Indexing
All Issues
Submission
Author Guidelines
Reviewers
Editorial Members
Publication Fee
Vol.1 , No. 3, Publication Date: Sep. 7, 2014, Page: 109-120
. Results obtained showed that there were significant differences in HbA1c (p<0.005) and weight (p=0.001). The Intervention group HbA1c values and weight were significantly reduced (p<0.005) when compared with the control group, suggesting that exercise has an impact on the glycaemic control of Type 2 diabetes mellitus. This further reinforces the importance of exercise of any intensity on these two parameters. The difference in cholesterol was not significant but improved remarkably (p=0.008) which indicated that the difference is not big in magnitude. The improvement on glycaemic control correlated strongly with consistence in exercise programme (r = 0.333)2. The recommendation that exercise training can be used as a therapeutic means to lower blood glucose levels in Type 2 diabetes mellitus stems primarily from the fact that exercise has pronounced effects upon the metabolism of glucose. Further studies are recommended to elucidate how the metabolic effect of physical activity and Type 2 diabetes are modulated by duration of diabetes and intensity of exercise on the glycaemic control and lipid profile.&picture=http://www.aascit.org/aascit/decorators/img/journal/906.jpg)
| [1] | Nwaokoro Joakin Chidozie, Department of Public Health, School of Health, Federal University of Technology Owerri, P.M.B. 1526, Imo State, Nigeria. |
| [2] | Agius-Muscat Hugo, Faculty of Medicine, University of Malta, Msida, Malta. |
| [3] | Ellul Alan, St. Luke’s Hospital, Diabetes Clinic, Gwardamangia, Pieta, Malta. |
| [4] | Trapani Josef, Dept of Nursing, Faculty of Health Sciences, Msida, University of Malta. |
| [5] | Grixti Moira, Diabetes Clinic, St Luke’s Hospital, Gwardamangia, Pieta, Malta. |
Type 2 diabetes has become a great source of concern to governments, individuals and health care givers all over the world because of its serious long-term complications, such as blindness, kidney disease, heart disease, stroke, limb amputation and reduced life expectancy. Therefore, this study sets out to investigate the impact of physical activity in glycaemic control of Type 2 diabetic adults amongst the Maltese population. Well structured questionnaires were administered on a hundred and twenty patients who were regularly attending the Diabetes Clinic, at St. Luke’s Hospital, aged 30 to 44 years. They were informed that the questionnaires were designed for people with Type 2 diabetes. Only hundred patients responded and attended the first meeting prior to the exercise programme. These patients were randomly assigned into control and intervention groups using random sampling technique. Data collected from respondents were analyzed, put into Tables and were subjected to descriptive statistics and analysis of variance (ANOVA). Results obtained showed that there were significant differences in HbA1c (p<0.005) and weight (p=0.001). The Intervention group HbA1c values and weight were significantly reduced (p<0.005) when compared with the control group, suggesting that exercise has an impact on the glycaemic control of Type 2 diabetes mellitus. This further reinforces the importance of exercise of any intensity on these two parameters. The difference in cholesterol was not significant but improved remarkably (p=0.008) which indicated that the difference is not big in magnitude. The improvement on glycaemic control correlated strongly with consistence in exercise programme (r = 0.333)2. The recommendation that exercise training can be used as a therapeutic means to lower blood glucose levels in Type 2 diabetes mellitus stems primarily from the fact that exercise has pronounced effects upon the metabolism of glucose. Further studies are recommended to elucidate how the metabolic effect of physical activity and Type 2 diabetes are modulated by duration of diabetes and intensity of exercise on the glycaemic control and lipid profile.
