public health problems in both developed and developing countries. Cardiovascular disease is the most prevalent complication of type 2 diabetes. In the past decade, the associations of physical activity, physical fitness and changes in the lifestyle with the risk of type 2 diabetes have been assessed by a number of prospective studies and clinical trials. A few studies have also evaluated the joint associations of physical activity, body mass index and glucose levels with the risk of type~2 diabetes. The results based on prospective studies and clinical trials have shown that moderate or high levels of physical activity or physical fitness and changes in the lifestyle (dietary modification and increase in physical activity) can prevent type 2 diabetes.

Epidemiological studies of exercise in diabetes prevention

2007 ◽  
Vol 32 (3) ◽  
pp. 583-595 ◽  
Author(s):  
Gang Hu ◽  
Timo A. Lakka ◽  
Tuomas O. Kilpeläinen ◽  
Jaakko Tuomilehto
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Clinical Trials ◽  
Physical Fitness ◽  
Prospective Studies ◽  
Scientific Evidence ◽  
Total Mortality ◽  
Epidemiological Studies ◽  
Glucose Levels

Type 2 diabetes is one of the fastest growing public health problems in both developed and developing countries. It is estimated that the number of people with diabetes in the world will double in coming years, from 171 million in 2000 to 366 million in 2030. Cardiovascular disease accounts for more than 70% of total mortality among patients with type 2 diabetes. The associations of physical activity, physical fitness, and changes in the lifestyle with the risk of type 2 diabetes have been assessed by a number of prospective studies and clinical trials in the past decade. Several studies have also evaluated the joint associations of physical activity, body mass index, and glucose levels with the risk of type 2 diabetes. Prospective studies and clinical trials have shown that moderate or high levels of physical activity or physical fitness and changes in the lifestyle (dietary modification and increase in physical activity) can prevent type 2 diabetes. Our review of the scientific evidence confirms that 30 min/d of moderate- or high-level physical activity is an effective and safe way to prevent type 2 diabetes in all populations.

scholarly journals Type 2 diabetes patients’ views on prevention of hypoglycaemia – a mixed methods study investigating self-management issues and self-identified causes of hypoglycaemia

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Stijn Crutzen ◽  
Tessa van den Born-Bondt ◽  
Petra Denig ◽  
Katja Taxis
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Mixed Methods ◽  
Food Intake ◽  
Mixed Methods Study ◽  
Self Management ◽  
Hypoglycaemic Event ◽  
Glucose Levels ◽  
Management Issues

Abstract Background Hypoglycaemia is a common and potentially avoidable adverse event in people with type 2 diabetes (T2D). It can reduce quality of life, increase healthcare costs, and reduce treatment success. We investigated self-management issues associated with hypoglycaemia and self-identified causes of hypoglycaemia in these patients. Methods In this mixed methods study qualitative semi-structured interviews were performed, which informed a subsequent quantitative survey in T2D patients. All interviews were audio recorded, transcribed verbatim and coded independently by two coders using directed content analysis, guided by the Theoretical Domains Framework. Descriptive statistics were used to quantify the self-management issues and causes of hypoglycaemia collected in the survey for the respondents that had experienced at least one hypoglycaemic event in the past. Results Sixteen participants were interviewed, aged 59–84 years. Participants perceived difficulties in managing deviations from routine, and they sometimes lacked procedural knowledge to adjust medication, nutrition or physical activity to manage their glucose levels. Grief and loss of support due to the loss of a partner interfered with self-management and lead to hypoglycaemic events. Work ethic lead some participant to overexerting themselves, which in turn lead to hypoglycaemic events. The participants had difficulties preventing hypoglycaemic events, because they did not know the cause, suffered from impaired hypoglycaemia awareness and/or did not want to regularly measure their blood glucose. When they did recognise a cause, they identified issues with nutrition, physical activity, stress or medication. In total, 40% of respondents reported regular stress as an issue, 24% reported that they regularly overestimated their physical abilities, and 22% indicated they did not always know how to adjust their medication. Around 16% of patients could not always remember whether they took their medication, and 42% always took their medication at regular times. Among the 83 respondents with at least one hypoglycaemic event, common causes for hypoglycaemia mentioned were related to physical activity (67%), low food intake (52%), deviations from routine (35%) and emotional burden (28%). Accidental overuse of medication was reported by 10%. Conclusion People with T2D experience various issues with self-managing their glucose levels. This study underlines the importance of daily routine and being able to adjust medication in relation to more physical activity or less food intake as well as the ability to reduce and manage stress to prevent hypoglycaemic events.

scholarly journals Clinical Measures of Physical Fitness Predict Insulin Resistance in People at Risk for Diabetes

