Lifestyle Interventions for Patients With and at Risk for Type 2 Diabetes

Schellenberg, Elizabeth Sumamo; Dryden, Donna M; Vandermeer, Ben; Ha, Christine; Korownyk, Christina

doi:10.7326/0003-4819-159-8-201310150-00007

Cited by 464 publications

(318 citation statements)

References 65 publications

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“…Therefore, hyperglycemia at baseline, even in those not achieving NODI criteria, or the increasing trend of plasma glucose levels after PD therapy commencement should garner more attention in PD patients. Whether clinicians should take action to initiate lifestyle modifications, such as exercise training, weight loss, and dietary counseling, to prevent the occurrence of diabetes in these subjects is unknown (20,21). The target of plasma glucose control for these patients before NODI is also to be determined by exploring the association between glucose level and outcomes from large-scale multi-center cohort studies.…”

Section: Discussionmentioning

confidence: 99%

Older Age, Higher Body Mass Index and Inflammation Increase the Risk for New-Onset Diabetes and Impaired Glucose Tolerance in Patients on Peritoneal Dialysis?

2016

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N ew-onset diabetes and impaired glucose tolerance (IGT) have been shown to be associated with increased cardiovascular events and risk of death in the general population (1-3) and in patients undergoing dialysis (4-7). Since new-onset diabetes and IGT (NODI) is a common complication among patients on dialysis (4)(5)(6)8), it is important to explore the potential risk factors for this complication. However, published data on this issue are limited in dialysis populations.To our knowledge, traditional risk factors, such as age, male gender, obesity, hypertension, and hyperlipidemia, have been recognized to increase the risk for new-onset diabetes in the general population (9-11). These traditional factors, as well as uremia-related factors including malnutrition, inflammation, and comorbidities, have previously shown to be associated with new-onset diabetes, IGT, or fasting hyperglycemia in dialysis patients in 2 cross-sectional (4,8) and 2 longitudinal cohort datasets, respectively (6,7). However, the above parameters were collected at baseline or at a single timepoint in these studies, which makes it impossible to analyze the association between time-varying variables and outcomes. In addition, glucose is inevitably used as an osmotic agent in all commercial solutions for PD patients in China, accounting for about 20% of total energy intake (12,13). A previous study has indicated the potential side effects of dialysate glucose including a tendency for hyperglycemia and hyperinsulinemia in a dose-dependent manner in PD patients (14). However, 2 recent papers did not compare the higher risk for new-onset diabetes in PD populations with their hemodialysis (HD) counterpart (6,7). It is therefore of interest to explore the potential effect of the amount of dietary energy intake and glucose absorption via dialysate on the incidence of NODI in PD patients.All of the above mentioned contributors actually exist at the start of PD therapy and then vary to different degrees during follow-up. To determine the critical contributors to NODI, baseline characteristics and time-dependent variables need to be analyzed in Cox regression models. In this paper, we report a prospective cohort study to explore the incidence and risk factors for NODI, taking baseline and time-dependent covariates into account. METHODS SUBJECT SELECTIONAll the non-diabetic incident patients on chronic PD between August 2003 and August 2011 were enrolled in this This single copy is for your personal, non-commercial use only. For permission to reprint multiple copies or to order presentation-ready copies for distribution, contact Multimed Inc. at marketing@multi-med.com 278 DONG et al. MAY 2016 -VOL. 36, NO. 3 PDI study. All patients visited with a physician at least once every 3 months. All subjects began the PD program within 1 month after catheter implantation and were given lactate-buffered glucose dialysate with a twin-bag connection system (Baxter Healthcare, Guangzhou, China). This study was approved by the Medical Ethics Committee of Peking ...

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Section: Discussionmentioning

confidence: 99%

Older Age, Higher Body Mass Index and Inflammation Increase the Risk for New-Onset Diabetes and Impaired Glucose Tolerance in Patients on Peritoneal Dialysis?