Keywords
Physical Activity, Glycaemic Control, Type 2 Diabetes, Maltese Population
Reference
| [01] | Ainsworth BE, Haskell WL, Leon AS, Jacobs JR, Montoya HJ, et al. (1993). Compendium of physical activities: Classification of energy costs of human physical activities. Med Sci Sports Exerc; 25:71-80. |
| [02] | Ali, S.M, (2002), Nutritional status and birth outcomes of the diabetic and non-diabetic pregnant women. Bangladesh Med. Res. Conc. Bull., 3: 97-103. |
| [03] | American College of Obstetricians and Gynecologists. (1994). Diabetes and Pregnancy. Technical Bulletin No. 200. |
| [04] | American Diabetes Association, (2000), Gestational diabetes mellitus (Position Statement). Diabetes Care 23 (Suppl. 1):S77–S79. |
| [05] | American Diabetes Association (2002) Clinical practice recommendations. Gestational diabetes mellitus. Diabetes Care. 25 (Supple. 1): S94-S96. |
| [06] | American Diabetes Association. (2004). Gestational diabetes mellitus Diabetes Care ;27 Suppl 1:S88-90 |
| [07] | Annis AM, Caulder MS, Cook ML, Duquette D.(2005). Family history, diabetes, and other demographic and risk factors among participants of the National Health and Nutrition Examination Survey 1999-2002; 2: A19. |
| [08] | Barker Dj, Glucman PD, Godfrey KM, Harding JE, Owens JA, et al (1993).Fetal nutrition and cardiovascular disease in adult life. 314: 938-42. |
| [09] | Beisher, N.A., Oats, J.N., Sheedy, M.T. and Waslstab, J.E. (1991). Incidence and severity of gestational diabetes according to country of birth in women living in Australia. Diabetes 40(Supple. 2): 35-38 |
| [10] | Berkowitz GS, Lapinski RH, Wein R, Lee D.(1992). Race/ethnicity and other risk factors for gestational diabetes. Am J epidemiol; 135: 965-973 |
| [11] | Berkus MD, Langer O, Siler-Khodr T, Timmreck L. (1996). Insulin secretion and insulin sensitivity postpartum J Soc Gynecol Invest 3:295. |
| [12] | Bung P, Artal R, Khodiguian N, Kjos S. (1991). Exercise in gestational diabetes. An Optional therapeutic approach? Diabetes; 40 Suppl 2:182-5. |
| [13] | Buschard K, Buch I, Molsted-Pedersen L, Hougaard P, et al (1987). Increased incidence of true type I diabetes acquired during pregnancy. BMJ 294:275–279. |
| [14] | Catalano PM, Vargo KM, Bernstein IM, Amini SB.(1999). Incidence and risk factors associated with abnormal postpartum glucose tolerance in women with gestational diabetes. Am J Obstet Gynecol ;165 (4 Pt 1): 914-9 |
| [15] | Conway, D.L. and Langer, O. (1999). Effects of new criteria for type 2 diabetes on the postpartum glucose intolerance in women with gestational diabetes. Am.J. Obstet. Gynecol., 181: 610-614. |
| [16] | Cosson E, Benchimol M, Carbillon L, Pharisien I, Paries J. et al. (2006) Universal rather than selective screening for gestational diabetes mellitus may improve fetal outcomes. Diabetes Metab 32:140–146. |
| [17] | Cousins L, Baxi L, Chez R, Coustan D, Gabbe S, et al. (1991). Screening recommendations for gestational diabetes mellitus. Am J Obstet Gynecol 165:493–496. |
| [18] | Coustan DR, Carpenter MW, O’ Sullivan PS, Carr SR. (1993). Gestational diabetes: Predictors of subsequence disordered glucose metabolism. Am J Obstet Gynecol ;1139-44. |
| [19] | Coustan DR, Nelson C, Carpenter MW, Carr SR, Rotondo L, Widness JA.(1989) Maternal age and screening for gestational diabetes: A population-based study. Obstet Gynecol 73:557. |
| [20] | Dempsey JC, Butler CL, Sorensen Tk Lee IM, Thompson ML. et al. (2004). A case-control study of maternal recreational physical activity and risk of gestational diabetes mellitus. Diabetes Res Clin Pract; 66: 203-15. |
| [21] | Dempsey JC, Sorensen Tk, Williams MA, Lee IM, Miller RS, et al. (2004). Prospective study of gestational diabetes mellitus risk in relation to maternal recreational physical activity before and during pregnancy. Am J Epidemiol; 159: 663-70. |
| [22] | DeVeciana M, Major CA, Morgan M, Asrat T, Toohey JS et al (1995). Postprandial versus pre-prandial blood glucose monitoring in women with gestational diabetes mellitus requiring insulin therapy. N Engl J Med 333:1237. |
