Physical Activity in U.S. Adults With Diabetes and At Risk for Developing Diabetes, 2003

Morrato, Elaine H.; Hill, James O.; Wyatt, Holly R.; Ghushchyan, Vahram; Sullivan, Patrick W.

doi:10.2337/dc06-1128

Cited by 415 publications

(358 citation statements)

References 35 publications

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“…This is an alarming finding, as it was previously reported in the United States that especially high-risk subjects do not engage in regular physical activity (Morrato et al, 2007). Therefore, these subjects may be especially prone to dropout en stay in their non-active physical behavior.…”

Section: Dropouts To the Intervention Programmentioning

confidence: 62%

Predictors of lifestyle intervention outcome and dropout: the SLIM study

et al. 2011

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Background/Objectives: To evaluate the effect of a 4.1-year (range 3-6 years) lifestyle intervention according to general public health recommendations on glucose tolerance and dropout in a Dutch population with impaired glucose tolerance (IGT). Subjects/Methods: In the Study on Lifestyle intervention and Impaired glucose tolerance Maastricht, 147 Caucasian IGT subjects were randomized to an intervention group (INT: n ¼ 74; 38 male, 36 female) and control group (CON: n ¼ 73; 37 male, 36 female). Annually, subjects underwent measurements of body weight, anthropometry, glucose tolerance (oral glucose tolerance test), insulin resistance (homeostasis model assessment-insulin resistance), maximal aerobic capacity (VO 2 max), blood lipids and blood pressure. INT received individual advice regarding a healthy diet and physical activity. Results: INT decreased their saturated fat intake, increased their carbohydrate intake (Po0.05) and VO 2 max (P ¼ 0.04) compared with CON. Body weight did not change significantly (P ¼ 0.20) between the groups. After an initial decrease, 2-h glucose levels overall increased in INT ( þ 0.11 mmol/l), but significantly less than CON ( þ 1.18 mmol/l; P ¼ 0.04). Diabetes incidence was lower in INT versus CON (30 versus 56%, P ¼ 0.04). Change in body weight was associated with change in 2-h glucose levels (b ¼ 0.399 mmol/l per kg, P ¼ 0.02). Dropouts had a lower aerobic fitness and socioeconomic status, and a higher body mass index (BMI) and 2-h glucose compared with non-dropouts. Conclusions: Prolonged feasible changes in diet and physical activity prevent deterioration of glucose tolerance and reduce diabetes risk. Low socioeconomic status, low aerobic fitness and high BMI and 2-h glucose are indicative of dropout to the program.

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Section: Dropouts To the Intervention Programmentioning

confidence: 62%

Predictors of lifestyle intervention outcome and dropout: the SLIM study

et al. 2011

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“…However, sustained compliance with exercise programmes, especially by individuals with type 2 diabetes, is at best mediocre [26,27]. Observational studies have revealed associations between the time spent sitting and markers of metabolic disturbance [8][9][10].…”

Section: Discussionmentioning

confidence: 99%

Breaking sitting with light activities vs structured exercise: a randomised crossover study demonstrating benefits for glycaemic control and insulin sensitivity in type 2 diabetes

