Primary Care Diabetes最新文献

Editorial Board and Aims & Scopes 编辑委员会和目标与范围

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2024-09-17 DOI: 10.1016/S1751-9918(24)00168-2

引用次数: 0

Vision loss and diabetic retinopathy prevalence and risk among a cohort of Indigenous and non-Indigenous Australians with type 2 diabetes receiving renal haemodialysis treatment: The retinopathy in people currently on renal dialysis (RiPCORD) study 接受肾性血液透析治疗的澳大利亚土著和非土著 2 型糖尿病患者中视力丧失和糖尿病视网膜病变的发生率和风险：肾透析患者视网膜病变（RiPCORD）研究。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2024-09-03 DOI: 10.1016/j.pcd.2024.08.005

Aims

Diabetic nephropathy, vision loss and diabetic retinopathy (DR) are frequent comorbidities among individuals with type 2 diabetes (T2D). The Retinopathy in People Currently On Renal Dialysis (RiPCORD) study sought to examine the epidemiology and risk of vision impairment (VI) and DR among a cohort of Indigenous and non-Indigenous Australians with T2D currently receiving haemodialysis for end-stage renal failure (ESRF).

Methods

A total of 106 Indigenous and 109 non-Indigenous Australians were recruited in RiPCORD across five haemodialysis centres in urban and remote settings. Clinical assessments, questionnaires and medical record data determined the rates of ocular complications and risk factor profiles.

Results

Prevalence rates include unilateral VI, 23.5 %; bilateral VI, 11.7 %; unilateral blindness, 14.2 %; and bilateral blindness, 3.7 %, with no significant differences between sub-cohorts (p=0.30). DR prevalence rates were 78.0 % among non-Indigenous Australians and 93.1 % among Indigenous Australians (p=<0.001). Non-Indigenous ethnicity (OR: 0.28) and pre-dialysis diastolic blood pressure (OR: 0.84 per 10-mmHg) were protective, while peripheral vascular disease (OR: 2.79) increased DR risk.

Conclusions

Ocular complications among individuals with T2D and ESRF are disproportionately high, especially for Indigenous Australians, and beyond what can be accounted for by risk factor variation. Findings suggest a need to improve screening and preventative efforts within this high-risk population group.

目的：糖尿病肾病、视力减退和糖尿病视网膜病变（DR）是 2 型糖尿病（T2D）患者的常见并发症。目前接受肾透析者视网膜病变（RiPCORD）研究旨在调查目前因终末期肾衰竭（ESRF）而接受血液透析治疗的澳大利亚土著和非土著 T2D 患者群体中视力损伤（VI）和糖尿病视网膜病变的流行病学和风险：方法：RiPCORD 在城市和偏远地区的五个血液透析中心共招募了 106 名土著澳大利亚人和 109 名非土著澳大利亚人。临床评估、问卷调查和医疗记录数据确定了眼部并发症的发病率和风险因素概况：发病率包括单侧 VI 23.5%；双侧 VI 11.7%；单侧失明 14.2%；双侧失明 3.7%，各亚组之间无显著差异（P=0.30）。非土著澳大利亚人和土著澳大利亚人的DR患病率分别为78.0%和93.1%（p=结论：患有 T2D 和 ESRF 的人眼部并发症的比例过高，尤其是澳大利亚土著人，而且超出了风险因素变化所能解释的范围。研究结果表明，有必要改进这一高风险人群的筛查和预防工作。

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引用次数: 0

Glycemic status and effect on mortality: Multifactorial prevention programme for cardiovascular disease in Finnish primary care 血糖状况及其对死亡率的影响：芬兰初级保健中的心血管疾病多因素预防计划。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2024-09-02 DOI: 10.1016/j.pcd.2024.08.004

Aims

To compare 13-year mortality rates in normoglycemic, prediabetic and diabetic subjects attending a community-based screening and intervention programme.