| [23] | Di Cianni G, Benzi L, Casadidio I, Orsini P, Rossi L, et al. (1997). Screening of gestational diabetes in Tuscany: results in 2000 cases. Am 1st Super Santa ;33:389-391 |
| [24] | Di Cianni G, Volpe L, Lencioni C, Miccoli R, Cuc-curu, I, et al.(2003). Prevalence and risk factors for gestational diabetes assessed by universal screening. Diabetes res Clin Pract : 62:131-7. |
| [25] | Dornhorst A, Paterson CM, Nicholls, JS, Wadsworth J, Chiu DC, et al. (1992). High prevalence of gestational diabetes in women from ethnic minority group. Diabet Med ;9:820-825 |
| [26] | Dye TD, Knox KL, Artal R, Aubry RH, Wojtowycz MA. (1997). Physical activity, obesity, and diabetes in pregnancy. Am J Epidemiol; 146:961-5. |
| [27] | Egeland GM, Skjaerven R, Irgens LM.(2000). Birth characteristics of women who develop gestational diabetes: population based study. BMJ 321:546-7. |
| [28] | England LJ, Levine RJ, Qian C, Soule LM, Schisterman EF, et al. (2004). Glucose tolerance diabetes and risk of gestational diabetes mellitus in nulliparous women who smoke during pregnancy. Am J Epidemiol; 160: 1205-13. |
| [29] | F.S Wokoma, Celestine T, John. C, E. Enyinadah, (2002). Topical journal of obstetrics and Gynaecology, Vol 18, No 2, |
| [30] | Ferrara, A., Kahn, MM. (2004). An increase in the incidence of gestational diabetes mellitus: Northern California, 1991-2000. Obstet. Gynecol., 103 (3): 526-33. |
| [31] | Hariri S, Yoon PW, Moonesinghe R, Valdez R, Khoury MJ. (2006). Evaluation of family history as a risk factor and screening tool for detecting undiagnosed diabetes in a nationally representative survey population. Genet Med; 8:752-9 |
| [32] | Hariri S, Yoon PW, Qureshi N, Valdez R, Scheuner MT, et al (2006). Family history of type 2 diabetes: a population-based screening tool for prevention Genet Med 8:102-8. |
| [33] | Helmrich SP, Ragland DR, Leung RW, Paffenbarger Jr. RS. (1991). Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. .N. Engl J Med; 325: 147-52. |
| [34] | Henci, G. (1996). Gestational diabetes: The emperor has no clothes. Birth Gazette Spring. 12: 2. |
| [35] | Homko C, Sivan E, Chen X, Reece EA, Boden G.(2001). Insulin secretion during the after pregnancy in patients with gestational diabetes mellitus. J Clim Endocrinol Metab ; 86:568-573 |
| [36] | Innes KE, Byers TE, Marshall JA, Baron A, Orleans M, et al (2002) Association of a women’s own birth weight with subsequent risk for gestational diabetes. JAMA ; 287:2534-41. |
| [37] | Jang HC, Cho YM, Park KS, Kim SY, Lee Kin MY, Yang JH, Shin SM.(2001) Pregnancy outcome in Korean women with gestational diabetes mellitus diagnosed by the Carpenter-Coustan criteria. J Pettitt DJ Gestational diabetes mellitus JAMA;286:2516-8 |
| [38] | Keshavarz M, Cheung NW, Babaee GR, Moghadam HK, Ajami ME, Shariati M.(2005). Gestational diabetes in Iran: incidence, risk factors and pregnancy out comes. Diabetes Res Clin Pract ;69:279-86. |
| [39] | Kim, C, Newton KM, Knopp RH. (2002). Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabetes Care ;25:1862-8 |
| [40] | King, H. (1998). Epidemiology of glucose intolerance and gestational diabetes in women of childbearing age. Diabetes Care. 21. Supple. 2: 9-13. |
| [41] | Kjos SL, Buchanan TA, Greenspoon JS, MOntoro M, Bernstein GS, Mestman JH.(1990). Gestational diabetes mellitus: the prevalence of glucose intolerance and diabetes mellitus in the first two months post partum. Am J Obstet Gynecol;163 (pt 1): 93-8 |
| [42] | Kousta, E, Lawrence NJ, Penny A, Millauer BA, Robinson S, et al. (2000). Women with a history of gestational diabetes of European and South Asian origin are shorter than women with normal glucose tolerance in pregnancy. Diabet Med;17:792-7. |
| [43] | Kritz-Silverstein D, Barrett-Connor E, Wingard DL, Friedlander NJ. (1994). Relation of pregnancy history to insulin levels in older, nondiabetic women. Am J Epidemiol;140:375-382 |
| [44] | Kritz-Silverstein D, Barrett-Connor E, Wingard Dl. (1989). The effect of parity on the later development of non-insulin dependent diabetes mellitus or impaired glucose tolerance. N Engl J Med; 321: 1214-1219. |
