Remedial Actions for the Physical Inactivity of Hospitalized Patients With Type 2 Diabetes

Abstract

OBJECTIVEPhysical inactivity is often suspected in hospitalized patients with type 2 diabetes but has yet to be quantified.RESEARCH DESIGN AND METHODSWe measured the level of physical activity of 36 hospitalized (H) and 36 free-living nonhospitalized (NH) type 2 diabetic subjects with actimeters (SenseWear Arm-Band).RESULTSThe number of steps (H: 4,381 ± 3,742 steps/24 h, NH: 7,220 ± 4,763 steps/24 h; P < 0.01), duration of physical activity (H: 45 ± 57 min/24 h, NH: 148 ± 116 min/24 h; P < 0.005), and physical activity expenditure (H: 287 ± 390 kcal/24 h, NH: 1,035 ± 1,006 kcal/24 h; P < 0.005) were two- to threefold lower in the hospitalized patients. Simple advice enabled us to increase their recorded levels of physical activity by ∼50% (P < 0.005), and a further 50% (P < 0.05) was obtained by the use of a pedometer.CONCLUSIONSThe physical inactivity of hospitalized patients with type 2 diabetes is significant and remediable, although the advice given must take into account the existence of sensory neuropathy and silent myocardial ischemia.

Differences in the daily activity of patients with diabetic foot ulcers compared to controls in their free‐living environments

“…Estimated daily steps , energy expenditure and METs and lying and sleep durations have been validated in comparison to the gold standard criterion measures of manual step counts , indirect calorimetry or doubly labelled water techniques and polysomnography, respectively . Furthermore, the armband is now regularly used as the research gold standard criterion measure to test consumer‐wearable activity monitors (such as Fitbits) , has been used to measure daily activity outcomes in numerous studies investigating cohorts of people with diabetes and by studies conducted by members of our team . For this study, the armband captured the following estimated daily activity outcomes of interest: steps, energy expenditure (kJ), average METs, physical activity (>3 METs) duration (minutes) and energy expenditure (kJ), lying duration (minutes) and sleep duration (minutes) .…”

“…Fourth, all participant characteristics were captured using valid and reliable tools (2,15) and according to international reporting standards for diabetic foot studies (45). Fifth, we used a multi-sensor device to measure the multiple daily activity outcomes we reported, and this device has been tested to be valid and reliable to measure these multiple different daily activity outcomes in the free-living conditions of cohorts of patients with different conditions (21)(22)(23)(24)(25)(26)(27)(28)(29)(30); this device has also been successfully used for the same purposes in multiple other diabetes studies (33)(34)(35). Last, we used a validated sleep quality tool to help corroborate the sleep duration findings (20).…”

Physical Activity Measured by the SenseWear Armband in Women With Rheumatoid Arthritis

“…34,41,42 One study in older adults (average ageϭ75 years, BMIϭ26 kg/m 2 ) reported a PAEEՆ 3METs value of 282 kcal/d. 34 Another study in patients with type 2 diabetes (average ageϭ55 years, BMIϭ34 kg/m 2 ) reported a PAEEՆ 3METs value of 287 kcal/d.…”

“…34 Another study in patients with type 2 diabetes (average ageϭ55 years, BMIϭ34 kg/m 2 ) reported a PAEEՆ 3METs value of 287 kcal/d. 41 The third study assessed people with chronic obstructive pulmonary disease (COPD) during 2 days (12 hours per day) and reported a PAEEՆ 3METs value of 412 kcal/d. 42 In our cohort, the PAEEՆ3METs value was 239 kcal/d.…”

Adult patients hospitalised for inaugural diabetes in Bordeaux during 1996-1997 and 2008-2009: a changing scene

“…The higher weight of these antiGAD-patients is a therapeutic challenge: due to the intense clinical signs, most of them must be treated by insulin, further gaining weight during the following months as shown in the Table 3. Only ~1/4 of the patients can reasonably return home without insulin, with dietary advices, and oral anti diabetic agents, without further gaining weight for the 2008-2009 period, probably because we have intensified our education for physical activity [23]. But these patients are especially heavier and the discharge without insulin becomes less frequent, as shown in the Table 4.…”