Type 2 Diabetes, Prediabetes
Conditions
Brief summary
The aim of the study is to investigate the effects of two levels of primary care physical activity interventions on metabolic control and cardiovascular risk factors, compared to usual care in patients with pre- and type 2 diabetes. The hypothesis is that both levels of interventions have effect on HbA1c with the more intense Group intervention having superior effects.
Detailed description
Regularly physical activity may decrease the risk for type 2 diabetes, cardiovascular diseases, overweight and premature deaths. Despite the evidence that physical activity is beneficial to health,it is often ignored and underused aspect in diabetes care. The aim of the study is to investigate the effects of two levels of primary care physical activity interventions on metabolic control and cardiovascular risk factors, compared to usual care in patients with pre- and type 2 diabetes.
Interventions
BEHAVIORALPedometer intervention
Intensive intervention with pedometer. The participants are instructed to set daily step goal and to record their daily steps on a website.
BEHAVIORALGroup meetings
Participants receive 12 group meetings over two years' time.
BEHAVIORALIndividual consultations
Participants receive 10 individual meetings with a diabetes specialist nurse. Physical activity on prescription is used to set individual goals and to highlight the importance of physical activity.
Sponsors
Karolinska Institutet
Uppsala University
Arizona State University
Sophiahemmet University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
40 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
Ability to communicate in Swedish Age 40-80 years Type 2 diabetes: Diagnosed type 2 diabetes with a duration of \>=1 year Pre-diabetes: HbA1c \>39-\<47, Fasting plasma glucose \>5.6 mmol/l
Exclusion criteria
* Myocardial infarction in the past 6 months * serum creatinine \>140 * diabetic ulcer or risk for ulcer * prescribed insulin in past 6 months * additional disease prohibiting physical activity * have experienced repeated hypoglycaemia or severe hypoglycaemia in past 12 months * classified in very hard-intensity activity according to Stanford Brief Activity Survey * having no access to internet.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| HbA1c (mmol/mol) | up to month 24. | Haemoglobin A1c |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total cholesterol (mmol/L) | week 0, 12, 24, and month 12 and 24. | total Cholesterol is determined by using enzymatic method |
| HDL (mmol/L) | week 0, 12, 24, and month 12, 18 and 24. | HDL is determined by using a homogeneous method (lowdensity lipoprotein)(High-density lipoprotein) |
| ApoB (g/l) | week 0, 24 and month 24. | Apolipoprotein B is determined by using turbimetric method |
| ApoA1 (g/l) | week 0, 24 and month 24. | ApolipoproteinA1 is determined by using turbimetric method |
| C-peptide (pmol/l) | week 0, 12, 24, and month 12 and 24. | C-peptid are determined by using immunometric method using two monoclonal antibodies and detection with electrochemiluminiscense using a Modular E system (Beckman Coulter, Inc.). |
| BMI (kg/m2) | week 0,8, 12,16, 24, and month 9, 12, 18 and 24. | Body mass index |
| Weight (kg) | week 0,8, 12,16, 24, and month 9, 12, 18 and 24. | Tanita digital scale (Model TBF- 300A, Arlington Heights, IL). Weight is measured with light clothes, no shoes to the nearest 0.1 kg. |
| % Body Fat | week 0,8, 12,16, 24, and month 9, 12, 18 and 24. | % Body Fat is determined by Tanita digital scale (Model TBF- 300A, Arlington Heights, IL). |
| Waist circumference (cm) | week 0,8, 12,16, 24, and month 9, 12, 18 and 24. | Waist circumference is measured with SECA 201 tape, horizontal around the waist 2 cm above the umbilicus. |
| Sagittal Abdominal Diameter (cm) | week 0,8, 12,16, 24, and month 9, 12, 18 and 24. | Sagittal abdominal diameter is measured with the subject in a supine position with the knees expanded at the level of the umbilicus using a Holtain-Kahn abdominal caliper (Holtain, Ltd., Crosswell, Crymych; Dyfed, UK). |
| Resting blood pressure (mmHg) | week 0,8, 12,16, 24, and month 9, 12, 18 and 24. | diastolic blood pressure and systolic blood pressure. Resting blood pressure is measured with Omron M6 Comfort. |