2016

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“…19 Lifestyle changes such as weight loss (7% of body weight) and moderate physical activity (150 minutes per week) can reduce the risk of diabetes by as much as 58%. 20 To prevent 1 case of diabetes during a 3-year period, 6.9 persons would have to participate in the lifestyle intervention program. 16 The Finnish Diabetes Prevention Study published in 2003 21 evaluated the effects of a lifestyle intervention on short-term and long-term changes in diet and exercise behavior, and the effect of the intervention on glucose and lipid metabolism.…”

Section: Lifestyle Interventionmentioning

confidence: 99%

Prediabetes and Lifestyle Modification: Time to Prevent a Preventable Disease

Tuso

2014

TPJ

199

143

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“…African-American women have the highest obesity rate and are the least active of any other ethnic or gender groups in the United States. 7 More than half of African-American women (58%) are overweight or obese as compared to one-third of the adult population. African-American women's obesity is almost twice that of Caucasian women and significantly higher than that of Mexican-American women (44.9%).…”

Section: -6mentioning

confidence: 99%

“…7 Obesity and physical inactivity are two major risk factor for diabetes. African-Americans in general, and African-American women specifically, have higher obesity and physical inactivity rates.…”

Section: -6mentioning

confidence: 99%

Diabetes Prevention in African-American Communities

Brown¹

2016

Obes Res Open J

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Type-2 Diabetes (T2D) has reached epidemic proportions with the number of people being diagnosed almost tripling in recent generations.1 T2D is the most common form of diabetes and accounts for about 90% to 95% of all cases of diagnosed diabetes.1 T2D currently affects 10% of Americans, predictions are that by 2050, 1 of every 5 Americans will be affected by T2D.2 Sadly, the incidence of T2D is also among the rise in children and has been predicted to become the "new epidemic" in with an overall increase of 33% in incidence and prevalence during the past decade.3 T2D is a major health threat that not only has devastating health and psychosocial effects, but will also significantly impact health care expenses in the future. 4-6The prevalence of T2D is higher in African-Americans and other ethnic minorities. African-Americans are 1.7 times more likely to have diabetes than non-Hispanic whites.2 In addition, African-Americans are more likely to suffer complications from diabetes, such as end-stage renal disease and lower extremity amputations.7 African-Americans are 3.4 times more likely to have end stage renal disease and 3.5 times likely to be hospitalized for lower limb amputations as compared to non-hispanic whites. 7Obesity and physical inactivity are two major risk factor for diabetes. African-Americans in general, and African-American women specifically, have higher obesity and physical inactivity rates. African-American women have the highest obesity rate and are the least active of any other ethnic or gender groups in the United States.7 More than half of African-American women (58%) are overweight or obese as compared to one-third of the adult population. African-American women's obesity is almost twice that of Caucasian women and significantly higher than that of Mexican-American women (44.9%).1 Consequently, this domino effect of obesity and diabetes contributes to the growing gap in health disparities.Despite the fact that T2D is preventable, T2D continues to be on the rise in AfricanAmerican communities. African-Americans and other ethnic minorities continue to carry the heavy burden of the devastating effects of diabetes. Studies have shown that lifestyle interventions have been successful in preventing or delaying the onset of diabetes.2,8 Diabetes prevention interventions have proven to work outside of research settings. In particular, the National Diabetes Prevention Program (NDPP) has been proven to work in community based settings. The program is a lifestyle change program designed for individuals who have prediabetes or are at risk for diabetes and has been proven to reduce their risk of developing diabetes by 58%. Prediabetes is a condition in which blood glucose levels are higher than normal, but not high enough for a diagnosis of diabetes, Ironically, despite the high prevalence of diabetes and prediabetes among African-Americans and other minorities, little is known about successful interventions for this population.2,9,10 Thus, there is a real need to add to the body of knowledge informati...

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Lifestyle Interventions for Patients With and at Risk for Type 2 Diabetes

Abstract: Agency for Healthcare Research and Quality.

Cited by 464 publications

References 65 publications

Older Age, Higher Body Mass Index and Inflammation Increase the Risk for New-Onset Diabetes and Impaired Glucose Tolerance in Patients on Peritoneal Dialysis?

Older Age, Higher Body Mass Index and Inflammation Increase the Risk for New-Onset Diabetes and Impaired Glucose Tolerance in Patients on Peritoneal Dialysis?

Prediabetes and Lifestyle Modification: Time to Prevent a Preventable Disease

Diabetes Prevention in African-American Communities

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