Assessing the Association Between Exercise Status and Poor Glycemic Control

Mosen, David M.; Glauber, Harry; Stoneburner, Ashley; Feldstein, Adrianne C.; Fortmann, Steve

doi:10.17294/2330-0698.1499

Cited by 6 publications

(13 citation statements)

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“…Participant numbers ranged from 96 to 892,223. There were 28 longitudinal cohort studies [18, 21, 28, 29, 32–37, 40–57] and 13 cross-sectional studies [17, 19, 20, 22–27, 30, 31, 38, 39]. All included studies were conducted in high or upper-middle-income countries.…”

Section: Resultsmentioning

confidence: 99%

“…Gender of participants were not described in two studies [23, 49] and in those that did (n = 39) [17–22, 24–48, 50–57], the percentage of female ranged from 2% to 70%. Ethnicity was reported in 11 studies [19, 20, 24, 29, 31, 32, 39, 44, 45, 49, 53] and socioeconomic status was seldom reported (n = 7) [29, 32, 38–40, 52, 54]. Full details of participants are shown in S2 Table.…”

Section: Resultsmentioning

confidence: 99%

“…We identified 25 studies [17–40, 57] that explored associations between MM condition count and glycaemic outcomes. Fourteen studies [17, 19, 20, 22–24, 26, 29, 31, 32, 35, 37–39] reported HbA1c, 10 studies [18, 21, 27, 28, 30, 33, 34, 36, 40, 57] hypoglycaemia, and one study [25] measured glycaemia in terms of fasting plasma glucose. All results of the included studies are summarised in S3 Table.…”

Section: Resultsmentioning

confidence: 99%

“…The majority of studies (10/14)[17, 20, 22–24, 26, 29, 31, 35, 38] showed no association with MM count while four studies [19, 32, 37, 39] found that increased MM count was associated with higher HbA1c. These four studies used different methods of data analysis (S3 Table).…”

Section: Resultsmentioning

confidence: 99%

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Associations between multimorbidity, all-cause mortality and glycaemia in people with type 2 diabetes: A systematic review

et al. 2018

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IntroductionType 2 diabetes (T2D) is a major health priority worldwide and the majority of people with diabetes live with multimorbidity (MM) (the co-occurrence of ≥2 chronic conditions). The aim of this systematic review was to explore the association between MM and all-cause mortality and glycaemic outcomes in people with T2D.MethodsThe search strategy centred on: T2D, MM, comorbidity, mortality and glycaemia. Databases searched: MEDLINE, EMBASE, CINAHL Complete, The Cochrane Library, and SCOPUS. Restrictions included: English language, quantitative empirical studies. Two reviewers independently carried out: abstract and full text screening, data extraction, and quality appraisal. Disagreements adjudicated by a third reviewer.ResultsOf the 4882 papers identified; 41 met inclusion criteria. The outcome was all-cause mortality in 16 studies, glycaemia in 24 studies and both outcomes in one study. There were 28 longitudinal cohort studies and 13 cross-sectional studies, with the number of participants ranging from 96–892,223. Included studies were conducted in high or upper-middle-income countries. Fifteen of 17 studies showed a statistically significant association between increasing MM and higher mortality. Ten of 14 studies showed no significant associations between MM and HbA1c. Four of 14 studies found higher levels of MM associated with higher HbA1c. Increasing MM was significantly associated with hypoglycaemia in 9/10 studies. There was no significant association between MM and fasting glucose (one study). No studies explored effects on glycaemic variability.ConclusionsThis review demonstrates that MM in T2D is associated with higher mortality and hypoglycaemia, whilst evidence regarding the association with other measures of glycaemic control is mixed. The current single disease focused approach to management of T2D seems inappropriate. Our findings highlight the need for clinical guidelines to support a holistic approach to the complex care needs of those with T2D and MM, accounting for the various conditions that people with T2D may be living with.Systematic review registrationInternational Prospective Register of Systematic Reviews CRD42017079500

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Associations between multimorbidity, all-cause mortality and glycaemia in people with type 2 diabetes: A systematic review

et al. 2018

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“…Medication adherence in this study was related to the patient's adherence to both antidiabetic and antihypertensive treatments. Low medication adherence is known to lead to impaired glycaemic and blood pressure control and increases the incidence of adverse events [ 27 , 28 ]. Patients with uncontrolled systolic blood pressure less often show hyperkalemia than patients with better control ( p =0.103; Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