2008 ◽  
Vol 88 (11) ◽  
pp. 1355-1364 ◽  
Author(s):  
Chiao-Nan Chen ◽  
Lee-Ming Chuang ◽  
Ying-Tai Wu
Keyword(s):  
Physical Activity ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Body Mass Index ◽  
At Risk ◽  
Risk Factor ◽  
Waist Circumference ◽  
Physical Fitness ◽  
Clinical Measures

Background and Purpose Physical inactivity has been well documented as a risk factor for type 2 diabetes. Previous studies measured the level of physical activity either with questionnaires or with direct measurements of maximum oxygen uptake. However, questionnaires are patient-report measures, and methods for obtaining direct maximum oxygen uptake measurements often are not available clinically. The purpose of this study was to investigate whether clinical measurement of health-related physical fitness with a simple test battery can predict insulin resistance, a precursor of type 2 diabetes, in people at risk for diabetes. Subjects and Methods A total of 151 volunteers with at least one diabetes risk factor (overweight, hypertension, dyslipidemia, family history, impaired glucose tolerance, gestational diabetes, or delivering a baby weighing more than 4.0 kg) were recruited. Insulin resistance (as determined with the homeostasis model assessment of insulin resistance [HOMA-IR]), physical fitness (including body composition, as determined with the body mass index and waist circumference), muscle strength (handgrip strength [force-generating capacity]), muscle endurance (sit-up test), flexibility (sit-and-reach test), and cardiorespiratory endurance (step test) were measured, and a physical activity questionnaire was administered. Backward regression analysis was used to build the prediction models for insulin resistance from components of physical fitness and physical activity. Results Body mass index, muscle strength, and cardiorespiratory fitness predicted HOMA-IR in men (adjusted R2=.264). In women, age, waist circumference, and cardiorespiratory fitness were the predictors of HOMA-IR (adjusted R2=.438). Discussion and Conclusion Clinical measures of physical fitness can predict insulin resistance in people at risk for diabetes. The findings support the validity of clinical measures of physical fitness for predicting insulin resistance in people at risk for diabetes.

scholarly journals Relationships of Changes in Physical Activity and Sedentary Behavior With Changes in Physical Fitness and Cardiometabolic Risk Profile in Individuals With Type 2 Diabetes: The Italian Diabetes and Exercise Study 2 (IDES_2)

2021 ◽  
Author(s):  
Stefano Balducci ◽  
Jonida Haxhi ◽  
Massimo Sacchetti ◽  
Giorgio Orlando ◽  
Patrizia Cardelli ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Risk ◽  
Physical Fitness ◽  
Cardiovascular Risk Factors ◽  
Risk Profile ◽  
Risk Scores ◽  
Metabolic Equivalents

<a><strong>Objective.</strong></a> In the Italian Diabetes and Exercise Study_2, a behavioral counseling <a>promoted</a> a sustained increase in physical activity (PA) volume (+3.3 metabolic equivalents-hour·week<sup>-1</sup>), moderate-to-vigorous-intensity PA (MVPA, +6.4 min·day<sup>-1</sup>), and light-intensity PA (LPA, +0.8 hours·day<sup>-1</sup>) and decrease in sedentary time (SED-time, -0.8 hours·day<sup>-1</sup>). Here, we investigated <a>the relationships of changes in PA/SED-time with changes in physical fitness and cardio-metabolic risk profile in individuals with type 2 diabetes</a>. <p><b>Research Design and Methods. </b><a>In this 3-year randomized clinical trial, 300 physically inactive and sedentary patients were randomized 1:1 to receive one-month theoretical and practical counseling once-a-year or standard care. </a>Changes in physical fitness and cardiovascular risk factors/scores according to quartiles of accelerometer-measured changes in PA/SED-time were assessed, together with univariate and multivariable associations between these parameters<a>, in the whole cohort and by study arm</a>.</p> <p><b>Results. </b>Physical fitness increased and HbA<sub>1c</sub> and coronary heart disease 10-year risk scores decreased with quartiles of MVPA and SED-time change. In quartile IV of MVPA increase and SED-time decrease, cardiorespiratory fitness increased by 5.23 and 4.49 ml·min<sup>-1</sup>·kg<sup>-1</sup> and HbA<sub>1c</sub> decreased by 0.73 and 0.85%, respectively. Univariate correlations confirmed these relationships and mean changes in both MPVA and SED-time predicted changes in physical fitness and cardiovascular risk factors/scores independently of one another and of other confounders. Similar findings were observed with LPA and PA volume and in each group separately.</p> <p><b>Conclusions. </b>Even modest increments in MVPA may have a clinically meaningful impact and reallocating SED-time to LPA may also contribute to improve outcomes, possibly by increasing total energy expenditure.</p>

scholarly journals Joint Associations of Physical Activity and Hypertension with the Development of Type 2 Diabetes among Urban Men and Women in Mainland China

