The relationship between physical activity, restless legs syndrome, and health-related quality of life in type 2 diabetes

Abstract

To evaluate the relationship between physical activity with co morbidities and health-related quality of life in type 2 diabetic patients with and without restless legs syndrome (RLS). This is an observational study, set at tertiary care diabetic outpatient clinic, where 200 consecutive type 2 diabetic patients and 47 controls participated. Physical activity level was established by the International Physical Activity Questionnaire (IPAQ) and RLS diagnosis and RLS severity were established using the criteria defined by the International Restless Legs Syndrome Study Group; excessive daytime sleepiness was evaluated by the Epworth Sleepiness Scale, quality of sleep by the Pittsburgh Sleep Quality Index and Health-Related Quality of Life by the Short-Form Health Survey (SF-36). Depressive symptoms were investigated by Beck Depression Inventory (BDI- II). Among all diabetic patients (58 % women, mean age 52.7 ± 5.7), disease duration varied from 1 to 30 years (11.7 ± 7.5). Diabetic patients had more hypertension (76 %), peripheral neuropathy (65 %), and depressive symptoms (31 %) than controls; no gender differences were found between cases with and without depressive symptoms. RLS patients (72 % female) had worse quality of sleep. With regards to the quality of life domains, more active RLS diabetic patients had better perception of functional capacity, physical limitation, pain, and general health state (p < 0.05). RLS symptom severity did not vary according to physical activity (IPAQ level). This study shows that the physical activity is associated with a better perception of functional capacity, physical limitation, and pain in diabetic patients with RLS; thus a more active lifestyle should be encouraged.

Effect of perceived racial discrimination on self-care behaviors, glycemic control, and quality of life in adults with type 2 diabetes

“…[4-5] A number of studies have shown racial disparities exist in diabetes self-management and psychosocial factors are an important consideration in care. [4-8]. …”

Restless legs syndrome in patients with type 2 diabetes: effectiveness of pramipexole therapy

“…A possible mechanism is that decreased leptin levels and elevated ghrelin levels increase appetite and caloric intake and reduce energy expenditure, which facilitates the development of impaired glucose tolerance and obesity 14–16. In addition, patients with diabetes have more hypertension (76%), peripheral neuropathy (65%), and depressive symptoms (31%) 17. RLS is thus a significant sleep disorder that could be an important factor in diabetes management and health outcomes 18…”

“…As to treatment of RLS, physical activity is associated with a better perception of functional capacity, physical limitation, and pain in patients with diabetes with RLS 17. A large study involving 268 patients with diabetes showed that twice-a-week, supervised , aerobic and resistance training plus exercise and counselling for 12 months improves physical and mental Health-Related Quality of Life measures 19.…”

Daytime sleepiness in patients with type 2 Diabetes Mellitus – a prospective cohort study

“…Three previously trained interviewers collected behavior questionnaires, demographic and clinical information using a face-to-face interview. Comorbidity severity was evaluated by the Charlson Comorbidity Index (CCI) [25] previously used in diabetic patients [26], depressive symptoms by the Beck Depression Inventory (BDI II) [27] previously validated [28] and sleep quality by the Pittsburgh Sleep Quality Index (PSQI) [29]. Levels of physical activity were evaluated by the International Physical Activity Questionnaire (IPAQ) [30,31].…”