Methods

Population survey identified 2569 cardiovascular disease (CVD) white risk subjects aged 45–70 years and without manifested CVD or diabetes. Oral glucose tolerance test was performed, and multifactorial intervention was provided. Effect of glycemic status on mortality was estimated in models adjusted for age, gender, education years, smoking, body mass index, mean arterial pressure, total cholesterol, and physical activity.

Results

Of the subjects, 2055 (77 %) were normoglycemic, 380 (14 %) had prediabetes and 224 (9 %) diabetes. Compared to the normoglycemic group, the fully adjusted hazard ratios (HR) for all-cause mortality were 1.34 (95 % CI: 0.98–1.83) in the prediabetes group and 2.31 (95 % CI: 1.62–3.31) in the diabetes group. Standardized mortality rates were 0.63 (95 % CI: 0.54–0.73), 0.91 (95 % CI: 0.69–1.18), and 1.55 (95 % CI: 1.19–2.02) in the normoglycemic, prediabetes, and diabetes groups, respectively. The most common cause of death was cancer (42 % of all deaths), followed by CVD (28 %).

Conclusions/interpretation

Screen-detected diabetes carries a substantial risk of death even after primary care intervention. The pattern of excess mortality has shifted towards cancer deaths.

目的：比较参加社区筛查和干预计划的血糖正常、糖尿病前期和糖尿病患者 13 年的死亡率：方法：通过人口调查确定了 2569 名年龄在 45-70 岁之间、无心血管疾病或糖尿病表现的心血管疾病（CVD）高危人群。进行了口服葡萄糖耐量试验，并提供了多因素干预。在对年龄、性别、受教育年限、吸烟、体重指数、平均动脉压、总胆固醇和体力活动进行调整后的模型中估算了血糖状况对死亡率的影响：受试者中有 2055 人（77%）血糖正常，380 人（14%）患有糖尿病前期，224 人（9%）患有糖尿病。与血糖正常组相比，糖尿病前期组全因死亡率的完全调整危险比（HR）为 1.34（95 % CI：0.98-1.83），糖尿病组为 2.31（95 % CI：1.62-3.31）。血糖正常组、糖尿病前期组和糖尿病组的标准化死亡率分别为 0.63（95 % CI：0.54-0.73）、0.91（95 % CI：0.69-1.18）和 1.55（95 % CI：1.19-2.02）。最常见的死因是癌症（占死亡总数的 42%），其次是心血管疾病（28%）：筛查出的糖尿病患者即使在接受初级保健干预后仍有很大的死亡风险。超额死亡率的模式已转向癌症死亡。

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引用次数: 0

Efficacy of a health education technology program in improving adherence to self-management behaviors and quality of life among adults with type 2 diabetes: A randomized controlled trial 健康教育技术项目在提高 2 型糖尿病成人患者自我管理行为的依从性和生活质量方面的效果：随机对照试验。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2024-09-01 DOI: 10.1016/j.pcd.2024.08.003

Aim

This study examined the efficacy of a health education technology program on self-management adherence behavior and quality of life among people with type 2 diabetes (T2D).

Methods

A randomized experimental study design was employed. A total of 110 subjects was recruited. The experimental group received a novel technology education program plus routine shared care. The control group received routine shared care alone. Quality of life and adherence to self-management behavior questionnaires were used to measure outcomes. A linear mixed-effects model was used to analyze changes in quality of life after controlling for pre-test effects. The odds ratio was calculated for differences in adherence behavior between the two groups.

Results

The between-group mean difference in quality of life scores and adherence to physical activity comparing pre-test at 3 months follow-up showed significant progress at 3 months post-test compared with the control group. However, the increase in mean quality of life scores and adherence behavior at 6 months did not demonstrate a sustained between-group difference.

Conclusion

The results showed adherence to physical activity and improved quality of life in patients with T2D at 3 months post intervention. Therefore, the program can be used as an intensive model for diabetes shared care.

