The efficacy of lifestyle intervention in type 2 diabetes is greatest when exercise is combined with therapeutic education, nutritional and psychological counselling. Aim: To describe the multidisciplinary lifestyle intervention model used at CURIAMO and the results obtained in type 2 diabetes care after the initial four-month intensive period. Research design and methods: The intervention, which includes seven steps, involves the following experts: endocrinologists, sport medicine doctors or cardiologists, psychologists, dieticians, educators, nurses, exercise physiologists, and promoters of outdoor activities. 142 subjects with type 2 diabetes (age 56±10 years, Mean±SD) completed the four month intensive lifestyle intervention. Results: Before and after the intensive intervention the following parameters significantly (p<0.05) changed: HbA1c (7.2±1 to 6.7±1 %), plasma triglycerides (161±97 to 149±85 mg%), systolic (143±15 to 133) and diastolic (83±8 to 77±8) blood pressure (mmHg), waist circumference (110±12 to 106±12 cm), fat mass (32±11 to 30±11 kg ), cardiorespiratory fitness (9.7±2 to 19.3±3 ml/kg-1215 ·min-1), blood lactate/walking speed ratio (1.7±0.2 to 0.7±0.1), energy expenditure (IPAQ) increased by 27±4 MET215 ·h-1215 ·week-1, daily defined doses and costs of anti-diabetic and anti-hypertensive drugs were reduced by approximately 10%. Using psychological and quality of life assessment tools (CES-D, SF-36), 20% of subjects with a pathological score for depression come back to normal values, whereas perceived quality of life (at baseline significantly lower vs. standard population sample) reached the median scores of healthy Italian population. Conclusion: A lifestyle intervention delivered by a multidisciplinary approach significantly ameliorates body composition, metabolic control, blood pressure, cardiorespiratory fitness, energy expenditure and quality of life, while reduces depressive symptoms use and costs of drugs in type 2 diabetes. The impact of the intervention in terms of cost/efficacy and age adjusted years of quality of life needs to be documented with a prolonged follow-up.
A multidisciplinary approach for optimal use of exercise in diabetes care.
DE FEO, Pierpaolo;PAZZAGLI, Chiara;
2011
Abstract
The efficacy of lifestyle intervention in type 2 diabetes is greatest when exercise is combined with therapeutic education, nutritional and psychological counselling. Aim: To describe the multidisciplinary lifestyle intervention model used at CURIAMO and the results obtained in type 2 diabetes care after the initial four-month intensive period. Research design and methods: The intervention, which includes seven steps, involves the following experts: endocrinologists, sport medicine doctors or cardiologists, psychologists, dieticians, educators, nurses, exercise physiologists, and promoters of outdoor activities. 142 subjects with type 2 diabetes (age 56±10 years, Mean±SD) completed the four month intensive lifestyle intervention. Results: Before and after the intensive intervention the following parameters significantly (p<0.05) changed: HbA1c (7.2±1 to 6.7±1 %), plasma triglycerides (161±97 to 149±85 mg%), systolic (143±15 to 133) and diastolic (83±8 to 77±8) blood pressure (mmHg), waist circumference (110±12 to 106±12 cm), fat mass (32±11 to 30±11 kg ), cardiorespiratory fitness (9.7±2 to 19.3±3 ml/kg-1215 ·min-1), blood lactate/walking speed ratio (1.7±0.2 to 0.7±0.1), energy expenditure (IPAQ) increased by 27±4 MET215 ·h-1215 ·week-1, daily defined doses and costs of anti-diabetic and anti-hypertensive drugs were reduced by approximately 10%. Using psychological and quality of life assessment tools (CES-D, SF-36), 20% of subjects with a pathological score for depression come back to normal values, whereas perceived quality of life (at baseline significantly lower vs. standard population sample) reached the median scores of healthy Italian population. Conclusion: A lifestyle intervention delivered by a multidisciplinary approach significantly ameliorates body composition, metabolic control, blood pressure, cardiorespiratory fitness, energy expenditure and quality of life, while reduces depressive symptoms use and costs of drugs in type 2 diabetes. The impact of the intervention in terms of cost/efficacy and age adjusted years of quality of life needs to be documented with a prolonged follow-up.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
