abstract: The winter holiday period has been highlighted as a major risk period for weight gain due to excess caloric intake in the form of fat and sugar. Furthermore, diets high in fat and sugar have been implicated in the pathogenesis of diabetes and cardiovascular disease. Exercise aids in the prevention of weight/fat gain, and prevents deleterious changes in cardiometabolic function. The objective of this study was to examine the effects of a fat-sugar supplemented diet, with and without two different exercise training protocols, on body composition, glycemic control and other markers of cardiovascular disease in an at-risk population of overweight and obese males. Twenty-seven, healthy overweight/obese (BMI >25 kg/m2) males were fed 2 donuts per day, 6 days/week, for four weeks, while maintaining their current diet. In addition, all subjects were randomized to one of the following conditions: sedentary control, 1,000 kcal/week moderate-intensity continuous training (MICT) (50% of peak oxygen consumption), or 1,000 kcal/week high-intensity interval training (HIIT) (90-95% of peak heart rate). Supervised exercise training was performed 4 days/week on a cycle ergometer. Changes in body weight and composition, endothelial function, arterial stiffness, glycemic control, blood lipids and cardiorespiratory fitness (CRF) were assessed before and after the intervention. Body weight, lean mass and visceral fat increased significantly in HIIT (p<0.05) and were unchanged in MICT. There was a trend for a significant increase in body weight (p=0.07) and lean mass (p=0.11) in control. Glycemic control during the 2-h OGTT improved significantly in MICT and control, with no change in HIIT. Hepatic insulin resistance index (IRI) and 30-min insulin during the OGTT improved significantly after MICT and worsened following control (p=0.03), while HIIT was unchanged. CRF increased significantly in both HIIT and MICT, with no change in control (p<0.001). There were no significant changes in other markers of cardiovascular disease. The addition of a fat-sugar supplement (~14,500 kcal) over a 4-week period was not sufficient to induce deleterious changes in body composition and cardiometabolic health in overweight/obese young males. Exercise training did not afford overweight/obese males additional health benefits, with the exception of improvements in fitness and hepatic IRI. / Dissertation/Thesis / Doctoral Dissertation Physical Activity, Nutrition and Wellness 2016

Conselho Nacional de Desenvolvimento Científico e Tecnológico / Segundo a American Diabetes Association, é importante a ênfase no controle glicêmico com o objetivo de prevenir complicações microvasculares em diabéticos, e a adoção de um plano alimentar saudável é fundamental no tratamento destes pacientes. O método de contagem de carboidratos é uma estratégia nutricional, é um método usado por indivíduos diabéticos, que associa o total de carboidratos ingerido nas refeições com a dose de insulina utilizada, com o objetivo de manter a glicemia dentro dos limites convenientes. O objetivo desse estudo foi avaliar se a intervenção nutricional, utilizando o método de contagem de carboidratos, influencia o controle glicêmico de pacientes com diabetes mellitus tipo 1 (DM1). Foram avaliados 157 DM1, 96 constituíram o grupo intervenção com dieta prescrita e com o uso do método de contagem de carboidratos e 61 pacientes DM1 constituíram o grupo controle com dieta prescrita e sem contagem de carboidratos. Os diabéticos foram monitorados por um período de seis meses. Na primeira visita foram submetidos a um questionário de caracterização dos indivíduos, avaliação antropométrica, bioquímica, clínica e dietética. Houve diferença significativa entre o registro alimentar preenchido durante 3 dias e a dieta prescrita, nos gramas de proteína consumidos por dia 50,39 + 29,27 e 22,01 + 3,05 (p= 0,02), como também no índice glicêmico (IG) do almoço 43,00 + 24,89 e 7,83 + 1,88 (p=0,02), e do jantar 50,09 + 35,09 e 7,56 + 2,57 (p=0,00). Em relação a avaliação antropométrica houve aumento não significativo em ambos os grupos, no Índice de Massa Corporal calculado e nos parâmetros antropométricos (circunferência abdominal, circunferência de quadril e relação cintura-quadril). Na avaliação dos parâmetros bioquímicos, observa-se diminuição significativa, somente no grupo intervenção, da hemoglobina glicada (A1C) de 9,8 + 2,26 para 9,1 + 2,16 (p= 0,023) após 6 meses. As correlações entre os dados antropométricos e a A1C, e entre os diferentes tipos de ácidos graxos da dieta proposta e parâmetros bioquímicos colesterol, triglicerídeos, HDLc e LDLc plasmáticos foram consideradas de baixa intensidade. Diante dos resultados concluiu-se que a intervenção por meio do método de contagem de carboidratos proporcionou uma melhora significativa no controle glicêmico dos pacientes estudados. / According to the American Diabetes Association, is important to focus on glycemic control in order to prevent microvascular complications in patients with type 1 diabetes, and the adoption of a plan healthy food is crucial in treating these patients. The method of carbohydrate counting is a nutritional strategy, it is a method used by diabetic individuals, which combines the total carbohydrate intake at meals with the dose of insulin used, with the goal of maintaining blood glucose within the limits appropriate. The aim of this study was to assess whether the nutrition intervention, using the method of carbohydrate couting, influences the glycemic control of patients with diabetes mellitus type 1 (DM1). We evaluated 157 DM1, 96 constituted the intervention group with diet and the use of the method of carbohydrate counting and 61 DM1 patients formed the control group with diet and without the method of carbohydrate counting. The patients were monitored for six months. In the first visit were submitted to a questionnaire, anthropometric, biochemical, clinical and dietary evaluations. Significant difference between the food record completed for 3 days and prescribed diet, in grams of protein consumed per day 50.39 + 29.27 and 22.01 + 3.05 (p = 0.02), on the glycemic index (GI) of lunch 43.00 + 24.89 and 7.83 + 1.88 (p = 0.02), and dinner 50.09 + 35.09 and 7.56 + 2.57 (p = 0.00). For anthropometric assessment increase was not significant in both groups, the body mass index and anthropometric parameters (waist circumference, hip circumference and the waist-hip ratio). In the assessment of biochemical parameters, there is a significant decrease, only in the intervention group, the glycated hemoglobin (A1C) from 9.8 + 2.26 to 9,1 + 2.16 (p = 0.023) after 6 months. The correlations between the anthropometric data and A1C, and between different types of fatty acids in the diet proposal and biochemical parameters cholesterol, triglycerides, HDLc and LDLc plasma were of low intensity. The results concluded that intervention by the method of carbohydrate counting has provided a significant improvement in glycemic control of patients.