目的：本研究探讨了健康教育技术项目对 2 型糖尿病（T2D）患者自我管理行为和生活质量的影响：方法：采用随机实验研究设计。方法：采用随机实验研究设计，共招募了 110 名受试者。实验组接受新技术教育项目和常规共同护理。对照组只接受常规共同护理。采用生活质量和自我管理行为依从性问卷来测量结果。在控制测试前效应后，采用线性混合效应模型分析生活质量的变化。计算了两组间坚持行为差异的几率：与对照组相比，组间生活质量评分和坚持体育锻炼的平均差异在测试后 3 个月的随访中与测试前相比有显著进步。然而，在 6 个月时，生活质量平均得分和坚持体育锻炼行为的增加并未显示出持续的组间差异：结果表明，干预后 3 个月，T2D 患者坚持体育锻炼并提高了生活质量。因此，该计划可作为糖尿病共同护理的强化模式。

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引用次数: 0

The effect of training to diabetes patients according to planned behavior theory on self-efficacy and patient empowerment: A randomized study 根据计划行为理论对糖尿病患者进行培训对自我效能和患者能力的影响：随机研究。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2024-08-24 DOI: 10.1016/j.pcd.2024.08.002

Aim

To examine the effect of training provided to type 2 diabetes patients according to the theory of planned behavior on self-efficacy and patient empowerment.

Methods

This study, pre-test-post-test active control group single-blind experimental design, was conducted in the internal medicine outpatient clinic of a state hospital between April and October 2023. Participants were randomly assigned to the intervention group (IG; n = 45) and control group (CG; n = 47). The intervention group received a theory-based training program consisting of 5 sessions lasting approximately 40 min. each. Diabetes Management Self-Efficacy Scale, Patient Empowerment Scale and the patient's laboratory results were used for data collection.

Results

In the study, while the posttest self-efficacy and patient empowerment scores of the intervention group increased compared to the pretest, there was an decrease in HbA1C level. On the post-test measurements between groups, self-efficacy and patient empowerment scores were higher and effect sizes were higher in the intervention group, while no difference was found in HbA1C values.

Conclusion

The training program provided according to the theory of planned behavior in diabetes patients provides positive contributions to disease management.

目的：研究根据计划行为理论为 2 型糖尿病患者提供的培训对自我效能和患者授权的影响：本研究采用前测-后测主动对照组单盲实验设计，于 2023 年 4 月至 10 月期间在一家国立医院的内科门诊进行。参与者被随机分配到干预组（IG；n = 45）和对照组（CG；n = 47）。干预组接受以理论为基础的培训计划，包括 5 节课，每节课约 40 分钟。数据收集采用了糖尿病管理自我效能量表、患者赋权量表和患者的化验结果：在这项研究中，虽然干预组的后测自我效能和患者赋权得分与前测相比有所提高，但 HbA1C 水平却有所下降。在组间的后测测量中，干预组的自我效能和患者授权得分更高，效应大小更大，而 HbA1C 值没有发现差异：结论：根据计划行为理论为糖尿病患者提供的培训计划为疾病管理做出了积极贡献。

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引用次数: 0

Prevalence of cardiovascular autonomic neuropathy in an admixed population of patients with type 1 diabetes. Lessons from a pioneer multicentre study in Brazil 1 型糖尿病患者混合人群中心血管自律神经病变的患病率。巴西一项先驱性多中心研究的启示。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2024-08-15 DOI: 10.1016/j.pcd.2024.08.001

AIMS

To evaluate the prevalence of cardiovascular autonomic neuropathy (CAN) and its associated factors in Brazilian patients with type 1 diabetes (T1D).

Methods

This cross-sectional, multicentre study was conducted in 14 public clinics in ten Brazilian cities. From 1760 patients, 1712 were included (97.3 %): 953 females (55.7 %), 930 (54.3 %) Caucasians, aged 29.9 ±11.9 years and with diabetes duration of 15.4 ± 9.2 years. CAN was evaluated using cardiovascular autonomic reflex tests.

