Changes in physical activity among adults with diabetes: a longitudinal cohort study of inactive patients with Type 2 diabetes who become physically active.
Changes in physical activity among adults with diabetes: a longitudinal cohort study of inactive patients with Type 2 diabetes who become physically active.
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DOI：
10.1111/dme.12748
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发表时间：
2015-08
期刊：
影响因子：
--
通讯作者：
Grant RW
中科院分区：
文献类型：
--
作者：
Palakodeti S;Uratsu CS;Schmittdiel JA;Grant RW
To identify the predictors and clinical effects among inactive patients with diabetes who become physically active, in the setting of a large integrated health system. We studied adults with Type 2 diabetes with at least two clinic visits between December 2011 and November 2012 who reported being inactive at their first visit. The mean (±sd) interval between their first and last visit was 6.2 (±2.3) months. We analysed self‐reported moderate‐to‐vigorous physical activity data collected using a structured intake form during routine clinical care. The study cohort (N = 6853) had a mean age of 60.2 years; 51.4% were women and 53.6% were non‐white. Nearly two‐thirds (62.5%, n = 4280) reported remaining physically inactive, while 16.0% reported achieving the recommended moderate‐to‐vigorous physical activity levels (≥ 150 min/week) by the last visit of the study period. Female gender (odds ratio 0.77, 95% CI 0.67, 0.88), obesity (BMI 30–34.9 kg/m2: odds ratio 0.76, 95% CI 0.60, 0.97; BMI ≥ 35 kg/m2: odds ratio 0.55, 95% CI 0.42, 0.70), chronic kidney disease (odds ratio 0.78, 95% CI 0.65, 0.94) and depression (odds ratio 0.77, 95% CI 0.62, 0.96) were each independently associated with not achieving the recommended moderate‐to‐vigorous physical activity level, while physician referral to lifestyle education was a positive predictor (odds ratio 1.40, 95% CI 1.09, 1.85). Controlling for baseline differences, patients achieving the recommended moderate‐to‐vigorous physical activity target lost 1.0 kg more weight compared with patients remaining inactive (P < 0.001). Patients with diabetes in a real‐world clinical setting lost weight after becoming physically active; however, nearly two‐thirds of patients remained inactive. Novel interventions to address physical inactivity in primary care should address barriers faced by older patients with medically complex disease. This is the first large‐scale longitudinal assessment of exercise changes among inactive patients with Type 2 diabetes that is paired with clinically relevant endpoints. Previous analyses of exercise habits have typically been derived from cross‐sectional survey data or less representative clinical trial participants.
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