Comparison of Effects of ACEIs and ARBs on Albuminuria and Hyperkalemia in Indonesian Hypertensive Type 2 Diabetes Mellitus Patients

Agustina

Yunir

Prawiroharjo

et al. 2020

International Journal of Hypertension

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Purpose. Due to economic consideration, Indonesia’s formulary restrictions are at odds with the treatment guidelines of the American Diabetes Association (ADA) and the Eighth Joint National Committee (JNC 8). ADA and JNC 8 equally recommend the prescription of an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) for hypertensive patients with type 2 diabetes mellitus (T2DM) with overt proteinuria (urine albumin to creatinine ratio (UACR) ≥ 300 mg/g creatinine). However, since 1 April 2018, Indonesian formulary restricted telmisartan and valsartan only for T2DM patients with declined renal function as shown by eGFR value. There is no compelling evidence in favor of ACEI over ARB or vice versa except for data supporting the early use of both drugs in patients with overt proteinuria. However, ARB is a choice if ACEI’s side effects, that is, coughing, occurs. Therefore, it necessitates a detailed evaluation of the effects of ACEIs and ARBs on albuminuria and their side effect, hyperkalemia, specific to Indonesian T2DM patients. Methods. This cross-sectional study involved 134 T2DM patients whose treatment was restricted to either ACEIs (n = 57) or ARBs (n = 77) for at least two months before the study during May–October 2018. Patients with known end-stage renal disease and those receiving dialysis were excluded. UACR and blood potassium levels were compared between the two study groups. Also, the risk factors of albuminuria and hyperkalemia were estimated using multivariate analysis. Results. T2DM patients in the ACEI and ARB groups had similar characteristics except for a higher body mass index (p=0.008), lower glomerular filtration rate (p=0.04), and a longer duration of prior treatment (p<0.001) in the ARB group. This study showed no differences between the ACEI and ARB groups in the proportion of cases with albuminuria (p=0.97) and hyperkalemia (p=0.86), even after adjustment for confounders. In addition, uncontrolled diastolic blood pressure was a significant factor associated with albuminuria (OR: 4.897, 95% CI: 1.026–23.366; p=0.046), whereas a female was 70.1% less likely to develop hyperkalemia than a male (OR: 0.299, 95% CI: 0.102–0.877; p=0.028). Conclusion. This cross-sectional study demonstrated that ACEIs and ARBs have a similar effect on albuminuria and hyperkalemia in Indonesian hypertensive T2DM patients, even after correction for potentially confounding variables.

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Practical implications for providing physical activity counseling for the older adult: An integrative review

Otmanowski

Chase

2020

J Am Assoc Nurse Pract

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Background: Physical inactivity in the older adult is associated with functional decline, increased fall risk, and threatens the ability of the older adult to live independently. Nurse practitioners, with their expertise in health promotion and chronic disease management, are well positioned to provide physical activity (PA) counseling. However, there is a gap in the literature describing a practical formula for providing PA counseling and PA prescriptions for clinical practice. Objective: The objective of this integrative review was to synthesize the literature related to counseling interventions designed to increase PA among older adults and provide practical recommendations for incorporating recommendations into practice. Data sources: Five different databases were searched along with ancestry searching of relevant articles. Eligible studies tested methods of recommending PA for adults age ≥65 years, including in-person counseling, phone calls, written information, and exercise prescriptions. Conclusions: Health care providers are able to motivate older adults to increase PA in the short term. Diverse health care disciplines are efficacious at motivating older adults to increase PA. Various counseling interventions can be used with varying amounts of time investment. Implications for practice: Physical activity counseling is an underused but effective intervention for increasing PA in older adults. Older adults respond well to advice to increase their PA especially with the addition of a written exercise prescription. Basing PA counseling interventions on a theoretical construct such as social cognitive theory or transtheoretical stages of change theory improves the efficacy of the interventions.

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Assessing the Association Between Exercise Status and Poor Glycemic Control

Cited by 6 publications

References 0 publications

Associations between multimorbidity, all-cause mortality and glycaemia in people with type 2 diabetes: A systematic review

Associations between multimorbidity, all-cause mortality and glycaemia in people with type 2 diabetes: A systematic review

Comparison of Effects of ACEIs and ARBs on Albuminuria and Hyperkalemia in Indonesian Hypertensive Type 2 Diabetes Mellitus Patients

Practical implications for providing physical activity counseling for the older adult: An integrative review

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