Diabetes Spectrum最新文献

{"title":"Is There an Optimal Time of Day for Exercise? A Commentary on When to Exercise for People Living With Type 1 or Type 2 Diabetes.","authors":"Michael C Riddell,&nbsp;Lauren V Turner,&nbsp;Susana R Patton","doi":"10.2337/dsi22-0017","DOIUrl":"https://doi.org/10.2337/dsi22-0017","url":null,"abstract":"<p><p>Exercise is a cornerstone of diabetes self-care because of its association with many health benefits. Several studies that have explored the best time of day to exercise to inform clinical recommendations have yielded mixed results. For example, for people with prediabetes or type 2 diabetes, there may be benefits to timing exercise to occur after meals, whereas people with type 1 diabetes may benefit from performing exercise earlier in the day. One common thread is the health benefits of consistent exercise, suggesting that the issue of exercise timing may be secondary to the goal of helping people with diabetes establish an exercise routine that best fits their life.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10182965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9486390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Where to Start? Physical Assessment, Readiness, and Exercise Recommendations for People With Type 1 or Type 2 Diabetes.","authors":"Marni Armstrong, Sheri R Colberg, Ronald J Sigal","doi":"10.2337/dsi22-0016","DOIUrl":"10.2337/dsi22-0016","url":null,"abstract":"<p><p>Exercise plays an important role in the management of diabetes and is associated with many benefits such as decreased morbidity and mortality. For people exhibiting signs and symptoms of cardiovascular disease, pre-exercise medical clearance is warranted; however, requiring broad screening requirements can lead to unnecessary barriers to initiating an exercise program. Robust evidence supports the promotion of both aerobic and resistance training, with evidence emerging on the importance of reducing sedentary time. For people with type 1 diabetes, there are special considerations, including hypoglycemia risk and prevention, exercise timing (including prandial status), and differences in glycemic responses based on biological sex.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10182968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9514681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Activity Management for Youth With Type 1 Diabetes: Supporting Active and Inactive Children.","authors":"Elizabeth A Davis, Vinutha B Shetty, Shaun Y M Teo, Rachel J Lim, Susana R Patton, Craig E Taplin","doi":"10.2337/dsi22-0020","DOIUrl":"10.2337/dsi22-0020","url":null,"abstract":"<p><p>Regular physical activity and exercise are important for youth and essential components of a healthy lifestyle. For youth with type 1 diabetes, regular physical activity can promote cardiovascular fitness, bone health, insulin sensitivity, and glucose management. However, the number of youth with type 1 diabetes who regularly meet minimum physical activity guidelines is low, and many encounter barriers to regular physical activity. Additionally, some health care professionals (HCPs) may be unsure how to approach the topic of exercise with youth and families in a busy clinic setting. This article provides an overview of current physical activity research in youth with type 1 diabetes, a basic description of exercise physiology in type 1 diabetes, and practical strategies for HCPs to conduct effective and individualized exercise consultations for youth with type 1 diabetes.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10182969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9514676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Trends and Strategies for Exercise in Diabetes.","authors":"Susana R Patton, Michael C Riddell","doi":"10.2337/dsi22-0019","DOIUrl":"10.2337/dsi22-0019","url":null,"abstract":"","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10182964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9514677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing Priorities to Alleviate the Long-Term Impact of the COVID-19 Pandemic on Women Engaged in Diabetes Research, Education, and Care: A Concept Mapping Study.","authors":"Paulina Cruz, Allison Phad, Amy A Eyler, Brigid E Gregg, Rachel G Tabak","doi":"10.2337/ds22-0021","DOIUrl":"10.2337/ds22-0021","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to develop priorities through stakeholder engagement to alleviate the impact of the coronavirus disease 2019 (COVID-19) pandemic on the professional careers of women engaged in diabetes research, education, and care.</p><p><strong>Research design and methods: </strong>This study used concept mapping, a mixed-methods, multistep process, to generate a conceptual map of recommendations through the following steps: <i>1</i>) identify stakeholders and develop the focus prompt, <i>2</i>) generate ideas through brainstorming, <i>3</i>) structure ideas through sorting and rating on priority and likelihood, <i>4</i>) analyze the data and create a cluster map, and <i>5</i>) interpret and use results.</p><p><strong>Results: </strong>Fifty-two participants completed the brainstorming phase, and 24 participated in sorting and rating. The final concept map included seven clusters. Those rated as highest priority were to ensure supportive workplace culture (μ = 4.43); promote practices to achieve gender parity in hiring, workload, and promotion (μ = 4.37); and increase funding opportunities and allow extensions (μ = 4.36).