Effect of a low-resource-intensive lifestyle modification program incorporating gymnasium-based and home-based resistance training on Type 2 Diabetes Risk in Australian adults
- Payne, Warren, Walsh, Kerry, Harvey, Jack, Livy, Michelle, McKenzie, Kylie, Donaldson, Alex, Atkinson, Meredith, Keogh, Jennifer, Moss, Robert, Dunstan, David, Hubbard, Wendy
- Authors: Payne, Warren , Walsh, Kerry , Harvey, Jack , Livy, Michelle , McKenzie, Kylie , Donaldson, Alex , Atkinson, Meredith , Keogh, Jennifer , Moss, Robert , Dunstan, David , Hubbard, Wendy
- Date: 2008
- Type: Text , Journal article
- Relation: Diabetes Care Vol. 31, no. 12 (Dec 2008), p. 2244-2250
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- Description: OBJECTIVE - The purpose of this study was to assess the effectiveness of a low-resource-intensive lifestyle modification program incorporating resistance training and to compare a gymnasium-based with a home-based resistance training program on diabetes diagnosis sa us and risk. RESEARCH DESIGN AND METHODS - A quasi-experimental two-group study was undertaken with 122 participants with diabetes risk factors; 36.9% had impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) at baseline. The intervention included a 6-week group self-management education program, a gymnasium-based or home-based 12-week resistance training program, and a 34-week maintenance program. Fasting plasma glucose (FPG) and 2-h plasma glucose, blood lipids, blood pressure, body composition, physical activity, and diet were assessed at baseline and week 52. RESULTS - Mean 2-h plasma glucose and FPG fell by 0.34 mmol/l (95% CI -0.60 to -0.08) and 0.15 mmol/l (-0.23 to -0.07), respectively. The proportion of participants with IFG or IGT decreased from 36.9 to 23.0% (P = 0.006). Mean weight loss was 4.07 kg (-4.99 to -3.15). The only significant difference between resistance training groups was a greater reduction in systolic blood pressure for the gymnasium-based group (P = 0.008). CONCLUSIONS - This intervention significantly improved diabetes diagnostic status and reduced diabetes risk to a degree comparable to that of other low-resource-intensive lifestyle modification programs and more intensive interventions applied to individuals with IGT. The effects of home-based and gymnasium-based resistance training did not differ significantly.
- Description: C1
- Authors: Payne, Warren , Walsh, Kerry , Harvey, Jack , Livy, Michelle , McKenzie, Kylie , Donaldson, Alex , Atkinson, Meredith , Keogh, Jennifer , Moss, Robert , Dunstan, David , Hubbard, Wendy
- Date: 2008
- Type: Text , Journal article
- Relation: Diabetes Care Vol. 31, no. 12 (Dec 2008), p. 2244-2250
- Full Text:
- Reviewed:
- Description: OBJECTIVE - The purpose of this study was to assess the effectiveness of a low-resource-intensive lifestyle modification program incorporating resistance training and to compare a gymnasium-based with a home-based resistance training program on diabetes diagnosis sa us and risk. RESEARCH DESIGN AND METHODS - A quasi-experimental two-group study was undertaken with 122 participants with diabetes risk factors; 36.9% had impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) at baseline. The intervention included a 6-week group self-management education program, a gymnasium-based or home-based 12-week resistance training program, and a 34-week maintenance program. Fasting plasma glucose (FPG) and 2-h plasma glucose, blood lipids, blood pressure, body composition, physical activity, and diet were assessed at baseline and week 52. RESULTS - Mean 2-h plasma glucose and FPG fell by 0.34 mmol/l (95% CI -0.60 to -0.08) and 0.15 mmol/l (-0.23 to -0.07), respectively. The proportion of participants with IFG or IGT decreased from 36.9 to 23.0% (P = 0.006). Mean weight loss was 4.07 kg (-4.99 to -3.15). The only significant difference between resistance training groups was a greater reduction in systolic blood pressure for the gymnasium-based group (P = 0.008). CONCLUSIONS - This intervention significantly improved diabetes diagnostic status and reduced diabetes risk to a degree comparable to that of other low-resource-intensive lifestyle modification programs and more intensive interventions applied to individuals with IGT. The effects of home-based and gymnasium-based resistance training did not differ significantly.