Results

The prevalence of CAN was 23.4 %. Multivariable hierarchical logistic regression showed CAN associated with age, smoking, lower socioeconomic status, higher yearly medical appointments, insulin therapeutic regimens, higher levels of HbA1c, total cholesterol, uric acid, diastolic blood pressure and heart rate, presence of retinopathy, diabetic kidney disease and a tendency to be associated with severe hypoglycemia. Lower health-related quality of life was also found in univariate analysis in these patients.

Conclusions

Patients with T1D presented an important prevalence of CAN that was associated with other diabetes-related chronic complications, and also with demographic, clinical and laboratorial traditional risk factors. Considering lack of formal policy, our data could be used for guiding public health approach to awareness and CAN’s screening, diagnosis and clinical management in patients with T1D in Brazil.

目的：评估巴西 1 型糖尿病（T1D）患者中心血管自主神经病变（CAN）的患病率及其相关因素：这项横断面多中心研究在巴西 10 个城市的 14 家公立诊所进行。在 1760 名患者中，纳入了 1712 人（97.3%）：其中 953 人为女性（55.7%），930 人为白种人（54.3%），年龄为（29.9±11.9）岁，糖尿病病程为（15.4±9.2）年。通过心血管自律神经反射测试对 CAN 进行了评估：结果：CAN 的发病率为 23.4%。多变量分层逻辑回归显示，CAN 与年龄、吸烟、较低的社会经济地位、较高的年就诊率、胰岛素治疗方案、较高的 HbA1c、总胆固醇、尿酸、舒张压和心率水平、视网膜病变、糖尿病肾病以及与严重低血糖相关的倾向有关。在单变量分析中还发现，这些患者的健康相关生活质量较低：T1D患者的CAN发病率很高，与其他糖尿病相关慢性并发症以及人口、临床和实验室传统风险因素有关。考虑到缺乏正式政策，我们的数据可用于指导公共卫生方法，以提高巴西T1D患者对CAN的认识，并对其进行筛查、诊断和临床管理。

{"title":"Prevalence of cardiovascular autonomic neuropathy in an admixed population of patients with type 1 diabetes. Lessons from a pioneer multicentre study in Brazil","authors":"","doi":"10.1016/j.pcd.2024.08.001","DOIUrl":"10.1016/j.pcd.2024.08.001","url":null,"abstract":"<div><h3>AIMS</h3><p>To evaluate the prevalence of cardiovascular autonomic neuropathy (CAN) and its associated factors in Brazilian patients with type 1 diabetes (T1D).</p></div><div><h3>Methods</h3><p>This cross-sectional, multicentre study was conducted in 14 public clinics in ten Brazilian cities. From 1760 patients, 1712 were included (97.3 %): 953 females (55.7 %), 930 (54.3 %) Caucasians, aged 29.9 ±11.9 years and with diabetes duration of 15.4 ± 9.2 years. CAN was evaluated using cardiovascular autonomic reflex tests.</p></div><div><h3>Results</h3><p>The prevalence of CAN was 23.4 %. Multivariable hierarchical logistic regression showed CAN associated with age, smoking, lower socioeconomic status, higher yearly medical appointments, insulin therapeutic regimens, higher levels of HbA1c, total cholesterol, uric acid, diastolic blood pressure and heart rate, presence of retinopathy, diabetic kidney disease and a tendency to be associated with severe hypoglycemia. Lower health-related quality of life was also found in univariate analysis in these patients.</p></div><div><h3>Conclusions</h3><p>Patients with T1D presented an important prevalence of CAN that was associated with other diabetes-related chronic complications, and also with demographic, clinical and laboratorial traditional risk factors. Considering lack of formal policy, our data could be used for guiding public health approach to awareness and CAN’s screening, diagnosis and clinical management in patients with T1D in Brazil.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trends in utilization patterns of newer glucose-lowering drugs in US adults with type 2 diabetes and a history of coronary heart disease or heart failure: 2005–2019 美国 2 型糖尿病且有冠心病或心力衰竭病史的成人使用新型降糖药的模式趋势：2005-2019 年。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2024-08-02 DOI: 10.1016/j.pcd.2024.07.003

Background

The newer glucose-lowering drugs (GLDs), including Glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium-glucose cotransporter-2 inhibitors (SGLT2i), have demonstrated superior cardio- and renal protective benefits compared to older GLDs in individuals with type 2 diabetes (T2D) at high risk for cardiovascular disease (CVD).

