scholarly journals Motivation and Barriers to Maintaining Lifestyle Changes in Patients with Type 2 Diabetes after an Intensive Lifestyle Intervention (The U-TURN Trial): A Longitudinal Qualitative Study

2020 ◽  
Vol 17 (20) ◽  
pp. 7454
Author(s):  
Sabrina K. Schmidt ◽  
Liv Hemmestad ◽  
Christopher S. MacDonald ◽  
Henning Langberg ◽  
Laura S. Valentiner
Keyword(s):  
Type 2 Diabetes ◽  
Lifestyle Intervention ◽  
Exercise Group ◽  
Lifestyle Changes ◽  
Individual Interviews ◽  
Intensive Lifestyle Intervention ◽  
Intensive Intervention ◽  
One Year ◽  
And Coping

The purpose of this study was to explore and identify factors that influence motivation for and barriers to adopting and maintaining lifestyle changes in patients with type 2 diabetes, following participation in an intensive multiple-lifestyle intervention. Participants were recruited from the U-TURN trial, a one-year, intensive lifestyle intervention for type 2 diabetes patients. This study was conducted over time; informants were interviewed twice after the trial ended with a six-month interval between interviews. The qualitative data from these individual interviews were analysed using systematic text condensation with an inductive approach. Five themes emerged: Social support and relatedness, Achievement of results, Support from healthcare professionals, Identification with and acceptance of the new lifestyle and Coping with ongoing challenges. These are all important for maintaining lifestyle changes and diabetes self-management. Changing one’s lifestyle can be a constant, difficult struggle. For sustainable progress after an intensive intervention, the changes must be adopted and endorsed by patients and co-opted into their social setting. Belonging to an exercise group, confidence in managing the lifestyle adjustments and handling of challenges through continual support and professional diabetes treatment are crucial in maintaining and adhering to the new lifestyle.

scholarly journals Diabetes Remission after Nonsurgical Intensive Lifestyle Intervention in Obese Patients with Type 2 Diabetes

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Adham Mottalib ◽  
Mahmoud Sakr ◽  
Mohamed Shehabeldin ◽  
Osama Hamdy
Keyword(s):  
Type 2 Diabetes ◽  
Complete Remission ◽  
Lifestyle Intervention ◽  
Weight Reduction ◽  
Diabetes Remission ◽  
Obese Patients ◽  
Intensive Lifestyle Intervention ◽  
Oral Medications ◽  
One Year

Partial or complete remission from type 2 diabetes was recently observed after bariatric surgeries. Limited data is available about the possibility of inducing diabetes remission through intensive weight reduction. We retrospectively evaluated diabetes remissions after one year of the Weight Achievement and Intensive Treatment (Why WAIT) program, a 12-week intensive program for diabetes weight management in real-world clinical practice. Among 120 obese patients with type 2 diabetes who completed the program, 88 patients returned for follow-up at one year. Nineteen patients (21.6%) had major improvement in their glycemic control, defined as achieving an A1C <6.5% after one year. Four patients (4.5%) achieved either partial or complete diabetes remission defined as A1C <6.5% and <5.7%, respectively, on no antihyperglycemic medications for one year; 2 achieved partial remission (2.3%) and 2 achieved complete remission (2.3%). At the time of intervention, patients who achieved diabetes remission had shorter diabetes duration (<5 years) and lower A1C (<8%) and were treated with fewer than 2 oral medications. They achieved a weight reduction of >7% after 12 weeks. These results indicate that a subset of obese patients with type 2 diabetes is appropriate for intensive lifestyle intervention with the aim of inducing diabetes remission.

Intensive Lifestyle Intervention for Type 2 Diabetes—Reply

JAMA ◽  
2017 ◽  
Vol 318 (24) ◽  
pp. 2494
Author(s):  
Mathias Ried-Larsen ◽  
Mette Yun Johansen ◽  
Bente Klarlund Pedersen
Keyword(s):  
Type 2 Diabetes ◽  
Lifestyle Intervention ◽  
Intensive Lifestyle Intervention

scholarly journals Effect of a 12-Month Intensive Lifestyle Intervention on Hepatic Steatosis in Adults With Type 2 Diabetes

Diabetes Care ◽  
2010 ◽  
Vol 33 (10) ◽  
pp. 2156-2163 ◽  
Author(s):  
M. Lazo ◽  
S. F. Solga ◽  
A. Horska ◽  
S. Bonekamp ◽  
A. M. Diehl ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Hepatic Steatosis ◽  
Lifestyle Intervention ◽  
Intensive Lifestyle Intervention

scholarly journals Type 2 diabetes remission 1 year after an intensive lifestyle intervention: A secondary analysis of a randomized clinical trial