- Description: C1
Issues in the provision of nursing care to people undergoing cardiac surgery who also have type 2 diabetes
- Wellard, Sally, Cox, Helen, Bhujoharry, Claire
- Authors: Wellard, Sally , Cox, Helen , Bhujoharry, Claire
- Date: 2007
- Type: Text , Journal article
- Relation: International journal of nursing practice Vol. 13, no. 4 (2007), p. 222-228
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- Description: There has been little investigation of the issues associated with caring for patients presenting for cardiac surgery with a comorbid diagnosis of diabetes although there is some evidence that the diabetes management is suboptimal. This study aimed to identify issues that patients and cardiac specialist nurses experience with the provision of inpatient services for people undergoing cardiac surgery who also have type 2 diabetes. A qualitative interpretive design, using individual interviews with patients and nurses, provided data about some of these issues. The study found that nurses had high levels of confidence in their cardiac care but little confidence in diabetes management. Patients described concerns about their diabetes care and treatment regimens. A 'typical journey' for a person with diabetes undergoing cardiac surgery was identified. The findings support the need to build increased capacity in specialist nurses to support diabetes care as a secondary diagnosis.
- Description: C1
- Description: 2003005865
- Authors: Wellard, Sally , Cox, Helen , Bhujoharry, Claire
- Date: 2007
- Type: Text , Journal article
- Relation: International journal of nursing practice Vol. 13, no. 4 (2007), p. 222-228
- Full Text:
- Reviewed:
- Description: There has been little investigation of the issues associated with caring for patients presenting for cardiac surgery with a comorbid diagnosis of diabetes although there is some evidence that the diabetes management is suboptimal. This study aimed to identify issues that patients and cardiac specialist nurses experience with the provision of inpatient services for people undergoing cardiac surgery who also have type 2 diabetes. A qualitative interpretive design, using individual interviews with patients and nurses, provided data about some of these issues. The study found that nurses had high levels of confidence in their cardiac care but little confidence in diabetes management. Patients described concerns about their diabetes care and treatment regimens. A 'typical journey' for a person with diabetes undergoing cardiac surgery was identified. The findings support the need to build increased capacity in specialist nurses to support diabetes care as a secondary diagnosis.
- Description: C1
- Description: 2003005865
Effect of a health coach intervention for the management of individuals with type 2 diabetes mellitus in China : a pragmatic cluster randomized controlled trial
- Chapman, Anna, Browning, Colette, Enticott, Joanne, Yang, Hui, Liu, Shuo, Zhang, Tuohong, Thomas, Shane
- Authors: Chapman, Anna , Browning, Colette , Enticott, Joanne , Yang, Hui , Liu, Shuo , Zhang, Tuohong , Thomas, Shane
- Date: 2018
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 6, (2018)
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- Description: Aim: To determine the effect of a health coach intervention for the management of glycemic control, as well as physiological, psychological and self-care outcomes of patients with type 2 diabetes mellitus (T2DM), compared with usual care. Methods:This pragmatic cluster RCT was conducted in the Fengtai district of Beijing from August 2011 to December 2013. Forty-one community health stations (CHSs) were cluster randomized (stratified geographically, 1:1 ratio) and eligible, randomly selected T2DM patients were sequentially contacted by CHSs. Control participants received usual care according to the Chinese Guideline for Diabetes Prevention and Management. Intervention participants received 18-months of health coaching based on principles of Motivational Interviewing (MI) plus usual care. Medical and pathology fees were waived for both groups. Outcome assessment was performed at baseline, 6, 12, and 18-months. The primary outcome was glycated hemoglobin (HbA1c); secondary outcomes encompassed a suite of physiological, psychological and self-care measures. Results:No differential treatment effect was found at 18-months for HbA1c (adj. difference -0.07, 95% CI -0.53 to 0.39, p = 0.769) or any specified secondary outcomes. Interestingly, both groups displayed a statistically and clinically significant within-group improvement of the same magnitude at 18-months for HbA1c (intervention: mean change -3.65, 95% CI -3.92 to -3.37; control: mean change -3.38, 95% CI -3.67 to -3.08). Conclusions:The lack of differential treatment effects observed indicate that it may be premature to recommend the routine delivery of health coach interventions based on MI principles for the management of T2DM in China. However, the large, comparable within-group improvement in mean HbA1c promotes the establishment of free, regular clinical health assessments for individuals with T2DM in China. © 2018 Chapman, Browning, Enticott, Yang, Liu, Zhang and Thomas.
