The impact of COVID-19 on the physical activity and sedentary behaviour levels of pregnant women with gestational diabetes #Covid19RftLks

Hillyard, M., Sinclair, M., Murphy, M., Casson, K. & Mulligan, C. | 2021 | The impact of COVID-19 on the physical activity and sedentary behaviour levels of pregnant women with gestational diabetes | PLoS ONE | 16 | 8 | e0254364. https://doi.org/10.1371/journal.pone.0254364

The authors’ objective was to understand how COVID-19 has affected the self-reported physical activity and sedentary behaviour levels of pregnant women with gestational diabetes mellitus (GDM). To this end they surveyed over 500 participants using an online survey to gauge levels of physical activity and sedentary behaviour in this population.

The COVID-19 pandemic has had a considerable impact on the activity levels of pregnant women with gestational diabetes and for the researchers of this study, highlights the need for targeted public health initiatives. In their paper they underline that the findings of their study will help policy makers and health service providers to understand how best to support pregnant women during subsequent waves of COVID-19 or future pandemics or situations requiring lockdown.

Abstract

Background

The aim of this study was to understand how physical activity and sedentary behaviour levels of pregnant women with gestational diabetes in the UK have been affected by COVID-19.

Methods

An online survey exploring physical activity and sedentary behaviour levels of pregnant women with gestational diabetes during COVID-19 was distributed through social media platforms. Women who had been pregnant during the COVID-19 outbreak and had gestational diabetes, were resident in the UK, were 18 years old or over and could understand written English were invited to take part.

Results

A total of 724 women accessed the survey, 553 of these met the eligibility criteria and took part in the survey. Sedentary time increased for 79 per cent of the women during the pandemic. Almost half of the women (47 per cent) were meeting the physical activity guidelines pre COVID-19 during their pregnancy, this dropped to 23 per cent during the COVID-19 pandemic. Fear of leaving the house due to COVID-19 was the most commonly reported reason for the decline. Significant associations were found between meeting the physical activity guidelines during COVID-19 and educational attainment, fitness equipment ownership and knowledge of how to exercise safely in pregnancy.

Conclusions and implications

These results show the impact of COVID-19 on physical activity and sedentary behaviour levels and highlight the need for targeted public health initiatives as the pandemic continues and for future lockdowns. Women with gestational diabetes need to know how it is safe and beneficial to them to engage in physical activity and ways to do this from their homes if fear of leaving the house due to COVID-19 is a barrier for them. Online physical activity classes provided by certified trainers in physical activity for pregnant women may help them remain active when face-to-face appointments are reduced and limited additional resources are available.

The impact of COVID-19 on the physical activity and sedentary behaviour levels of pregnant women with gestational diabetes [primary paper]

Free 10 week get moving course for people with diabetes

Diabetes UK | 01 April 2021| Sign up to our free ‘get moving’ classes

Starting in May, Diabetes UK ‘sPhysical Activity Coordinators will be running free 10 week courses specifically tailored to support people who are currently doing less than 30 minutes of exercise a week. 

From boxercise to Tai chi to movement to music, each weekly class will focus on a different gentle activity – giving you the chance to try out new ways to get active and find what suits you. Plus, we’ll be holding Q&A sessions at the end of each class, so that you can find out more about managing your condition and get tips and advice from our clinical experts and guest speakers. 

And because you’ll be part of the same group throughout the entire 10 weeks, you’ll also get the chance to meet and chat to other participants who all have the same goal – to move more and live well with diabetes.

The majority of our Get Moving courses will be held online, so you’ll just need to be able to log in via Zoom to take part. As all 10 classes will be held on the same day and time each week, we’ve got a number of courses running at different times throughout the week for you to choose from – including evenings and the weekend. 

Diabetes UK will also be running specific online courses for: 

  • women only
  • South Asian communities with translation
  • those wanting to do chair-based activities only. 

Simply register your interest to find out more about our time slots and availability, and we’ll be in touch with more details as soon as possible. 

Full details from Diabetes UK

Manchester research: Activity trackers can be useful tools in managing diabetes

University of Manchester|  October  2019 | Activity trackers can be useful tools in managing diabetes

Experts at The University of Manchester have conducted the largest review so far of the effect of movement-monitoring devices, accelerometers and pedometers, on the activity of individuals with diabetes and cardiovascular disease.

The review included data from 36 studies, with more than 5000 participants, researchers investigated the short-term effects of using wearable step-counting devices on the physical activity in adults with cardiometabolic conditions, such as type 2 diabetes, and cardiovascular disease (CVD). They found the devices were associated with small-to-medium improvements in physical activity.