PLoS ONE ◽  
2014 ◽  
Vol 9 (2) ◽  
pp. e88719 ◽  
Author(s):  
Fei Xu ◽  
Robert S. Ware ◽  
Lap Ah Tse ◽  
YouFa Wang ◽  
ZhiYong Wang ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Mainland China ◽  
Men And Women ◽  
Urban Men ◽  
Joint Associations

scholarly journals Effects of Moderate- Versus High-Intensity Exercise Training on Physical Fitness and Physical Function in People With Type 2 Diabetes: A Randomized Clinical Trial

2014 ◽  
Vol 94 (12) ◽  
pp. 1720-1730 ◽  
Author(s):  
J. David Taylor ◽  
James P. Fletcher ◽  
Ruth Ann Mathis ◽  
W. Todd Cade
Keyword(s):  
Type 2 Diabetes ◽  
Exercise Training ◽  
Physical Fitness ◽  
Physical Function ◽  
High Intensity ◽  
High Intensity Exercise ◽  
High Group ◽  
Glucose Levels ◽  
Intensity Training

Background Exercise training is effective for improving physical fitness and physical function in people with type 2 diabetes. However, limited research has been conducted on the optimal exercise training intensity for this population. Objective The primary study objective was to investigate the effects of moderate- versus high-intensity exercise training on physical fitness and physical function in people with type 2 diabetes. Design This was a randomized clinical trial. Setting The setting was a university campus. Participants Twenty-one people with type 2 diabetes were randomly allocated to receive either moderate-intensity training (MOD group) or high-intensity training (HIGH group). Intervention The MOD group performed resistance training at an intensity of 75% of the 8-repetition maximum (8-RM) and aerobic training at an intensity of 30% to 45% of the heart rate reserve (HRR). The HIGH group performed resistance training at an intensity of 100% of the 8-RM and aerobic training at an intensity of 50% to 65% of the HRR. Measurements Muscle strength (peak torque [newton-meters]), exercise capacity (graded exercise test duration [minutes]), and physical function (Patient-Specific Functional Scale questionnaire) were measured at baseline and 3 months later. Acute exercise-induced changes in glucose levels were assessed immediately before exercise, immediately after exercise, and 1 hour after exercise during the first exercise training session. Results Although both groups showed improvements in physical fitness and physical function, the between-group effect sizes were not statistically significant (exercise capacity estimated marginal mean [EMM] difference=2.1, 95% confidence interval [95% CI]=−0.2, 4.5; muscle strength EMM difference=20.8, 95% CI=−23.3, 65.0; and physical function EMM difference=0.1, 95% CI=−0.6, 0.9). Mean percent changes in glucose levels measured immediately before exercise and immediately after exercise, immediately after exercise and 1 hour after exercise, and immediately before exercise and 1 hour after exercise for the MOD group were −11.4%, −5.0%, and −15.8%, respectively; those for the HIGH group were −21.5%, 7.9%, and −15.3%, respectively. Limitations Sample size, lack of outcome assessor masking, and physical function measurement subjectivity were limitations. Conclusions Moderate- and high-intensity exercise training, as defined in this study, may lead to similar improvements in physical fitness and physical function in people with type 2 diabetes.

scholarly journals ORLISTAT IN COMBINATION THERAPY OF OBESITY AND TYPE 2 DIABETES

2017 ◽  
pp. 68-74 ◽  
Author(s):  
A. M. Mkrtumyan ◽  
E. V. Biryukova
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Clinical Trials ◽  
Food Intake ◽  
Combination Therapy ◽  
Systemic Effects ◽  
The Past ◽  
Prevention And Treatment ◽  
Treatment Of Obesity

Over the past years, the focus has been growing on the prevention and treatment of obesity. Obesity has long been considered not just as excess body fat but as a chronic relapsing disease, the result of energy disbalance, which develops with an increase in food intake and reduced energy expenditure and is closely associated with a number of serious complications. Orlistat (Xenical), a peripherally acting drug without systemic effects [11, 24, 27], has been widely used in pharmacological treatment of obesity. Xenical is the most well-studied medication for weight loss. More than 30,000 patients with obesity were involved in clinical trials, of which over 2,500 patients had type 2 diabetes. Till today, the drug remains a breakthrough in the treatment of overweight/obesity.

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