What is the actual daily movement in patients with complicated Type 2 Diabetes Mellitus.

Hagedoorn, I. (Ilse) (2017) What is the actual daily movement in patients with complicated Type 2 Diabetes Mellitus. thesis, Medicine.

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Abstract

Background: Cardiovascular diseases are the main cause of morbidity and mortality in patients with Type 2 Diabetes Mellitus (T2DM). Since T2DM is a lifestyle-related disease, movement should be one of the first treatment steps in T2DM. There is staggering evidence that both physical activity and sedentary breaks reduce independently the cardiovascular risk in T2DM. However, little is known about the actual daily movement in patients with T2DM, in particular, objective data of patients with complicated T2DM are missing. Objective: This study objectively measures different aspects of daily movement in patients with complicated T2DM. Material and Methods: In this cross-sectional cohort study, 98 patients with T2DM from a second-line centre were included for statistical analysis. During 8 consecutive days, patients wore a Fitbit Flex (an accelerometer) around the wrist. This device records the number of steps per minute (cadence), a measure of intensity of movement. Additional demographic, anthropometrics and diabetes related characteristics were obtained during the two visits at the outpatient department. Results: Looking at the total steps per day, 85% (n=83) did not met the goal of ≥10.000 steps per day and almost half of all patients (44%) fulfilled the criteria for ‘limited activity/ sedentary behaviour’ (i.e. <5000 steps per day). The percentage of microvascular and macrovascular complications was lower in each group of increased steps. Only 5% (n=5) met the recommendation of ≥150 minutes per week of at least moderate to vigorous physical activity, based on objective measurements. Of the total waking hours per day, 76% (11:41h) were spent at 0 steps per minute (non-movement) of which 7 hours were spent in prolonged sedentary bouts of at least 30 consecutive minutes. Conclusion: In this somewhat older study population, the great majority do not adhere to the general recommendations for daily movement and three-quarters of the waking time no steps are measured. Since some activity is better than none, there is a lot to improve. Implementing step counting devices in clinical practice will be of great importance to improve daily movement and to shift the focus back on lifestyle interventions.

Item Type:	Thesis (Thesis)
Supervisor name:	Faculty Supervisor: and Laverman, Dr. G.D.
Supervisor name:	Second Supervisor: and Gant, Drs. C. M. and ZGT Almelo, department of internal medicine/Nephrology
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 11:03
Last Modified:	25 Jun 2020 11:03
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/2321

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