et al. 2016

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Aims/hypothesis We aimed to examine the effects of breaking sitting with standing and light-intensity walking vs an energy-matched bout of structured exercise on 24 h glucose levels and insulin resistance in patients with type 2 diabetes. Methods In a randomised crossover study, 19 patients with type 2 diabetes (13 men/6 women, 63 ± 9 years old) who were not using insulin each followed three regimens under free-living conditions, each lasting 4 days: (1) Sitting: 4415 steps/day with 14 h sitting/day; (2) Exercise: 4823 steps/day with 1.1 h/day of sitting replaced by moderate-to vigorous-intensity cycling (at an intensity of 5.9 metabolic equivalents [METs]); and (3) Sit Less: 17,502 steps/day with 4.7 h/day of sitting replaced by standing and light-intensity walking (an additional 2.5 h and 2.2 h, respectively, compared with the hours spent doing these activities in the Sitting regimen). Blocked randomisation was performed using a block size of six regimen orders using sealed, non-translucent envelopes. Individuals who assessed the outcomes were blinded to group assignment. Meals were standardised during each intervention. Physical activity and glucose levels were assessed for 24 h/day by accelerometry (activPAL) and a glucose monitor (iPro2), respectively. The incremental AUC (iAUC) for 24 h glucose (primary outcome) and insulin resistance (HOMA2-IR) were assessed on days 4 and 5, respectively. Results The iAUC for 24 h glucose (mean ± SEM) was significantly lower during the Sit Less intervention than in Sitting (1263 ± 189 min × mmol/l vs 1974 ± 324 min × mmol/l; p = 0.002), and was similar between Sit Less and Exercise (Exercise: 1383 ± 194 min × mmol/l; p = 0.499). Exercise failed to improve HOMA2-IR compared with Sitting (2.06 ± 0.28 vs 2.16 ± 0.26; p = 0.177). In contrast, Sit Less (1.89 ± 0.26) significantly reduced HOMA2-IR compared with Exercise (p = 0.015) as well as Sitting (p = 0.001). Conclusions/interpretation Breaking sitting with standing and light-intensity walking effectively improved 24 h glucose levels and improved insulin sensitivity in individuals with type 2 diabetes to a greater extent than structured exercise. Thus, our results suggest that breaking sitting with standing and light-intensity walking may be an alternative to structured exercise to promote glycaemic control in patients type 2 diabetes.

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“…However, most patients with T2D do not meet these standards [19,20]. In fact, people with T2D are less likely to engage in regular PA than their peers without diabetes, even though the majority of people with T2D recognize that regular PA is important [19,20].…”

Section: Introductionmentioning

confidence: 99%

How can clinical practices pragmatically increase physical activity for patients with type 2 diabetes? A systematic review

Luoma

Leavitt

Marrs

et al. 2017

Behav. Med. Pract. Policy Res.

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Although regular physical activity (PA) is a cornerstone of treatment for type 2 diabetes (T2D), most adults with T2D are sedentary. Randomized controlled trials (RCTs) have proven the effectiveness of PA behavioral interventions for adults with T2D but have rarely been conducted in healthcare settings. We sought to identify PA interventions that are effective and practical to implement in clinical practice settings. Our first aim was to use the valid Pragmatic-Explanatory Continuum Indicator Summary 2 (PRECIS-2) tool to assess the potential for future implementation of PA interventions in clinical practice settings. Our second aim was to identify interventions that effectively increased PA and glycemic control among the interventions in the top tertile of PRECIS-2 scores. We searched PubMed MED-LINE from January 1980 through May 2015 for RCTs of behavioral PA interventions coordinated by clinical practices for patients with T2D. Dual investigators assessed pragmatism by PRECIS-2 scores, and study effectiveness was extracted from original RCT publications. The PRECIS-2 scores of the 46 behavioral interventions (n = 13,575 participants) ranged from 3.0 to 4.8, where 5 is the most pragmatic score. In the most pragmatic tertile of interventions (n = 16) by PRECIS-2 scores, 30.8 and 31.3% of interventions improved PA outcomes and hemoglobin A1c, respectively. A minority of published evidence-based PA interventions for adults with T2D were both effective and pragmatic for clinical implementation. These should be tested for dissemination using implementation trial designs.

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Physical Activity in U.S. Adults With Diabetes and At Risk for Developing Diabetes, 2003

Cited by 415 publications

References 35 publications

Predictors of lifestyle intervention outcome and dropout: the SLIM study

Predictors of lifestyle intervention outcome and dropout: the SLIM study

Breaking sitting with light activities vs structured exercise: a randomised crossover study demonstrating benefits for glycaemic control and insulin sensitivity in type 2 diabetes

How can clinical practices pragmatically increase physical activity for patients with type 2 diabetes? A systematic review

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