Results from previous studies have shown that the use of pedometers helps patients

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with chronic conditions to increase their physical activity levels. However, the authors of this paper note that a major limitation from previous studies is that interventions involving step-counting devices vary a lot, so it is unclear which interventions are most effective.

Dr Alex Hodkinson, one of the researchers who carried out the study, said; “This study differs to earlier ones because it has looked at which types of interventions using the two most common monitoring devices (accelerometers and pedometers) are most effective in improving physical activity among people with diabetes and cardiometabolic conditions.” (Source: University of Manchester).

Activity trackers can be useful tools in managing diabetes [press release]

The article is available from JAMA Network Open 

 

 

Physical activity reduces mortality in patients with diabetes

New research suggests patients with type 2 diabetes should be prescribed physical activity to control blood sugar and improve heart health | European Association of Preventive Cardiology | via ScienceDaily

Patients with type 2 diabetes should be prescribed physical activity to control blood sugar and improve heart health. That is one of the recommendations in a position paper of the European Association of Preventive Cardiology (EAPC), a branch of the European Society of Cardiology (ESC). The paper is published in the European Journal of Preventive Cardiology, a journal of the ESC.

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One in 11 adults worldwide have diabetes, of which 90% is type 2 diabetes. Nearly all patients with type 2 diabetes develop cardiovascular complications, which are the leading causes of death in this group.

The paper provides practical recommendations for doctors on how to motivate patients to incorporate physical activity into their daily routine, set achievable and measurable goals, and design individualised exercise training programmes to meet those goals.

Full story at ScienceDaily

Journal reference: Kemps, H. et al. | Exercise training for patients with type 2 diabetes and cardiovascular disease: What to pursue and how to do it. A Position Paper of the European Association of Preventive Cardiology (EAPC) |  European Journal of Preventive Cardiology | January 14th 2019

Following heart health guidelines may also reduce diabetes risk, finds US research

Science Daily | January 2019 | Following heart health guidelines also reduces diabetes risk

Lifestyle characteristics that are associated with supporting a healthy heart have also been found to reduce the risk of diabetes, in a new US study.  Researchers at Ohio State Wexner Medical Center, assessed diabetes among 7,758 participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study and used the American Heart Association’s Life’s Simple 7 as a guide for measuring heart health among the group.

 

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The Simple 7 health factors and lifestyle behaviours characteristics are:

  • physical activity
  • diet
  • weight
  • cholesterol
  • blood pressure
  • blood glucose
  • tobacco use

Overall, the study participants who were in the recommended, ideal ranges for at least four of the seven health factors had a 70 per cent lower risk of developing diabetes over the next decade.

Lead author of the study Dr. Joshua J. Joseph, an endocrinologist and assistant professor at The Ohio State University Wexner Medical Center, said:

“What’s interesting is when we compared people who had normal blood glucose and those who already had impaired blood glucose; those in normal levels who attained four or more guideline factors had an 80 percent lower risk of developing diabetes. Those who were already diabetic or prediabetic and met four of the factors had no change in lowering their risk for diabetes.”

He added: “Healthy people need to work to stay healthy. Follow the guidelines. Don’t proceed to high blood sugar and then worry about stopping diabetes. By that point, people need high-intensity interventions that focus on physical activity and diet to promote weight loss and, possibly, medications to lower the risk of diabetes.”

Read the full news story from Science Daily

The findings are published in the latest issue of Diabetologia 

Aims/hypothesis

Ideal cardiovascular health (CVH) is associated with lower diabetes risk. However, it is unclear whether this association is similar across glycaemic levels (normal [<5.6 mmol/l] vs impaired fasting glucose [IFG] [5.6–6.9 mmol/l]).

 

Methods

A secondary data analysis was performed in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study. Incident diabetes was assessed among 7758 participants without diabetes at baseline (2003–2007) followed over 9.5 years. Baseline cholesterol, blood pressure, diet, smoking, physical activity and BMI were used to categorise participants based on the number (0–1, 2–3 and more than or equal to 4) of ideal CVH components. Risk ratios (RRs) were calculated using modified Poisson regression, adjusting for cardiovascular risk factors.

Results

Among participants (mean age 63.0 [SD 8.4] years, 56% female, 73% white, 27% African-American), there were 891 incident diabetes cases. Participants with equal to or more than 4 vs 0–1 ideal CVH components with normal fasting glucose (n = 6004) had 80% lower risk, while participants with baseline IFG (n = 1754) had 13% lower risk.  Additionally, the magnitude of the association of ideal CVH components with lower diabetes risk was stronger among white than African-American participants (p for interaction = 0.0338).