| Muscle strength | week 0, 12, 24, and month 9, 12, 18 and 24. | measured by hand-held dynamometry. Hand grip strength is measured in kilograms using the hand-held Saehan Hydraulic Hand Dynamometer, model SH5001 (former Jamar) (Saehan Corporation, Masan, South Korea). |
| Change in Smoking and snuffing habits | Evaluation is conducted at baseline and at 24 months after completion of the intervention period | Change in Smoking and snuffing habits is measured with questions on current and previous habits and the dose |
| fasting plasma glucose (mmol/L) | week 0, 12, 24, and month 9, 12, 18 and 24. | Determined by a glucose oxidase method |
| Physical activity level (counts/min) | week 0 and month 6, 12, 18, 24 | Actigraph accelerometer GT1M |
| Steps/day | week 0, 8, 12, 16, 24, and month 9, 12, 18 and 24. | Actigraph accelerometer GT1M |
| fasting-Insulin (mU/l) | week 0, 12, 24, and month 12 and 24. | Serum insulin concentrations are determined with RIA-kits purchased from Pharmacia & Upjohn, Stockholm. |
| LDL (mmol/L) | week 0, 12, 24, and month 12 and 24. | LDL is determined by using a homogeneous method (lowdensity lipoprotein) |
| IGF BP1 (μg/L) | week 0, 12, 24, and month 12 and 24. | insulin-like growth factor binding protein 1 |
| Free fatty acids (mmol(L ) | week 0, 12, 24, and month 12 and 24. | Samples are saved for later free fatty acid analyses. |
| Triglycerides (mmol/L) | week 0, 12, 24, and month 12, 18 and 24. | Triglycerides is determined by using enzymatic method (Triglycerides) |
Other
| Measure | Time frame | Description |
|---|---|---|
| Change in Stress and working condition | Evaluation is conducted at baseline and at week 12, 24 and month 12 and 24 after completion of the intervention period | Change in Stress and working condition is measured by four questions |
| EuroQol (EQ-5D) | week 0, 12, 24 and month 12 and 24 | measured by EQ-5D assess components of health related QoL (HRQoL). EQ-5D includes measures related to mobility, hygiene, daily activities, pain/ discomfort and anxiety/depression. |
| Sleep | Evaluation is conducted at baseline and at week 12, 24 and month 12 and 24 after completion of the intervention period | Sleep is measured by two questions. One question on difficulties falling asleep and one question on sleep quality. |
| Self reported physical activity | week 0, 12, 24 and month 12 and 24 | International Physical Activity Questionnaire (IPAQ) self-reported 7-item questionnaire to assess physical activity. |
| Self-efficacy for exercise | week 0, 12, 24 and month 12 and 24 | The questionnaire Self-efficacy for exercise is a 5 item questionnaire and assess one´s confidence to continue exercising in different situations. |
| Physical Activity Social Support (PASS) | week 0, 12, 24 and month 12 and 24 | Physical Activity Social Support (PASS) for exercise 6 items. |
| Change in Neighborhood Environment | Evaluation is conducted at baseline and at week 12, 24 and month 12 and 24 after completion of the intervention period | Change in Neighborhood Environment is measured by 17 questions about Walking Environment, Availability of healthy Foods, Safety and Social cohesion |
| Change in Perceived Stress Scale (PSS) | Evaluation is conducted at baseline and at week 12, 24 and month 12 and 24 after completion of the intervention period | Change in Perceived Stress is measured by the Perceived Stress Scale (PSS) which is a 14- items questionnaire. |
| Change in diabetes distress (PAID-20) | Evaluation is conducted at baseline and at week 12, 24 and month 12 and 24 after completion of the intervention period | Diabetes distress is measured by The Problem Areas in Diabetes questionnaire (Swe-PAID-20): This is a 20 items questionnaire |
| Hospital Anxiety and Depression Scale (HADS) | week 0, 12, 24 and month 12 and 24 | HADS is a 14 item questionnaire and consists of two subscales depression and anxiety, with seven items each. |
| Change in Alcohol habits | Evaluation is conducted at baseline and at week 24 and month 12 and 24 after completion of the intervention period | Change in Alcohol habits is measured by two questions from AUDIT-The alcohol Use disorders |
| Change in Dietary habits | Evaluation is conducted at baseline and at week 8, 12, 24 and month 12 and 24 after completion of the intervention period | Change in Dietary habits is measured by a set of questions developed and validated by The Swedish National Food Agency. |
Countries
Sweden
Outcome results
None listed