Successful behavioural strategies to increase physical activity and improve glucose control in adults with Type 2 diabetes

Avery, Leah; Flynn, Darren; Dombrowski, Stephan U; Wersch, Anna van; Sniehotta, Falko F.; Trenell, Michael I.

doi:10.1111/dme.12738

Cited by 67 publications

(87 citation statements)

References 14 publications

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“…Five key techniques have been identified: 1) prompt focus on past success, 2) barrier identification/problemsolving, 3) use of follow-up prompts, 4) provision of information on where/ when to perform the behavior, and 5) prompt review of behavioral goals (175). However, motivational interviewing is not significantly better than usual care (176), and other intervention factors associated with weight loss, such as number and duration of contacts, have been inconsistent or not associated with greater participation (177).…”

Section: Behavior-change Strategiesmentioning

confidence: 99%

“…Adults should avoid taking ,5,000 steps/ day (179-181) and to strive for $7,500 steps/day (182). The positive findings for pedometers are not universal (175), however, and some individuals may require greater support to realize benefits. Longer-term efficacy and determination of which populations can benefit from pedometers and other wearable activity trackers (183) require further evaluation.…”

Section: Behavior-change Strategiesmentioning

confidence: 99%

See 1 more Smart Citation

Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association

et al. 2016

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The adoption and maintenance of physical activity are critical foci for blood glucose management and overall health in individuals with diabetes and prediabetes. Recommendations and precautions vary depending on individual characteristics and health status. In this Position Statement, we provide a clinically oriented review and evidencebased recommendations regarding physical activity and exercise in people with type 1 diabetes, type 2 diabetes, gestational diabetes mellitus, and prediabetes.Physical activity includes all movement that increases energy use, whereas exercise is planned, structured physical activity. Exercise improves blood glucose control in type 2 diabetes, reduces cardiovascular risk factors, contributes to weight loss, and improves well-being (1,2). Regular exercise may prevent or delay type 2 diabetes development (3). Regular exercise also has considerable health benefits for people with type 1 diabetes (e.g., improved cardiovascular fitness, muscle strength, insulin sensitivity, etc.) (4). The challenges related to blood glucose management vary with diabetes type, activity type, and presence of diabetes-related complications (5,6). Physical activity and exercise recommendations, therefore, should be tailored to meet the specific needs of each individual. TYPES AND CLASSIFICATIONS OF DIABETES AND PREDIABETESPhysical activity recommendations and precautions may vary by diabetes type. The primary types of diabetes are type 1 and type 2. Type 1 diabetes (5%-10% of cases) results from cellular-mediated autoimmune destruction of the pancreatic b-cells, producing insulin deficiency (7). Although it can occur at any age, b-cell destruction rates vary, typically occurring more rapidly in youth than in adults. Type 2 diabetes (90%-95% of cases) results from a progressive loss of insulin secretion, usually also with insulin resistance. Gestational diabetes mellitus occurs during pregnancy, with screening typically occurring at 24-28 weeks of gestation in pregnant women not previously known to have diabetes. Prediabetes is diagnosed when blood glucose levels are above the normal range but not high enough to be classified as diabetes; affected individuals have a heightened risk of developing type 2 diabetes (7) but may prevent/delay its onset with physical activity and other lifestyle changes (8). TYPES OF EXERCISE AND PHYSICAL ACTIVITYAerobic exercise involves repeated and continuous movement of large muscle groups (9). Activities such as walking, cycling, jogging, and swimming rely primarily on aerobic energy-producing systems. Resistance (strength) training includes exercises with free weights, weight machines, body weight, or elastic resistance bands. Flexibility exercises improve range of motion around joints (10). Balance exercises benefit gait and prevent falls (11). Activities like tai chi and yoga combine flexibility, balance, and resistance activities.