Background: The One Drop vertical bar Mobile app supports manual and passive (via HealthKit and One Drop's glucose meter) tracking of self-care and glycated hemoglobin A(1c) (HbA(1c)). Objective: We assessed the HbA(1c) change of a sample of people with type 1 diabetes (T1D) or type 2 diabetes (T2D) using the One Drop vertical bar Mobile app on iPhone and Apple Watch, and tested relationships between self-care tracking with the app and HbA(1c) change. Methods: In June 2017, we identified people with diabetes using the One Drop vertical bar Mobile app on iPhone and Apple Watch who entered two HbA(1c) measurements in the app 60 to 365 days apart. We assessed the relationship between using the app and HbA(1c) change. Results: Users had T1D (n=65) or T2D (n=191), were 22.7% (58/219) female, with diabetes for a mean 8.34 (SD 8.79) years, and tracked a mean 2176.35 (SD 3430.23) self-care activities between HbA(1c) entries. There was a significant 1.36% or 14.9 mmol/mol HbA(1c) reduction (F=62.60, P<.001) from the first (8.72%, 71.8 mmol/mol) to second HbA(1c) (7.36%, 56.9 mmol/mol) measurement. Tracking carbohydrates was independently associated with greater HbA(1c) improvement (all P<.01). Conclusions: Using One Drop vertical bar Mobile on iPhone and Apple Watch may favorably impact glycemic control.

Background: Findings are inconsistent regarding the degree to which depression may exert a negative impact on glycemic control in patients with type 2 diabetes. We therefore aimed to examine the longitudinal relationship between depression, behavioral factors, and glycemic control. Methods: In a prospective component of a nationally representative sample, 866 patients with type 2 diabetes aged ≧18 years completed a standardized assessment including a laboratory screening, questionnaires, and diagnostic measures. Subsequent to baseline (t0), patients were tracked over a period of 12 months (t1). Depression was assessed according to DSM-IV and ICD-10 criteria. Glycemic control was determined by levels of glycosylated hemoglobin (HbA1c); a level of ≧7% was judged as unsatisfactory. Regression analyses were performed to analyze the prospective relationship between depression, medication adherence, diabetes-related health behavior, and HbA1c. Results: Patients with depression at t0 revealed increased rates of medication nonadherence (adjusted OR: 2.67; CI: 1.38–5.15) at t1. Depression (adjusted regression coefficient: β = 0.96; p = 0.001) and subthreshold depression (β = 1.01; p < 0.001) at t0 also predicted increased problems with diabetes-related health behavior at t1. Adjusted ORs for poor glycemic control (HbA1c ≧7%) at t1 were also increased for patients with baseline depression (2.01; CI: 1.10–3.69). However, problems with medication adherence as well as problems with diabetes-related health behavior at t0 did not predict poor glycemic control at t1. Conclusions: In a prospective representative study of patients with type 2 diabetes, baseline depression predicted problems with medication adherence, problems with health-related behaviors, and unsatisfactory glycemic control at follow-up.