- Authors: Chapman, Anna , Browning, Colette , Enticott, Joanne , Yang, Hui , Liu, Shuo , Zhang, Tuohong , Thomas, Shane
- Date: 2018
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 6, (2018)
- Full Text:
- Reviewed:
- Description: Aim: To determine the effect of a health coach intervention for the management of glycemic control, as well as physiological, psychological and self-care outcomes of patients with type 2 diabetes mellitus (T2DM), compared with usual care. Methods:This pragmatic cluster RCT was conducted in the Fengtai district of Beijing from August 2011 to December 2013. Forty-one community health stations (CHSs) were cluster randomized (stratified geographically, 1:1 ratio) and eligible, randomly selected T2DM patients were sequentially contacted by CHSs. Control participants received usual care according to the Chinese Guideline for Diabetes Prevention and Management. Intervention participants received 18-months of health coaching based on principles of Motivational Interviewing (MI) plus usual care. Medical and pathology fees were waived for both groups. Outcome assessment was performed at baseline, 6, 12, and 18-months. The primary outcome was glycated hemoglobin (HbA1c); secondary outcomes encompassed a suite of physiological, psychological and self-care measures. Results:No differential treatment effect was found at 18-months for HbA1c (adj. difference -0.07, 95% CI -0.53 to 0.39, p = 0.769) or any specified secondary outcomes. Interestingly, both groups displayed a statistically and clinically significant within-group improvement of the same magnitude at 18-months for HbA1c (intervention: mean change -3.65, 95% CI -3.92 to -3.37; control: mean change -3.38, 95% CI -3.67 to -3.08). Conclusions:The lack of differential treatment effects observed indicate that it may be premature to recommend the routine delivery of health coach interventions based on MI principles for the management of T2DM in China. However, the large, comparable within-group improvement in mean HbA1c promotes the establishment of free, regular clinical health assessments for individuals with T2DM in China. © 2018 Chapman, Browning, Enticott, Yang, Liu, Zhang and Thomas.
- Li, Jiemin, Drury, Vicki, Taylor, Beverley
- Authors: Li, Jiemin , Drury, Vicki , Taylor, Beverley
- Date: 2013
- Type: Text , Journal article
- Relation: Contemporary Nurse Vol. 45, no. 2 (2013), p. 188-196
- Full Text: false
- Reviewed:
- Description: Purpose: The purpose of this study was to describe, through qualitative methods, the experiences and ways of coping of older Singaporean Chinese women with type 2 diabetes. Methods: Using a qualitative approach, 10 Singaporean Chinese women between the ages of 60–69 described their experiences of living and coping with type 2 diabetes. Data were collected via semi-structured interviews and analysed using thematic analysis. Results: Three themes were identified in the analysis: (i) Living with diabetes; (ii) Coping with diabetes; and (iii) Caring for the self in diabetes. Conclusions: Findings indicate that women living and coping with diabetes confront numerous issues. In order to help these patients initiate and sustain lifestyle modifications, healthcare providers are encouraged to be empathetic and supportive and an understanding of the coping strategies used will ensure that effective coping strategies are utilised. Furthermore, diabetes education for family members will assist them to provide essential, ongoing support for the patient.