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Section: Behavior-change Strategiesmentioning

confidence: 99%

Section: Behavior-change Strategiesmentioning

confidence: 99%

Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association

et al. 2016

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“…For example, strictly educational interventions are less effective than interventions that integrate behavioral strategies, and compared with simpler designs, multicomponent interventions are more effective [4,40–42]. Among behavioral interventions, larger effect sizes are found in those that explicitly name an underlying theory, yet this remains relatively uncommon [2,13,41].…”

Section: What Does Workmentioning

confidence: 99%

Effective strategies for encouraging behavior change in people with diabetes

Hood¹,

Hilliard²,

Piatt³

et al. 2015

Diabetes Management

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Behavioral management of diabetes leads to better health outcomes. This paper reviews the available literature on facilitators of behavior change in people with diabetes and highlights approaches and strategies diabetes care providers can utilize. The research and clinical evidence points to the critical nature of considering the content and structure of recommendations, and utilizing problem solving and teamwork approaches. Furthermore, close attention to individual and community factors will optimize behavior change. These Practice points• Consider the five characteristics of effective messaging for behavior change recommendations. They are clarity, personal meaningfulness, frequency of feedback, active guidance and support, and patient interpretation. Messages conveyed to people with diabetes (PWD) that consider these key characteristics will increase the chances of effective implementation of behavior change.• Also work to promote trust with PWD by facilitating discussions about the personal side of living with diabetes and barriers to change that may not be offered without direct questioning.• Consider teaching problem solving in all clinical encounters. Problem solving is a learned skill with documented benefits on behavioral management of diabetes and health outcomes. Teach a simple method of identifying problems, goal setting, brainstorming solutions and implementing and evaluating a solution.• Go beyond education and consider multiple components to behavior change recommendations. These include bringing in other caregivers and individuals from the community, and ensuring health literacy and numeracy have been considered and addressed.• Rarely provide a 'one-size-fits-all' recommendation, but instead offer a recommendation that considers the age, gender, ethnicity, community infrastructure and perceptions about diabetes in PWD.• Screen for psychological factors that may complicate PWD's ability to implement and sustain behavior change recommendations. These include consideration of disordered eating or eating disorder, depressive symptoms and diabetes distress, and worries and fears related to diabetes (immediate and long term).For reprint orders, please contact: reprints@futuremedicine.com

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“…There is now considerable evidence that points to the positive success of interventions that include evidence-based behavioral change techniques (e.g. goal setting, self- monitoring, social support both within (Anderson et al 2014, Short et al 2013) and out with (Avery et al 2015) cancer settings.…”

Section: Discussionmentioning

confidence: 99%

Health Behaviors and their Relationship with Disease Control in People Attending Genetic Clinics with a Family History of Breast or Colorectal Cancer

Anderson

Caswell

Macleod

et al. 2016

Journal of Genetic Counseling

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The current work aimed to assess health behaviors, perceived risk and control over breast/colorectal cancer risk and views on lifestyle advice amongst attendees at cancer family history clinics. Participants attending the East of Scotland Genetics Service were invited to complete a questionnaire (demographic data, weight and height, health behaviors and psycho-social measures of risk and perceived control) and to participate in an in-depth interview. The questionnaire was completed by 237 (49 %) of attendees, ranging from 18 to 77 years (mean age 46 (±10) years). Reported smoking rates (11 %) were modest, most (54 %) had a BMI > 25 kg/m2, 55 % had low levels of physical activity, 58 % reported inappropriate alcohol intakes and 90 % had fiber intakes indicative of a low plant diet. Regression analysis indicated that belief in health professional control was associated with higher, and belief in fatalism with poorer health behavior. Qualitative findings highlighted doubts about the link between lifestyle and cancer, and few were familiar with the current evidence. Whilst lifestyle advice was considered interesting in general there was little appetite for non-tailored guidance. In conclusion, current health behaviors are incongruent with cancer risk reduction guidance amongst patients who have actively sought advice on disease risk. There are some indications that lifestyle advice would be welcomed but endorsement requires a sensitive and flexible approach, and the acceptability of lifestyle interventions remains to be explored.

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Successful behavioural strategies to increase physical activity and improve glucose control in adults with Type 2 diabetes

Cited by 67 publications

References 14 publications

Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association

Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association

Effective strategies for encouraging behavior change in people with diabetes

Health Behaviors and their Relationship with Disease Control in People Attending Genetic Clinics with a Family History of Breast or Colorectal Cancer

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