Introduction Physical activity (PA) is an important element in type 2 diabetes mellitus (T2DM) management. The aims of this study were to assess the percentage of adults with T2DM who perform PA, according to the intensity level and to describe barriers to exercise and the association between metabolic control and other clinical variables. Methods Multicenter, observational, cross-sectional study. Data were collected through the International PA Questionnaire (IPAQ) and the PA Barrier Questionnaire. Adults (18–65 years old) with T2DM from 17 Argentine diabetes centers were included, from May to July 2018. Results A total of 270 men (54.9 ± 9.8 years) and 225 women (55.3 ± 9.6 years) were included. Duration of diabetes: 8.2 ± 6.3 years. The BMI in men was 32 ± 10.6 kg/m 2 , whereas that in women was 32.5 ± 7.2 kg/m 2 . The last two HbA1c values were 7.6 ± 1.7% and 7.5 ± 1.6. Results also showed that 12.7% had clinical heart disease, 13.7% had nephropathy, 20.8% had neuropathy, 6.1% had diabetic foot and 14.1% had retinopathy. The level of PA was low in 52.3% of the patients studied and moderate in 30.5%. The most frequent barriers were: “lack of will” (59.6%) and “lack of energy” (37.2%). The low level of PA was associated with age (OR: 1.05 per year of age; p < 0.001), HbA1c (OR: 1.16 per 1%; p < 0.05), BMI (OR: 1.06 per kg/m 2 ; p < 0.001) and sex (OR: 1.69 for women; p < 0.01). Conclusions PA in a cornerstone in management T2DM. Nevertheless, in this study, 52.3% of T2DM adults showed low level of PA. The main barriers reported were related to low personal motivation. These factors should be taken into account to implement programs to promote physical activity.
Physical activity (PA) is a mainstay in the management of type 2 diabetes (T2D) treatment. Data about level of PA and perceived barriers to exercise in adults with T2D is lacking in Argentina. Objectives: Primary: To assess the percentage of adults with T2D who perform PA according to intensity level. Secondary: 1. To describe the barriers to exercise. 2. To describe the association between level of PA and metabolic control and other variables in the study population. 3. To evaluate sedentary time. Methods: Multicenter, observational, cross-sectional study of data collection through 2 questionnaires: International PA Questionnaire (IPAQ) short form and the “Barriers to being Active Quiz” developed by Center for Disease Control (CDC). Clinical and biochemical data were also collected. We included adults with T2D age 18 to 65 years, in 17 Argentine diabetes centers, from May 2nd to July 15th, 2018. Statistical Methods: Chi2, t student, Pearson and Spearman correlations, multiple logistic regression and multiple linear regression. Results: 270 men (age 54.9 ± 9.8 years) and 225 women (age 55.3 + 9.6 years) were included. Diabetes duration: 8.2 ± 6.3 years. BMI men: 32.0 ± 10.6 Kg/m2 and women: 32.5 ± 7.2 Kg/m2. Two last HbA1c: 7.6 ± 1.7% and 7.5 ± 1.6%. 32.5% treated with insulin. 12.7% had cardiovascular disease; 13.7% nephropathy; 20.8% neuropathy; 6.1% diabetic foot and 14.1% retinopathy. The level of PA by IPAQ was low in 52.3% and moderate in 30.5%. The most frequent barriers were: "lack of will" (59.6%), "lack of energy" (37.2%) and "lack of time" (31.5%). Multivariate analysis: low level of PA was associated with age (OR: 1.05 per year of age, p <0.001); A1c (OR: 1.16 per 1% p <0.05); BMI (OR: 1.06 per kg/m2, p <0.001) and sex (OR: 1.69 for women, p <0.01). Sedentary time: median of 5 hours/day, with a 75th percentile of 6 hours/day. It was associated with HbA1c in the multivariate analysis (p = 0.02). Conclusions: 52.3% showed a low level of PA and the main barriers are related to low personal motivation. Disclosure C. Gomez Martin: None. M.L. Pomares: None. C.M. Muratore: None. S. Apoloni: None. P.J. Avila: None. M. Rodriguez: None.