Objective

This study examined the trends of the newer GLDs use in people with T2D who had a history of coronary heart disease or heart failure in the United States.

Method

We used 2005–2019 data from the Medical Expenditure Panel Survey (MEPS). Individuals with self-reported diabetes and CVD history were identified.

Results

There was a steady increase in the use of GLP-1RA only from 2008 (3 %) to 2019 (21 %) and SGLT2i only from 2014 (5 %) to 2019 (12 %). Individuals with dual use of both newer GLD classes increased from 0.62 % in 2015 to 6 % in 2019. The overall uptake of these two newer drugs in 2019 was less than 40 %. In other words, 60 % of individuals who can substantially benefit from these newer treatments did not use the treatments.

Conclusion

The use of GLP-1RA and SGLT2i among individuals with T2D and a history of CVD was low and varied by insurance type. Policy-level interventions are needed to improve the use of these newer treatments further.

Summary

We examined how newer glucose-lowering drugs are used among individuals with type 2 diabetes and at high risk for coronary heart disease or heart failure in the US. We found that 60 % of individuals who can substantially benefit from these newer treatments did not use the treatments due to the variation of insurance type.

背景：较新的降糖药物（GLDs），包括胰高血糖素样肽-1受体激动剂（GLP-1RA）和钠-葡萄糖共转运体-2抑制剂（SGLT2i），在心血管疾病（CVD）高风险2型糖尿病（T2D）患者中的心血管和肾脏保护作用优于较老的GLDs：本研究探讨了美国有冠心病或心力衰竭病史的 2 型糖尿病患者使用新型 GLDs 的趋势：我们使用了 2005-2019 年医疗支出面板调查（MEPS）的数据。方法：我们使用了 2005-2019 年医疗支出小组调查（MEPS）的数据，对自述有糖尿病和心血管疾病史的个体进行了识别：结果：从 2008 年（3%）到 2019 年（21%），仅使用 GLP-1RA 的患者稳步增加；从 2014 年（5%）到 2019 年（12%），仅使用 SGLT2i 的患者稳步增加。同时使用两种较新 GLD 类药物的患者从 2015 年的 0.62% 增加到 2019 年的 6%。2019 年这两种较新药物的总体使用率不到 40%。换句话说，60%能够从这些较新疗法中大幅获益的人并未使用这些疗法：GLP-1RA和SGLT2i在有心血管疾病史的T2D患者中使用率较低，且因保险类型而异。总结：我们研究了美国 2 型糖尿病患者和冠心病或心力衰竭高危人群使用新型降糖药物的情况。我们发现，由于保险类型的不同，60% 可从这些较新治疗方法中获益的患者并未使用这些治疗方法。

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引用次数: 0

Glucagon-like peptide receptor agonists and risk for depression 胰高血糖素样肽受体激动剂与抑郁症风险。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2024-08-01 DOI: 10.1016/j.pcd.2024.05.005

Aims

Package labeling for weight loss formulations of semaglutide and liraglutide include a warning for suicidal thoughts and behaviors. The objective was to examine the association between glucagon-like peptide-1 receptor agonists (GLP-1RA) and incident depression.

Methods

This retrospective cohort study compared Veterans Health Administration patients initiated on a GLP-1RA versus a dipeptidyl peptidase-4 inhibitor (DPP-4i) between June 1, 2013 and June 30, 2020. The primary outcome was incident depression, defined as a new diagnosis of depression or new antidepressant prescription, within 1 year following drug initiation. Multivariable log-binomial regression was used to estimate relative risk, adjusted for confounding factors including patient demographics, comorbid conditions, and prior medication.

