Horm Metab Res 2023; 55(09): 617-624
DOI: 10.1055/a-2144-7236
Original Article: Endocrine Care

Positive Effects of Physical Activity on Prescription on Glycemic Control, Fitness, and Quality of Life in Newly Diagnosed Type 2 Diabetic Patients

Tam Ngoc Nguyen
1   Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
2   Scientific Research Department, National Geriatric Hospital, Ha Noi, Vietnam
,
Huyen Thi Thanh Vu
1   Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
2   Scientific Research Department, National Geriatric Hospital, Ha Noi, Vietnam
,
Long Quynh Khuong
3   Faculty of Science, Hasselt University, Diepenbeek, Belgium
,
Ingeborg van der Ploeg
4   Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
,
Carl Johan Sundberg
4   Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
5   Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
› Author Affiliations
Funding Information VR/SIDA — 348–2011–7246

Abstract

The aim was to investigate the effects of physical activity on prescription (PAP) compared with standard care (SC) in adult drug-naïve T2D patients. A randomized control trial was conducted with drug-naïve T2D patients attending an out-patient clinic Vietnam. Participants were randomly assigned to the PAP group (n+=+44) or the SC group (n+=+43). The PAP group received individualized recommendations for PA, intensive face-to-face training every two weeks. The SC group received the standard recommendations according to WHO guidelines. The mean HbA1c level change was larger (–10.6±6.4 mmol/mol) in the PAP group than in the SC group (–2.4±5.8 mmol/mol) (p<0.001). A one thousand step counts per day increase was significantly associated with a decrease of –2.43 mmol/mol in HbA1c [β=–2.43, 95%CI: (–2.94, –1.92]) in the PAP group. The fasting plasma glucose levels of the PAP group decreased significantly compared with the SC group. The VO2-max increased significantly more in the PAP group than in the SC group. PAP had clear positive effects on health-related Quality of Life [mean between group difference: 9.54 (95%CI 5.84,13.23)]. Insulin resistance, BMI, waist circumference, total cholesterol, LDL cholesterol and triglycerides were significantly more decreased in the PAP group than in the control group. In conclusion, the fact that even a small change in mean step counts over three months had a beneficial effect on health-related outcomes in drug-naïve T2D patients can have large implications for treatment and management practices, not least in a middle-income country like Vietnam.

Supplementary Material



Publication History

Received: 22 January 2023

Accepted after revision: 24 July 2023

Article published online:
07 September 2023

© 2023. Thieme. All rights reserved.