Many studies suggest that there is a difference in perceived stress (PS) among genders in general population. Gender differences in patients with diabetes are uncertain. Descriptions of gender differences in PS during Covid lockdown in people with diabetes are lacking. Objectives: To assess the differences regarding perceived stress and anxiety between genders among persons with diabetes during COVID-pandemic lockdown. Secondary: To describe the association between PS with metabolic control and other co-variables. Methods: Multicenter, cross-sectional observational study of data collection through an online survey. Adults with T1D and T2D in 37 Argentine Diabetes Centers were included, from April to May, 2020. Degree of stress was evaluated by the Perceived Stress Scale (PSS) , and anxiety by the Beck Anxiety Inventory (BAI) . Results: 2273 patients were included. 1194 (52.5%) were female. Age in woman 48.6 years and 52.1 in men. The proportion of patients with T2D was higher in male (58.6% vs. 48.9%) . Diabetes duration was around 14 years, similar in both genders. A1c levels were higher in female patients (7.7% vs. 7.5%, p < 0.05) . BAI and PPS scales resulted significantly correlated (r=0.58; p <0.001) . In the univariate analysis BAI and PPS scores were significantly higher in women with both T1D and T2D vs. men (BAI 8.9 vs. 6.6, p<0.001, PSS 14.3 vs. 11.8, p<0.001) . Using a logistic model as a discriminant function, female gender was significantly associated with BAI and PPS scores after adjustment for type of diabetes, age, A1c, educational level, living alone condition and the presence of comorbidities or complications (p<0.001) . Using multiple linear regression, BAI and PSS scores were significantly associated with female gender, after adjustment by the same covariates (BAI p<0.00 and PSS p<0.0013) . Conclusion: In the study sample, female gender was associated with higher scores of anxiety and PS, in a context of isolation due to COVID pandemic in Argentina. Disclosure M.L.Pomares: None. Study group covid-grad, argentine diabetes society: n/a. C.Gomez martin: None. S.Apoloni: None. C.M.Muratore: None. P.J.Avila: None. M.A.Forlino: Speaker's Bureau; Novo Nordisk. F.Rivera: None. L.Castagnino: None. B.Piedimonte: None.
Introducción: la pandemia por COVID-19 ha generado en muchos países la indicación de aislamiento, con el objeto de evitar la diseminación del virus. Esta situación ha hecho que personas con diabetes deban permanecer en sus hogares, pudiendo aparecer alteraciones del estado anímico y psicológico.Objetivos: evaluar el impacto psicológico de la cuarentena a través de la determinación del grado de ansiedad y estrés medidos por cuestionarios, en personas con DM1 y DM2 mayores de 18 años. Analizar la posible asociación de los puntajes obtenidos con diversos covariados independientes.Materiales y métodos: estudio multicéntrico, observacional transversal, de recolección de datos a través de cuestionarios online, enviados al azar por medios electrónicos desde el 1º de abril al 3 de mayo de 2020. Se evaluó el grado de estrés mediante la Escala de Estrés Percibido (PSS), y el grado de ansiedad mediante el Inventario de Ansiedad de Beck (BAI). Análisis estadístico: estadística descriptiva y test de confrontación de hipótesis, regresión lineal múltiple, chi2 y coeficiente de correlación de Spearman. Todo valor de p<0.05 fue considerado estadísticamente significativo (ES).
En personas con diabetes tipo 1 (DM1) el ejercicio físico realizado en forma regular brindaría protección cardiovascular y tendría propiedades inmunomoduladoras pero la compleja interacción entre los efectos del ejercicio sobre el metabolismo glucídico y la terapia con insulina exógena supone un verdadero desafío. El ejercicio aeróbico por la contracción muscular disminuye la glucemia, conduce a un estado de hiperinsulinemia relativa y genera hipoglucemia al inicio o después del mismo mientras que el ejercicio anaeróbico se asocia a hiperglucemia por aumento de catecolaminas e incremento de lactato que favorece la neoglucogénesis hepática. El deterioro de la respuesta de hormonas contrarreguladoras existente en la DM1 amplifica la variabilidad glucémica y dificulta el control metabólico.Existen guías y recomendaciones que buscan brindar un marco de seguridad para la prescripción de actividad física considerando la multiplicidad de disciplinas deportivas, la edad del paciente y la evaluación de las complicaciones crónicas de la diabetes antes del inicio de la misma. Entre las estrategias terapéuticas se encuentran la modulación con hidratos de carbono, la adecuación pre y pos ejercicio de la insulinoterapia y el control intensivo de glucemia y cetonas. Los nuevos infusores de insulina y monitoreo glucémico ofrecen la posibilidad del fraccionamiento y/o suspensión de dosis convirtiéndose en el gold standard entre los deportistas de alto rendimiento. A futuro modelos integrados con calculadoras de ejercicio inteligentes, capacidad predictiva y de “aprendizaje individualizado” (páncreas artificial) posibilitarán mantener la euglucemia y optimizar los beneficios del ejercicio como parte del tratamiento.
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