Results

Of 34,130 patients initiated on a GLP-1RA and 105,478 initiated on a DPP-4i, incident depression occurred in 7.7 % (n= 2263) and 6.3 % (n= 6602), respectively. After adjustment, the relative risk was 1.02 (95 % CI: 0.97 – 1.07), thus failing to demonstrate a significant increase in risk for incident depression following initiation of a GLP-1RA compared to DPP-4i. Relative risk estimates in all sensitivity analyses were also non-significant.

Conclusions

This study did not demonstrate a significant increase in risk for incident depression following GLP-1RA initiation.

目的：塞马鲁肽和利拉鲁肽减肥制剂的包装标签包括自杀想法和行为警告。目的是研究胰高血糖素样肽-1受体激动剂（GLP-1RA）与抑郁症事件之间的关联：这项回顾性队列研究比较了2013年6月1日至2020年6月30日期间开始服用GLP-1RA和二肽基肽酶-4抑制剂（DPP-4i）的退伍军人健康管理局患者。主要研究结果是抑郁症事件，即在开始用药后一年内新诊断出抑郁症或开出新的抗抑郁药处方。采用多变量对数二叉回归估算相对风险，并对包括患者人口统计学特征、合并症和既往用药情况在内的混杂因素进行调整：在34130名开始服用GLP-1RA和105478名开始服用DPP-4i的患者中，分别有7.7%（n= 2263）和6.3%（n= 6602）的患者发生抑郁症。经调整后，相对风险为 1.02 (95 % CI: 0.97 - 1.07)，因此未能证明与 DPP-4i 相比，开始使用 GLP-1RA 后发生抑郁症的风险显著增加。所有敏感性分析中的相对风险估计值也不显著：本研究并未证明使用GLP-1RA后抑郁症的发病风险会显著增加。

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引用次数: 0

Modifiable self-management practices impact nocturnal and morning glycaemia in type 1 diabetes 可改变的自我管理方法对 1 型糖尿病患者夜间和早晨血糖的影响。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2024-08-01 DOI: 10.1016/j.pcd.2024.06.007

Aims

To identify risk factors for nocturnal/morning hypo- and hyperglycaemia in type 1 diabetes.

Methods

Data on self-management practices were obtained from 3-day records. We studied the associations between self-management practices on the first recording day and the self-reported blood glucose (BG) concentrations on the subsequent night/morning.

Results

Of the 1025 participants (39 % men, median age 45 years), 4.4 % reported nocturnal hypoglycaemia (<3.9 mmol/l), 9.8 % morning hypoglycaemia, 51.5 % morning euglycaemia, and 34.3 % morning hyperglycaemia (≥8.9 mmol/l). Within hypoglycaemic range, insulin pump use was associated with higher nocturnal BG concentration (B=0.486 [95 % Confidence Interval=0.121–0.852], p=0.009). HbA_1c was positively (0.046 [0.028–0.065], p<0.001), while antecedent fibre intake (-0.327 [-0.543 – -0.111], p=0.003) and physical activity (PA) (-0.042 [-0.075 – -0.010], p=0.010) were inversely associated with morning BG concentration. The odds of morning hypoglycaemia were increased by previous day hypoglycaemia (OR=2.058, p=0.002) and alcohol intake (1.031, p=0.001). Previous day PA (0.977, p=0.031) and fibre intake (0.848, p=0.017) were inversely, while HbA_1c (1.027, p<0.001) was positively associated with the risk of morning hyperglycaemia.

Conclusions

Alcohol avoidance may prevent nocturnal hypoglycaemia, while PA and fibre intake may reduce hyperglycaemia risk. Avoidance of daytime hypoglycaemia and keeping HbA_1c in control may help maintain normoglycaemia also at night-time.