Perceptions of people with Type 2 diabetes about self-management and the efficacy of community based services
- Wellard, Sally, Rennie, Sheree, King, Rosemary
- Authors: Wellard, Sally , Rennie, Sheree , King, Rosemary
- Date: 2008
- Type: Text , Journal article
- Relation: Contemporary nurse : a journal for the Australian nursing profession Vol. 29, no. 2 (2008), p. 218-226
- Full Text:
- Description: Self-management has become a key strategy for managing the health care of people with diabetes. This study explored issues people with type 2 diabetes experienced in their self-management practices and access to regional community based services. Using a qualitative interpretative design data was collected from four participants who were interviews about their perceptions of facilitators, barriers and issues they encountered in their diabetes care in a regional setting. The findings indicate difficulties participants experienced in gaining access to quality services in regional areas, including long waiting times, difficulties making appointments, and their perception that healthcare professionals fail to acknowledge patients self-management knowledge and practices. Additionally, participants reported food choices affected their family relationships and experience of social stigma. These issues compromised their self-management decisions. The findings support other studies that show a need for health professionals to develop strategies to improve community based services for people with type 2 diabetes and to increase public awareness of the scope of diabetes management.
- Authors: Wellard, Sally , Rennie, Sheree , King, Rosemary
- Date: 2008
- Type: Text , Journal article
- Relation: Contemporary nurse : a journal for the Australian nursing profession Vol. 29, no. 2 (2008), p. 218-226
- Full Text:
- Description: Self-management has become a key strategy for managing the health care of people with diabetes. This study explored issues people with type 2 diabetes experienced in their self-management practices and access to regional community based services. Using a qualitative interpretative design data was collected from four participants who were interviews about their perceptions of facilitators, barriers and issues they encountered in their diabetes care in a regional setting. The findings indicate difficulties participants experienced in gaining access to quality services in regional areas, including long waiting times, difficulties making appointments, and their perception that healthcare professionals fail to acknowledge patients self-management knowledge and practices. Additionally, participants reported food choices affected their family relationships and experience of social stigma. These issues compromised their self-management decisions. The findings support other studies that show a need for health professionals to develop strategies to improve community based services for people with type 2 diabetes and to increase public awareness of the scope of diabetes management.
The effectiveness of self-management education with type 2 diabetes patients in Saudi Arabia : Systematic literature review
- Alhaiti, Ali, Jones, Linda, Qasim, Abdigani, BinhLenon, George
- Authors: Alhaiti, Ali , Jones, Linda , Qasim, Abdigani , BinhLenon, George
- Date: 2015
- Type: Text , Journal article
- Relation: International Journal of Current Research Vol. 7, no. 10 (2015), p. 21854-21860
- Full Text:
- Reviewed:
- Description: Background: Although there has been significant improvement in both understanding and treating type 2 diabetes, there is no indication of a decrease in its prevalence. This trend has led to an hypothesis that are still risk factors that have not been fully understood and dealt with and patient need effective treatment programs to help them deal with such. For along time, medical experts have emphasized the need for diabetic patients to exercise lifestyle changes such as dieting and engaging in physical exercise in order to maintain their conditions. Objectives: Self-care is increasingly becoming an important for diabetic patient seeking to manage their conditions. Consequently, this study is geared towards evaluating the efficiency level of self-care programs among type 2 diabetes (T2D) patients in Saudi Arabia. It will also describe the self-care programs’ effects on the outcome of disease and patients’ quality of life, and the importance of associated educational programs. Methods: This is a systematic review of published studies exploring the quality of self-care management, as well as its effect on promoting quality of life among T2D patients in Saudi Arabia. This review revealed 11 published papers which included Prospective cohort study, uncontrolled quasi-experimental intervention study with pre–post assessment, non experimental retrospective cross sectional survey, naturalistic observation, case control study, and qualitative interview. Results: The results from this review indicated that a significant percentage of T2D patients do not observe, or are selective with the type of self-care management they use. This habit leads to reduced quality of life, prolonged stay at the hospital, and extended recuperation period. The reviews indicated that educational programs have promoted self-care management among T2D patients. An educational program promotes self-care management among T2D patients and provides additional training for healthcare to facilitate and encourage self-care activity among the patients to minimize the growing number of T2D patients.