</p><p><strong>Conclusion: </strong>This study identified recommendations for institutions to better support women engaged in diabetes-related work to alleviate the long-term impact of the COVID-19 pandemic on their careers. Some areas were rated as high in priority and high in likelihood, such as ensuring a supportive workplace culture. In contrast, family-friendly benefits and policies were rated as high in priority but low in likelihood of being implemented; these may take more effort to address, including coordinated efforts within institutions (e.g., women's academic networks) and professional societies to promote standards and programs that advance gender equity in medicine.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10182967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9486389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Considerations and Practical Advice for People Living With Type 2 Diabetes Who Undertake Regular Exercise or Aim to Exercise Competitively.","authors":"Sam N Scott, Charlotte Hayes, Thomas Zeuger, Andrew P Davies, Rob C Andrews, Matthew Cocks","doi":"10.2337/dsi22-0015","DOIUrl":"10.2337/dsi22-0015","url":null,"abstract":"<p><p>This article provides practical tips for advising people with type 2 diabetes on how to engage in regular exercise safely and effectively. Its focus is on individuals who wish to exceed the minimum physical activity recommendation of 150 minutes/week of moderate-intensity exercise or even compete in their chosen sport. Health care professionals who work with such individuals must have a basic understanding of glucose metabolism during exercise, nutritional requirements, blood glucose management, medications, and sport-related considerations. This article reviews three key aspects of individualized care for physically active people with type 2 diabetes: <i>1</i>) initial medical assessment and pre-exercise screenings, <i>2</i>) glucose monitoring and nutritional considerations, and <i>3</i>) the combined glycemic effects of exercise and medications.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10182970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9514679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Abilities and Collaboration in Couples in Type 1 Diabetes Management.","authors":"Cynthia A Berg, Yana Suchy, Robert G Kent de Grey, Nancy A Allen, MaryJane S Campbell, Ascher Munion, Jonathan Butner, Vicki S Helgeson","doi":"10.2337/ds21-0057","DOIUrl":"10.2337/ds21-0057","url":null,"abstract":"<p><p>Managing type 1 diabetes involves coordinating complex daily behaviors that may rely on the cognitive abilities of people with diabetes (PWD) and spouses, especially as couples collaborate surrounding diabetes care. The aims of the study were to examine whether <i>1</i>) the cognitive abilities of PWD and their spouses predicted lower A1C, <i>2</i>) collaborating with a spouse with higher cognitive abilities was especially beneficial for PWD with lower cognitive abilities, and <i>3</i>) the benefit of the cognitive abilities of PWD and their spouse occurred through better self-care. Couples (<i>n</i> = 199) were recruited with one member diagnosed with type 1 diabetes (PWD 52% female sex, average age 46.81 years, average duration of diabetes 27 years; spouses 48% female sex; average age 46.40 years). PWD and spouses completed fluid (trail making tests from the Delis-Kaplan Executive Function System) and crystallized (information subtest from the Wechsler Adult Intelligence Scale-4th Edition) ability tests. PWD rated their spouse's collaboration in diabetes and reported self-care behaviors through surveys. A1C was assessed as a measure of blood glucose through a blood assay. Multiple regressions revealed that spouses' crystallized ability was the only statistically significant predictor, with higher values associated with lower A1C (<i>t</i> = -2.17, <i>P</i> <0.05). The interaction of crystallized ability of PWD × spouse crystallized ability × collaboration indicated that PWD with lower ability tended to benefit more when they collaborated with a spouse who scored higher in ability (<i>t</i> = -2.21, <i>P</i> <0.05). Mediational analyses indicated that spouses' crystallized ability was associated with lower A1C through better self-care behaviors of PWD (B = 0.03, SE = 0.01, <i>P</i> <0.01). We conclude that PWD benefit from the cognitive abilities of their spouses through better self-care behaviors that are important for maintaining lower A1C across adulthood.