目的：确定 1 型糖尿病患者夜间/早晨低血糖和高血糖的风险因素：从三天的记录中获取自我管理方法的数据。我们研究了第一个记录日的自我管理方法与随后夜间/早晨自我报告的血糖浓度之间的关联：结果：在 1025 名参与者（39% 为男性，中位年龄为 45 岁）中，4.4% 报告了夜间低血糖（1c 呈正相关（0.046 [0.028-0.065], p1c (1.027, pConclusions：避免饮酒可预防夜间低血糖，而摄入 PA 和纤维素可降低高血糖风险。避免日间低血糖和控制 HbA1c 可能有助于在夜间维持正常血糖。

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引用次数: 0

The effect of different times of day for exercise on blood glucose fluctuations 每天不同时间运动对血糖波动的影响。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2024-08-01 DOI: 10.1016/j.pcd.2024.06.004

Aims

This study aims to explore blood glucose variations before and after short-term intensive exercise in the morning or afternoon of a day and the trend of blood glucose fluctuations during exercise in patients with T2DM (type 2 diabetes, T2DM).

Methods

Blood glucose variations of Fouty during morning exercise 8:00–12:00 hours and twenty during afternoon exercise 14:30–18:30 hours). Patients with T2DM discharged from the hospital were analyzed retrospectively, with the baseline data checked through the medical record system before intervention. We were asked to perform seven times of treadmill aerobic exercise, which lasted for 30 minutes with incremental intensity for each time, for two weeks under the supervision of the Continuous Glucose Monitor (CGM) and the heart rate armband. The exercise intensity has been adjusted by the clinicians and specialist nurses from the Department of Diabetes Mellitus according to the blood glucose levels and heart rate curves during exercise; data including the height, weight, body mass index (BMI), waist-to-hip ratio, fasting blood glucose, glycosylated hemoglobin, in-exercise CGM-measured blood glucose value/min, and after-exercise fingertip blood glucose value of patients with T2DM were collected after the intensive exercise (2 weeks). SPSS 22.0 and GraphPad Prism 7 were adopted for statistical analysis using the T-test and ANOVA.

Result

No difference was observed in the baseline data between the morning and afternoon exercise groups before intervention; compared to the morning exercise group, the fasting C-peptide value (2.15±0.97 vs. 1.53±0.46) in the afternoon exercise group was higher than that in the morning exercise group, with a superior (p=0.029) effect after two weeks of intervention, exhibiting a significant difference in the results. According to the results of repeated variance ANOVA analysis, the time for the appearance of significant improvement in blood glucose in the afternoon exercise group was 5 minutes earlier (11th minute vs 1 minute)than that in the morning exercise group (15th minute vs 1 min); significant differences were observed in both time (p=0.048 vs p<0.01) between the two groups on exercise days, as revealed by the results of bivariate ANOVA; in comparison to the morning exercise group (7.42±1.68), there was a significant difference (p=0.049)in the mean blood glucose between the two groups 25 min after patients with T2DM in the afternoon exercise group (6.25±1.53) started to exercise; in addition, a significant statistical difference (p=0.021) was revealed in the CGM-measured hourly the mean blood glucose on exercise days between the morning(8.18±1.88) and afternoon exercise (6.75±1.40)groups at 4:00 pm in week one and two w.

Conclusions

Glycaemic improvement in the short-term intensive afternoon exercise group may

目的：本研究旨在探讨T2DM（2型糖尿病，T2DM）患者每天上午或下午进行短期强化运动前后的血糖变化以及运动过程中的血糖波动趋势：上午 8:00-12:00 运动时 Fouty 的血糖变化，下午 14:30-18:30 运动时 Fouty 的血糖变化。）对出院的 T2DM 患者进行回顾性分析，干预前通过病历系统检查基线数据。我们被要求在连续血糖监测仪（CGM）和心率臂章的监督下进行七次跑步机有氧运动，每次持续 30 分钟，强度递增，持续两周。运动强度由糖尿病科的临床医生和专科护士根据运动时的血糖水平和心率曲线进行调整；强化运动（2 周）后收集 T2DM 患者的身高、体重、体重指数（BMI）、腰臀比、空腹血糖、糖化血红蛋白、运动中 CGM 测得的血糖值/分钟、运动后指尖血糖值等数据。采用 SPSS 22.0 和 GraphPad Prism 7 进行统计分析，采用 T 检验和方差分析：干预前，上下午运动组基线数据无差异；与上午运动组相比，下午运动组空腹C肽值（2.15±0.97 vs. 1.53±0.46）高于上午运动组，干预两周后效果优于上午运动组（P=0.029），结果显示差异显著。根据重复方差方差分析结果，下午运动组血糖出现明显改善的时间（第 11 分钟 vs 1 分钟）比上午运动组（第 15 分钟 vs 1 分钟）提前了 5 分钟；两组时间均有显著性差异（P=0.048 vs P结论：短期强化运动对血糖改善的效果明显优于上午运动组（P=0.029）：下午短期强化运动组的血糖改善效果可能优于上午运动组，这可能与空腹C肽分泌更多和有效运动时间更长有关。运动时间是影响运动时血糖变化的一个因素。然而，运动时血糖水平的明显变化必须通过更长时间的运动干预来进一步观察。