Diabetes is the 7th leading cause of death in the United States and is the main cause of chronic kidney failure, nontraumatic limb amputations, blindness, myocardial infarction, and stroke. Many patients with diabetes do not meet goals for at least 1 control measure of blood sugar, blood pressure, or cholesterol. The purpose of the project was to implement a template for documentation--a toolkit for patient care management-to improve blood glucose and blood pressure levels in a rural health clinic in central Texas for 33 patients with diabetes during a 6- to 8-week timeframe. The practice-focused question asked whether management of patients with diabetes would be improved if documentation on a standard template were used by all providers at the site. Models used in this doctoral project included the chronic care model and the Institute for Healthcare Improvement breakthrough series collaborative model. Sources of evidence included published outcomes and research from a systematic review of the literature, archival and operational data collected from the rural health clinic, and evidence from the project. Glycosalated hemoglobin levels improved from a mean of 8.9 mg to 7.6 mg in 31 of 33 participants (t = 2.684, 30 df, p = .012). Systolic and diastolic blood pressures were reduced slightly, but changes were not statistically significant. Potential implications for positive change in nursing practice include improvements in clinical management, implementation of evidence-based practice, and improved outcomes for patients with diabetes. Incorporating evidence-based practice provides scientific justification for actions that will improve clinical outcomes for patients, which leads to healthier patients, families, and communities and contributes to positive social change.

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This study examines physical activity intervention outcome measures in children with Type 1 Diabetes (T1D). Additionally, it explores medical and psychosocial outcomes. Five databases (CINAHL, PsycINFO, MEDLINE, PubMed, Scopus) were used in this study. The selection of articles was done by using exclusion and inclusion criteria. The articles chosen for this study were restricted to those written in English and had to be peer-reviewed and published between 2012 and 2023. Besides, the focus was on quantitative studies. Six articles were eligible to be used in this study. Intervention types, durations, and outcome measurements have been reported. Results showed that the length of intervention should be more than twelve weeks to see the actual effect of interventions.  Additionally, while an effect of physical activity on glycemic control was observed, generalizable psychosocial outcomes could not be obtained. In future research, to reach generalizable conclusions, the sample of this study should be expanded. Also, in addition to clinical data, getting psychosocial data can provide helpful insights. It can offer tips to improve participants' quality of life.

No description available.

Blood glucose (BG) spikes increase chronic disease risk in those with and without diabetes. The fiber and phytonutrient content of fruit, such as raspberries has the potential to attenuate the BG spike of a high glycemic load (HGL) meal. We examined the effect of red raspberries (RRs) on the BG spike when added to a HGL meal. In this randomized cross-over trial, 16 university students were given breakfast cereal and almond milk (control), the control breakfast with 140g added RRs, and the control breakfast with sugar equivalent to the sugar content of the RRs (50% sugar increase from control). Meals given on 3 separate test days, being separated by a 1-week washout period. BG was measured at: fasting then 15 min, 30 min, 60 min, 90 min, and 120 min postprandial. Repeated measures ANOVA was performed to investigate differences in peak minus baseline BG (spike) and glucose incremental area under the curve (IAUC). The added RR meal had a lower BG spike compared to the added sugar meal (-12.8 mg/dL, CI: -22.8 to -2.79, p = 0.0083). Additionally, a lower BG was seen comparing the added RR meal to the control meal (-10.9 mg/dL, CI: -20.9 to -0.83, p = 0.0318). There were no significant differences for IAUC and the timing of peak BG among the meals. RR effect is likely attributed to high fiber-to-sugar ratio, polyphenol content, and greater amount of beneficial micronutrients. Based on obtained results from this pilot study, the practice of adding RRs to HGL meals such as breakfast, seems to reduce risk for T2DM in health populations through BG spike attenuation.