| [45] | Kumari AS, Badrinath P. (2002). Extreme grandmultiparity: is it an obstetric risk factors? Eur J Obsete Gyecol Reprod Biol; 101:22-5 |
| [46] | Leonardi MR, Bottoms SF. (1996) increase incidence of large for gestational infants not attributable to gestational diabetes. Am J Obstet Gynecol 174:393. |
| [47] | Manson JE, Rimm EB, Stampfer MJ, Colditz GA, Willett WC, Krolewski AS, et al. (1991). Physical activity and incidence of non-insulin-dependent diabetes mellitus in women. Lancet; 338: 774-8. |
| [48] | Maresh M. (2005) Screening for gestational diabetes mellitus. Fetal Neonatal Med 10:317–323, Mellitus: prospective population based study. Retrieved on May 29, 2011 from http://www.jstor.org/stable/29718722 |
| [49] | Metzger BE, Coustan DM, Organizing Committee. (1998) Summary and recommendations of the Fourth International Workshop-Conference on Gestational Diabetes Mellitus. Diabetes Care 21 (Suppl. 2):B161–B167. |
| [50] | Metzger BE. (1991) Summary and recommendations of the Third International Workshop Conference on Gestational Diabetes Mellitus. Diabetes 40 (Suppl. 2):197–201, 1991 |
| [51] | Moses GR. (1996). The recurrence rate of gestational diabetes in subsequent pregnancies. Diabetes Care 1996;19:1348-1350. |
| [52] | Moses RG, Moses J, knights S.(1999). Birth weight of women with gestational diabetes. Diabetes Care ;22:1059-62. |
| [53] | National Collaborating Centre for Women’s and Children’s Health. (1993) Antenatal Care: Routine Care for the Healthy Pregnant Woman. London, Royal College of Obstetricians and Gynaecology. |
| [54] | O’Sullivan JB, Mahan CM, Charles D, Dandrow RV.(1973) Screening criteria for high-risk gestational diabetic patients. Am J Obstet Gynecol 116:895–900. |
| [55] | Oregon BRFSS Behavioral Risk Factor Surveillance System. Salem (OR): Oregon Department of Human Services; 2005. |
| [56] | Perucchini D, Fischer U, Spinas GA, Huch R, Huch A, Lehmann R.(1999) Using fasting plasma glucose concentrations to screen for gestational diabetes. |
| [57] | Pettitt DJ, Knowler WE, Baird, R, Bennett PH. (1980). Gestational diabetes: Infant and maternal complication of pregnancy in relation to third-trimester glucose tolerance in the Pima Indians. Diabetes Care; 3: 458-464 |
| [58] | Sargeant LA, Khaw KT, Bingham S, Day NE, Luben RN, et al. (2001). Cigarette smoking and glycaemia: the EPIC-Norfolk Study. European Prospective Investigation into Cancer. Int J Epidemiol; 30: 547-54. |
| [59] | Schaefer-Graf, U.M., Buchanan, T.A., Xiang, A.H., peters, R.K. and Kjos, S.L. (2002). Clinical predicators for a high risk for the development of diabetes mellitus in the early puerperium in women with recent gestational diabetes mellitus. Am. J. Obset. Gynecol., 186: 751-756. |
| [60] | Solomon CG, Willett WC, Carey VJ, Rich-Edwards J, Hunter DJ, et al. (1997) A prospective study of pregravid determinants of gestational diabetes mellitus. JAMA; 278: 1078-83. |
| [61] | Terry PD, Weiderpass E, Ostenson CG, Cnattingius S. (2003). Cigarette smoking and the risk of gestational and pregestational diabetes in two consecutive pregnancies. Diabetes Care; 26: 2994-8. |
| [62] | Utah department of health, Office of vital records & statistics (2001). |
| [63] | Valdez R, Yoon PW, Liu T, Khoury MJ. (2007) Family history and prevalence of diabetes in the US population: 6-year results from the National Health and Nutrition Examination Survey (NHANES, 1999-2004). Diabetes Care 20: 2517-22. |
| [64] | Wah Cheung, N. and Byth, K. (2003). Population health significances of gestational diabetes. Diabetes Care. 26: |
| [65] | Wang L, Yamaguchi T, Yoshimine T, Kategiri A, Shirogane K, et al (2002). A case-control study of risk factors for development of type 2 diabetes: emphasis on physical activity. J Epidemiol; 12: 424-30. |
| [66] | Xiang AH, Kjos SL, Takayanagi M, Trigo E, Buchanan TA. (2010). Detailed physiological characterization of the development of type 2 diabetes in Hispanic women with prior gestational diabetes mellitus. Diabetes; 59;2625-30. |
| [67] | Yang X, Hsu-Hage B, Zhang H, Yu L, Dong L, Li J, et al. (2002). Gestational diabetes mellitus in women of single gravidity in Tianjin City, China, Diabetes Care; 25:847-51. |
