Aim: The research has four related aims; 1) to explore the relationship between body weight and diabetic control in patients with type 2 diabetes; 2) to identify whether, and what type of, lifestyle advice for patients with type 2 diabetes related to their diabetic control; 3) to identify whether types of lifestyle advice identified in aim 2 were related to effective diabetic control when tested in randomised controlled trials (RCTs); 4) to identify whether types of lifestyle advice identified in aim 2 were also related to effective prevention of diabetes when tested in RCTs. Variations in all outcomes due to socio-economic status (SES) were also assessed. Methods: An analysis of the James Cook University Hospital (Middlesbrough, UK) Diabetes Care Centre Register was conducted to address research aims 1 and 2. Cochrane systematic reviews were conducted to address research aims 3 and 4. Results: Mean body mass index (BMI) increased and mean glycated haemoglobin (HbA1c) decreased over the course of the research in the type 2 diabetes population; levels of BMI and HbA1c were highest in the lowest SES group. The systematic reviews found that at six and twelve months, advice on diet plus exercise compared with dietary alone was associated with a (pooled weighted mean) decrease from baseline in HbA1c of 0.9% (95% Cl 0.4 to 1.3) and 1.0% (95% Cl 0.4 to 1.5) in patients with type 2 diabetes, and that at twelve months, dietary advice plus exercise, compared with dietary advice alone, was associated with a statistically significant mean (pooled weighted mean) decrease in fasting plasma glucose of 0.2 mmol/l, (95% Cl 0.1 to 0.3), in normoglycaemic people. No analyses on SES in the primary studies included in either review were reported. Conclusion: Levels of BMI and diabetic control are worst in adult type 2 diabetics from low SES groups. Diabetic registers are useful, but additional data should be captured. The evidence base for advice on diet, with or without additional advice on exercise or behaviour, for adults with, or at risk of, type 2 diabetes is poor. However, advice on diet plus exercise, compared with dietary advice alone, does appear to afford some benefit.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:517529 |
| Date | January 2006 |
| Creators | Moore, Helen Joy |
| Publisher | Teesside University |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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