- Authors: Alhaiti, Ali , Jones, Linda , Qasim, Abdigani , BinhLenon, George
- Date: 2015
- Type: Text , Journal article
- Relation: International Journal of Current Research Vol. 7, no. 10 (2015), p. 21854-21860
- Full Text:
- Reviewed:
- Description: Background: Although there has been significant improvement in both understanding and treating type 2 diabetes, there is no indication of a decrease in its prevalence. This trend has led to an hypothesis that are still risk factors that have not been fully understood and dealt with and patient need effective treatment programs to help them deal with such. For along time, medical experts have emphasized the need for diabetic patients to exercise lifestyle changes such as dieting and engaging in physical exercise in order to maintain their conditions. Objectives: Self-care is increasingly becoming an important for diabetic patient seeking to manage their conditions. Consequently, this study is geared towards evaluating the efficiency level of self-care programs among type 2 diabetes (T2D) patients in Saudi Arabia. It will also describe the self-care programs’ effects on the outcome of disease and patients’ quality of life, and the importance of associated educational programs. Methods: This is a systematic review of published studies exploring the quality of self-care management, as well as its effect on promoting quality of life among T2D patients in Saudi Arabia. This review revealed 11 published papers which included Prospective cohort study, uncontrolled quasi-experimental intervention study with pre–post assessment, non experimental retrospective cross sectional survey, naturalistic observation, case control study, and qualitative interview. Results: The results from this review indicated that a significant percentage of T2D patients do not observe, or are selective with the type of self-care management they use. This habit leads to reduced quality of life, prolonged stay at the hospital, and extended recuperation period. The reviews indicated that educational programs have promoted self-care management among T2D patients. An educational program promotes self-care management among T2D patients and provides additional training for healthcare to facilitate and encourage self-care activity among the patients to minimize the growing number of T2D patients.
Ability of GHTD-amide and analogs to enhance insulin activity through zinc chelation and dispersal of insulin oligomers
- Paule, Sarah, Nikolovski, Biljana, Ludeman, Justin, Gray, Robyn, Spiccia, Leone, Zimmet, Paul, Myers, Mark
- Authors: Paule, Sarah , Nikolovski, Biljana , Ludeman, Justin , Gray, Robyn , Spiccia, Leone , Zimmet, Paul , Myers, Mark
- Date: 2009
- Type: Text , Journal article
- Relation: Peptides Vol. 30, no. 6 (2009), p. 1088-1097
- Full Text:
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- Description: GHTD-amide is a tetrapeptide originally isolated from human urine that has hypoglycemic activity. Insulin occurs in secretory granules of beta cells as zinc-stabilized hexamers and must disperse to monomeric form in order to bind to its receptor. The aim of this study was to identify whether GHTD-amide and an analog called ISF402 (VHTD-amide) reduce blood glucose through enhancement of insulin activity by dispersing oligomers of insulin. Peptides containing the HTD-amide sequence and a free α-amino group were optimal at binding Zn2+ and adopting secondary structure in the presence of Zn2+. Binding was concentration dependent and resulted in a 1:1 Zn:peptide complex. In vitro the tetrapeptides dispersed hexameric insulin to dimers and monomers. GHTD-amide and ISF402 potentiated the activity of hexameric insulin when co-injected into insulin resistant Zucker rats. Injection of peptides with insulin caused reductions in blood glucose and C-peptide significantly larger than achieved with insulin alone, and serum insulin time profiles were also altered consistent with a reduced clearance or enhanced dispersal of the injected insulin. Insulin potentiation by ISF402 was reduced when lispro insulin, which does not form zinc-stabilized hexamers, was used in place of hexameric zinc insulin. In conclusion, GHTD-amide and ISF402 are zinc binding peptides that disperse hexameric insulin in vitro, and potentiate the activity of hexameric insulin more so than monomeric lispro insulin. These results suggest that dispersal of hexameric insulin through chelation of Zn2+ contributes to the hypoglycemic activity of these tetrapeptides. Crown Copyright © 2009.