2019 ◽  
Vol 21 (10) ◽  
pp. 2257-2266 ◽  
Author(s):  
Mathias Ried‐Larsen ◽  
Mette Y. Johansen ◽  
Christopher S. MacDonald ◽  
Katrine B. Hansen ◽  
Robin Christensen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Lifestyle Intervention ◽  
Secondary Analysis ◽  
Diabetes Remission ◽  
Intensive Lifestyle Intervention ◽  
Type 2 Diabetes Remission

scholarly journals Effect of a long-term intensive lifestyle intervention on prevalence of cognitive impairment

Neurology ◽  
2017 ◽  
Vol 88 (21) ◽  
pp. 2026-2035 ◽  
Author(s):  
Mark A. Espeland ◽  
José A. Luchsinger ◽  
Laura D. Baker ◽  
Rebecca Neiberg ◽  
Steven E. Kahn ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Weight Loss ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Lifestyle Intervention ◽  
Cognitive Test ◽  
Intervention Effect ◽  
Intensive Lifestyle Intervention

Objective:To assess whether an average of 10 years of lifestyle intervention designed to reduce weight and increase physical activity lowers the prevalence of cognitive impairment among adults at increased risk due to type 2 diabetes and obesity or overweight.Methods:Central adjudication of mild cognitive impairment and probable dementia was based on standardized cognitive test battery scores administered to 3,802 individuals who had been randomly assigned, with equal probability, to either the lifestyle intervention or the diabetes support and education control. When scores fell below a prespecified threshold, functional information was obtained through proxy interview.Results:Compared with control, the intensive lifestyle intervention induced and maintained marked differences in weight loss and self-reported physical activity throughout follow-up. At an average (range) of 11.4 (9.5–13.5) years after enrollment, when participants' mean age was 69.6 (54.9–87.2) years, the prevalence of mild cognitive impairment and probable dementia was 6.4% and 1.8%, respectively, in the intervention group, compared with 6.6% and 1.8%, respectively, in the control group (p = 0.93). The lack of an intervention effect on the prevalence of cognitive impairment was consistent among individuals grouped by cardiovascular disease history, diabetes duration, sex, and APOE ε4 allele status (all p ≥ 0.50). However, there was evidence (p = 0.03) that the intervention effect ranged from benefit to harm across participants ordered from lowest to highest baseline BMI.Conclusions:Ten years of behavioral weight loss intervention did not result in an overall difference in the prevalence of cognitive impairment among overweight or obese adults with type 2 diabetes.Clinicaltrials.gov identifier:NCT00017953 (Action for Health in Diabetes).Level of evidence:This study provides Class II evidence that for overweight adults with type 2 diabetes, a lifestyle intervention designed to reduce weight and increase physical activity does not lower the risk of cognitive impairment.

scholarly journals Can the Onset of Type 2 Diabetes Be Delayed by a Group-Based Lifestyle Intervention in Women with Prediabetes following Gestational Diabetes Mellitus (GDM)? Findings from a Randomized Control Mixed Methods Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Angela O’Dea ◽  
Marie Tierney ◽  
Brian E. McGuire ◽  
John Newell ◽  
Liam G. Glynn ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Mixed Methods ◽  
Gestational Diabetes ◽  
Lifestyle Intervention ◽  
Intervention Group ◽  
Outcome Variable ◽  
Control Group ◽  
One Year

Objective. To evaluate a 12-week group-based lifestyle intervention programme for women with prediabetes following gestational diabetes (GDM).Design. A two-group, mixed methods randomized controlled trial in which 50 women with a history of GDM and abnormal glucose tolerance postpartum were randomly assigned to intervention (n=24) or wait control (n=26) and postintervention qualitative interviews with participants.Main Outcome Measures. Modifiable biochemical, anthropometric, behavioural, and psychosocial risk factors associated with the development of type 2 diabetes. The primary outcome variable was the change in fasting plasma glucose (FPG) from study entry to one-year follow-up.Results. At one-year follow-up, the intervention group showed significant improvements over the wait control group on stress, diet self-efficacy, and quality of life. There was no evidence of an effect of the intervention on measures of biochemistry or anthropometry; the effect on one health behaviour, diet adherence, was close to significance.Conclusions. Prevention programmes must tackle the barriers to participation faced by this population; home-based interventions should be investigated. Strategies for promoting long-term health self-management need to be developed and tested.

scholarly journals One-year effects of a group-based lifestyle intervention in adults with type 2 diabetes: A randomized encouragement trial

2018 ◽  
Vol 140 ◽  
pp. 36-44 ◽  
Author(s):  
David T. Liss ◽  
Emily A. Finch ◽  
Andrew Cooper ◽  
Avani Sheth ◽  
Ashantí D. Tejuosho ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Lifestyle Intervention ◽  
One Year
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