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9935285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10053585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Roadmap to the Effective Use of Continuous Glucose Monitoring in Primary Care.","authors":"Thomas W Martens","doi":"10.2337/dsi23-0001","DOIUrl":"10.2337/dsi23-0001","url":null,"abstract":"<p><p>Diabetes technology has undergone a remarkable evolution in the past decade, with dramatic improvements in accuracy and ease of use. Continuous glucose monitor (CGM) technology, in particular, has evolved, and coevolved with widely available consumer smartphone technology, to provide a unique opportunity to both improve management and decrease the burden of management for populations across nearly the entire spectrum of people living with diabetes. Capitalizing on that opportunity, however, will require both adoption of and adaptations to the use of CGM technology in the broader world of primary care. This article focuses on mechanisms to expand pathways to optimized glycemic management, thereby creating a robust roadway capable of improving care across broad populations managed in primary care settings. Recent expansions in access to devices combined with improved mechanisms for data access at the time of primary care visits and improved training and evolving systems of support within primary care, hold potential to improve glycemic management in diabetes across the health care spectrum.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10654126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138055582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Look at Barriers to Clinical Care Among Appalachian Residents Living With Diabetes.","authors":"Brittany L Smalls,&nbsp;Mary E Lacy,&nbsp;Adebola Adegboyega,&nbsp;Laura Hieronymus,&nbsp;Nicole Bacha,&nbsp;Tayla Nathoo,&nbsp;Philip M Westgate,&nbsp;Tofial Azam,&nbsp;Susan Westneat,&nbsp;Nancy E Schoenberg","doi":"10.2337/ds22-0001","DOIUrl":"https://doi.org/10.2337/ds22-0001","url":null,"abstract":"<p><p>In the United States, diabetes is the seventh leading cause of death and continues to rise in prevalence, with type 2 diabetes accounting for 90-95% of all cases. Rates of diabetes in Kentucky, and, in particular, the Appalachian region, are among the highest in the nation and are increasing faster than the national average. Despite this disproportionate burden, barriers to clinical appointment attendance have not been fully explored in this population. This article examines the association among perceived barriers to clinical attendance, glycemic control, and diabetes self-care as part of an ongoing study. We used a 25-item checklist developed using the Chronic Care Model to assess participants' barriers to clinic attendance. Glycemic control was assessed via A1C measurement. Diabetes self-care was assessed using the Summary of Diabetes Self-Care Activities measure. At the time of analysis, 123 of the 356 participants (34.6%) did not report any barriers to clinic attendance. For the remainder, the major reported barriers included forgetting appointments, inability to afford medicines or other treatment, and placing faith above medical care. The average A1C was 7.7%, and the average diabetes self-care summary score was 17.1 out of 35 points (with higher values indicating better self-care). Missing clinic appointments is associated with lower health outcomes, especially in vulnerable populations. This study can help educate clinic staff on perceived barriers to type 2 diabetes management among people with diabetes in Appalachia.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9935286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10763885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ensuring Equitable Care in Diabetes Management Among Patients of Health Resources & Services Administration-Funded Health Centers in the United States.","authors":"Nadereh Pourat,&nbsp;Xiao Chen,&nbsp;Connie Lu,&nbsp;Weihao Zhou,&nbsp;Brionna Hair,&nbsp;Joshua Bolton,&nbsp;Alek Sripipatana","doi":"10.2337/ds22-0016","DOIUrl":"https://doi.org/10.2337/ds22-0016","url":null,"abstract":"<p><strong>Aim: </strong>To explore whether there are racial/ethnic differences in diabetes management and outcomes among adult health center (HC) patients with type 2 diabetes.</p><p><strong>Methods: </strong>We analyzed data from the 2014 Health Center Patient Survey, a national sample of HC patients. We examined indicators of diabetes monitoring (A1C testing, annual foot/eye doctor visits, and cholesterol checks) and care management (specialist referrals, individual treatment plan, and receipt of calls/appointments/home visits). We also examined diabetes-specific outcomes (blood glucose levels, diabetes-related emergency department [ED] visits/hospitalizations, and diabetes self-management confidence) and general outcomes (number of doctor visits, ED visits, and hospitalizations). We used multilevel logistic regression models to examine racial/ethnic disparities by the above indicators.</p><p><strong>Results: </strong>We found racial/ethnic parity in A1C testing, eye doctor visits, and diabetes-specific outcomes. However, Hispanics/Latinos (odds ratio [OR] 0.26), non-Hispanic African Americans (OR 0.25), and Asians (OR 0.11) were less likely to receive a cholesterol check than Whites. Non-Hispanic African Americans (OR 0.43) were less likely to have frequent doctor visits, while Hispanic/Latino patients (OR 0.45) were less likely to receive an individual treatment plan.</p><p><strong>Conclusion: </strong>HCs largely provide equitable diabetes care but have room for improvement in some indicators. Tailored efforts such as culturally competent care and health education for some racial/ethnic groups may be needed to improve diabetes management and outcomes.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9935284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10763887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}