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  • References

  • 1 Nguyen CT, Pham NM, Lee AH. et al. Prevalence of and risk factors for type 2 diabetes mellitus in Vietnam: a systematic review. Asia Pac J Public Health 2015; 27: 588-600
  • 2 Tran QB, Hoang VM, Vu HL. et al. Risk factors for non-communicable diseases among adults in Vietnam: findings from the Vietnam STEPS survey 2015. J Global Health Sci 2020; 2: e7
  • 3 Trinh OT, Nguyen ND, Dibley MJ. et al. The prevalence and correlates of physical inactivity among adults in Ho Chi Minh City. BMC Public Health 2008; 8: 1-11
  • 4 Nguyen TN, Nguyen TT, Hagströmer M. et al. Physical activity and plasma glucose control among diabetic patients attending outpatients clinics in Hanoi, Vietnam. In J Environ Res Public Health 2021; 18: 1182
  • 5 Bull FC, Al-Ansari SS, Biddle S. et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med 2020; 54: 1451-1462
  • 6 Martín-Timón I, Sevillano-Collantes C, Segura-Galindo A. et al. Type 2 diabetes and cardiovascular disease: have all risk factors the same strength?. World J Diabetes 2014; 5: 444
  • 7 McTiernan A, Friedenreich CM, Katzmarzyk PT. et al. Physical activity in cancer prevention and survival: a systematic review. Med Sci Sports Exerc 2019; 51: 1252-1261
  • 8 Praet SF, Van Loon LJ. Optimizing the therapeutic benefits of exercise in type 2 diabetes. J App Physiol 2007; 103: 1113-1120
  • 9 Igarashi Y, Nogami Y. The effect of regular aquatic exercise on blood pressure: a meta-analysis of randomized controlled trials. Eur J Prevent Cardiol 2018; 2 5 190-199
  • 10 Sigal RJ, Armstrong MJ, Bacon SL. et al. Physical activity and diabetes. Canad J Diabetes 2018; 42: S54-S63
  • 11 Eriksson MK, Hagberg L, Lindholm L. et al. Quality of life and cost-effectiveness of a 3-year trial of lifestyle intervention in primary health care. Arch Intern Med 2010; 170: 1470-1479
  • 12 American Diabetes Association. Standards of medical care in diabetes – 2020 abridged for primary care providers. Clin Diabetes 2020; 38: 10
  • 13 Ferraro RA, Fischer NM, Xun H. et al. Nutrition and physical activity recommendations from the United States and European cardiovascular guidelines: a comparative review. Curr Opin Cardiol 2020; 35: 508-516
  • 14 Praet S, Van Loon L. Exercise: the brittle cornerstone of type 2 diabetes treatment. Diabetologia 2008; 51: 398-401
  • 15 Hellénius M-L, Sundberg CJ. Physical activity as medicine: time to translate evidence into clinical practice. Br J Sports Med 2011; 45: 158-158
  • 16 Onerup A, Arvidsson D, Blomqvist Å. et al. Physical activity on prescription in accordance with the Swedish model increases physical activity: a systematic review. Br J Sports Med 2019; 53: 383-388
  • 17 Kallings LV, Leijon ME, Kowalski J. et al. Self-reported adherence: a method for evaluating prescribed physical activity in primary health care patients. J Phys Act Health 2009; 6: 483-492
  • 18 Bennett H, Parfitt G, Davison K. Validity of submaximal step tests to estimate maximal oxygen uptake in healthy adults. Sports Med 2016; 46: 737-750
  • 19 Cink R, Thomas T. Validity of the Astrand-Ryhming nomogram for predicting maximal oxygen intake. Br J Sports Med 1981; 15: 182-185
  • 20 Trinh OT, Do Nguyen N, Van Der Ploeg HP. et al. Test-retest repeatability and relative validity of the Global Physical Activity Questionnaire in a developing country context. J Phys Act Health 2009; 6: S46-S53
  • 21 Tran TH, Trinh NL, Hoang Y. et al. Health-related quality of life among vietnamese breast cancer women. Cancer Control 2019; 26: 1073274819862787
  • 22 Cannata F, Vadalà G, Russo F. et al. Beneficial effects of physical activity in diabetic patients. J Funct Morphol Kinesiol 2020; 5: 70
  • 23 Colberg SR, Sigal RJ, Yardley JE. et al. Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes Care 2016; 39: 2065-2079
  • 24 Chapman J, Qureshi N, Kai J. Effectiveness of physical activity and dietary interventions in South Asian populations: a systematic review. Br J Gen Pract 2013; 63: e104-e114
  • 25 Lee I, Buchner DM. The importance of walking to public health. Med Science Sports Exer 2008; 40: S512
  • 26 Snowling NJ, Hopkins WG. Effects of different modes of exercise training on glucose control and risk factors for complications in type 2 diabetic patients: a meta-analysis. Diabetes Care 2006; 29: 2518-2527
  • 27 Najafipour F, Mobasseri M, Yavari A. et al. Effect of regular exercise training on changes in HbA1c, BMI and VO2max among patients with type 2 diabetes mellitus: an 8-year trial. BMJ Open Diabetes Res Care 2017; 5: e000414
  • 28 Lee DC, Sui X, Artero EG. et al. Long-term effects of changes in cardiorespiratory fitness and body mass index on all-cause and cardiovascular disease mortality in men: the Aerobics Center Longitudinal Study. Circulation 2011; 124: 2483-2490
  • 29 Stimpson NJ, Davison G, Javadi A-H. Joggin’the noggin: towards a physiological understanding of exercise-induced cognitive benefits. Neurosci Biobehav Rev 2018; 88: 177-186
  • 30 McAuley E, Kramer AF, Colcombe SJ. Cardiovascular fitness and neurocognitive function in older adults: a brief review. Brain Behav Immun 2004; 18: 214-220
  • 31 Rosenthal MJ, Fajardo M, Gilmore S. et al. Hospitalization and mortality of diabetes in older adults: a 3-year prospective study. Diabetes Care 1998; 21: 231-235
  • 32 Jing X, Chen J, Dong Y. et al. Related factors of quality of life of type 2 diabetes patients: a systematic review and meta-analysis. Health Qual Life Outcomes 2018; 16: 1-14
  • 33 Bergman RN, Kim SP, Hsu IR. et al. Abdominal obesity: role in the pathophysiology of metabolic disease and cardiovascular risk. Am J Med 2007; 120: S3-S8
  • 34 Kohrt WM, Kirwan JP, Staten MA. et al. Insulin resistance in aging is related to abdominal obesity. Diabetes 1993; 42: 273-281
  • 35 Williams PT. Changes in body weight and waist circumference affect incident hypercholesterolemia during 7 years of follow-up. Obesity 2008; 16: 2163-2168
  • 36 Kuo C, Hwu C, Chiang S. et al. Waist circumference predicts insulin resistance in offspring of diabetic patients. Diabetes Nutr Metab 2002; 15: 101-108
  • 37 Diaz KM, Shimbo D. Physical activity and the prevention of hypertension. Curr Hyperten Rep 2013; 15: 659-668
  • 38 Wasenius NS, Isomaa BA, Östman B. et al. Low-cost exercise interventions improve long-term cardiometabolic health independently of a family history of type 2 diabetes: a randomized parallel group trial. BMJ Open Diabetes Res 2020; 8: e001377