- Authors: Paule, Sarah , Nikolovski, Biljana , Ludeman, Justin , Gray, Robyn , Spiccia, Leone , Zimmet, Paul , Myers, Mark
- Date: 2009
- Type: Text , Journal article
- Relation: Peptides Vol. 30, no. 6 (2009), p. 1088-1097
- Full Text:
- Reviewed:
- Description: GHTD-amide is a tetrapeptide originally isolated from human urine that has hypoglycemic activity. Insulin occurs in secretory granules of beta cells as zinc-stabilized hexamers and must disperse to monomeric form in order to bind to its receptor. The aim of this study was to identify whether GHTD-amide and an analog called ISF402 (VHTD-amide) reduce blood glucose through enhancement of insulin activity by dispersing oligomers of insulin. Peptides containing the HTD-amide sequence and a free α-amino group were optimal at binding Zn2+ and adopting secondary structure in the presence of Zn2+. Binding was concentration dependent and resulted in a 1:1 Zn:peptide complex. In vitro the tetrapeptides dispersed hexameric insulin to dimers and monomers. GHTD-amide and ISF402 potentiated the activity of hexameric insulin when co-injected into insulin resistant Zucker rats. Injection of peptides with insulin caused reductions in blood glucose and C-peptide significantly larger than achieved with insulin alone, and serum insulin time profiles were also altered consistent with a reduced clearance or enhanced dispersal of the injected insulin. Insulin potentiation by ISF402 was reduced when lispro insulin, which does not form zinc-stabilized hexamers, was used in place of hexameric zinc insulin. In conclusion, GHTD-amide and ISF402 are zinc binding peptides that disperse hexameric insulin in vitro, and potentiate the activity of hexameric insulin more so than monomeric lispro insulin. These results suggest that dispersal of hexameric insulin through chelation of Zn2+ contributes to the hypoglycemic activity of these tetrapeptides. Crown Copyright © 2009.
Zinc, zinc transporters and Type 2 Diabetes
- Authors: Myers, Stephen , Nield, Alex
- Date: 2014
- Type: Text , Book chapter
- Relation: Endocrine diseases Chapter 2 p.
- Full Text: false
- Reviewed:
- Description: Insulin resistance is an important characteristic of Type 2 Diabetes (T2D) and is commonly associated with obesity, hypertension and cardiovascular disease (Carsten, 2000; Hulver and Lynis, 2004). Insulin resistance reduces insulin-stimulated glucose disposal due to multiple post-recepter intracellular defects in insulin signaling with subsequent reductions in glucose transport, glucose oxidation and incorporation of glucose into glycogen (Abdul-Ghani and DeFronzo, 2010; Peppa et al., 2010). The intracellular post-receptor regulatory effects of insulin include the regulation of the cellular glucose transport system, adaptive changes in gene expression and subsequent biosynthesis and action of the enzymes involved in the preservation of metabolism, and the modulation of genes that contribute to increased pro-mitotic, proliferative and anti-apoptotic activity of cells (Taton et al., 2010). Accordingly, the reduced activity of insulin action in any, or all of these post-receptor regulatory actions is insulin resistance. Given that insulin resistance usually precedes the development of T2D and is a major component of the progressive nature of this disease (Pagel-Langenickel et al., 2010), understanding the pathophysiology of insulin resistance will enable the development of therapeutic strategies to prevent or manage disease progression. Although many theories have been forthcoming, the primary mechanism of insulin resistance remains largely elusive.
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