{"title":"The effect of different times of day for exercise on blood glucose fluctuations","authors":"","doi":"10.1016/j.pcd.2024.06.004","DOIUrl":"10.1016/j.pcd.2024.06.004","url":null,"abstract":"<div><h3>Aims</h3><p>This study aims to explore blood glucose variations before and after short-term intensive exercise in the morning or afternoon of a day and the trend of blood glucose fluctuations during exercise in patients with T2DM (type 2 diabetes, T2DM).</p></div><div><h3>Methods</h3><p>Blood glucose variations of Fouty during morning exercise 8:00–12:00 hours and twenty during afternoon exercise 14:30–18:30 hours). Patients with T2DM discharged from the hospital were analyzed retrospectively, with the baseline data checked through the medical record system before intervention. We were asked to perform seven times of treadmill aerobic exercise, which lasted for 30 minutes with incremental intensity for each time, for two weeks under the supervision of the Continuous Glucose Monitor (CGM) and the heart rate armband. The exercise intensity has been adjusted by the clinicians and specialist nurses from the Department of Diabetes Mellitus according to the blood glucose levels and heart rate curves during exercise; data including the height, weight, body mass index (BMI), waist-to-hip ratio, fasting blood glucose, glycosylated hemoglobin, in-exercise CGM-measured blood glucose value/min, and after-exercise fingertip blood glucose value of patients with T2DM were collected after the intensive exercise (2 weeks). SPSS 22.0 and GraphPad Prism 7 were adopted for statistical analysis using the T-test and ANOVA.</p></div><div><h3>Result</h3><p>No difference was observed in the baseline data between the morning and afternoon exercise groups before intervention; compared to the morning exercise group, the fasting C-peptide value (2.15±0.97 <em>vs.</em> 1.53±0.46) in the afternoon exercise group was higher than that in the morning exercise group, with a superior (<em>p</em>=0.029) effect after two weeks of intervention, exhibiting a significant difference in the results. According to the results of repeated variance ANOVA analysis, the time for the appearance of significant improvement in blood glucose in the afternoon exercise group was 5 minutes earlier (11th minute <em>vs</em> 1 minute)than that in the morning exercise group (15th minute <em>vs</em> 1 min); significant differences were observed in both time (<em>p</em>=0.048 <em>vs p</em><0.01) between the two groups on exercise days, as revealed by the results of bivariate ANOVA; in comparison to the morning exercise group (7.42±1.68), there was a significant difference (<em>p</em>=0.049)in the mean blood glucose between the two groups 25 min after patients with T2DM in the afternoon exercise group (6.25±1.53) started to exercise; in addition, a significant statistical difference (<em>p</em>=0.021) was revealed in the CGM-measured hourly the mean blood glucose on exercise days between the morning(8.18±1.88) and afternoon exercise (6.75±1.40)groups at 4:00 pm in week one and two w.</p></div><div><h3>Conclusions</h3><p>Glycaemic improvement in the short-term intensive afternoon exercise group may","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1751991824001165/pdfft?md5=aa1f6bedd01913488dc777fcd9373705&pid=1-s2.0-S1751991824001165-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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