 

Conclusions/interpretation

A higher number of ideal CVH components was associated with a dose-dependent lower risk of diabetes for participants with normal fasting glucose but not IFG. Tailored efforts that take into account observed differences by race and glycaemic level are needed for the primordial prevention of diabetes.

 

Science Daily Following heart health guidelines also reduces diabetes risk

This article is available to Rotherham NHS staff  and can be requested here 

Physical activity reduces mortality in patients with diabetes

Science Daily | January 2019 | Physical activity reduces mortality in patients with diabetes

A new paper published in the European Journal of Caridology recommends that people with diabetes should be prescribed physical activity to control their blood sugar and improve their heart health (via Science Daily).

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The article provides practical recommendations for doctors on how to motivate patients to incorporate physical activity into their daily routine, set achievable and measurable goals, and design individualised exercise training programmes to meet those goals.  Recommendations relate to physical activity and cardiorespiratory fitness (CRF); glycaemic control; vascular function; and dyslipidaemia.

The lead author of the paper, Dr  Hareld Kemps said: “Just advising patients to exercise, which is what doctors typically do, is not enough,” said Dr Kemps. “Patients must be assessed for comorbidities, risks related to exercise, and personal preferences. This will be cost effective in the long run so we have to wake up policy makers and healthcare insurers to pay for it. That needs clinicians to take the lead and call for programmes to be reimbursed.”

“I can’t stress enough how effective even small increases in activity can benefit patients with type 2 diabetes and heart problems. Interrupting sitting with brief bouts of walking improves glucose control, while two hours of brisk walking per week reduces the risk of further heart problems.”

He advises patients to consult their own doctor for a personalised plan.

Science Daily Physical activity reduces mortality in patients with diabetes

Full reference:

Kemps, H. et al  |2019| Exercise training for patients with type 2 diabetes and cardiovascular disease: What to pursue and how to do it. A Position Paper of the European Association of Preventive Cardiology (EAPC)| European Journal of Preventive Cardiology| https://doi.org/10.1177/2047487318820420

Patients with type 2 diabetes mellitus suffer from dysregulation of a plethora of cardiovascular and metabolic functions, including dysglycaemia, dyslipidaemia, arterial hypertension, obesity and a reduced cardiorespiratory fitness. Exercise training has the potential to improve many of these functions, such as insulin sensitivity, lipid profile, vascular reactivity and cardiorespiratory fitness, particularly in type 2 diabetes mellitus patients with cardiovascular comorbidities, such as patients that suffered from an acute myocardial infarction, or after a coronary intervention such as percutaneous coronary intervention or coronary artery bypass grafting. The present position paper aims to provide recommendations for prescription of exercise training in patients with both type 2 diabetes mellitus and cardiovascular disease. The first part discusses the relevance and practical applicability of treatment targets that may be pursued, and failure to respond to these targets. The second part provides recommendations on the contents and methods to prescribe exercise training tailored to these treatment targets as well as to an optimal preparation and dealing with barriers and risks specific to type 2 diabetes mellitus and cardiac comorbidity.

The article is available to read and download from the European Journal of Preventive Cardiology

Diabetes and obesity higher among LGBQ teens

OnMedica| July 2018| Diabetes and obesity higher among LGBQ teens

A new study of American teenagers is the largest study to date to report differences in levels of physical activity (PA), sedentary behaviour and obesity by sex and sexual orientation among high-school-aged students (young people between 14 and 18 years old).
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Researchers at Northwestern University used data from  350,673 students. They found, with the exception of lesbian female students, after adjusting for age, race/ethnicity, BMI, and survey year, all non‐heterosexual youth reported significantly fewer days per week of PA compared to their sex‐matched heterosexual counterparts. Overall lesbian, gay, bisexual and questioning  (LGBQ) students took part in less physical activity (approximately one day a week less) than heterosexual students.

The number of hours of sedentary activity among this group was higher than heterosexual students (an average of 30 minutes more per school day than heterosexual counterparts), and lesbian, bisexual and questioning female students were 1.55 to 2.07 times more likely to be obese than heterosexual female students.

According to the study lesbian students were 1.85 times more likely to be overweight and lesbian, bisexual, and not sure female youth were 1.55‐2.07 times more likely to be obese than heterosexual female students. No significant differences in SB, overweight, or obesity were found among gay, bisexual, or unsure male youth compared to heterosexual male youth.

Lauren Beach, Lead author of the study, said:
“Many of these youth might be taking part in sedentary activities – like playing video games – to escape the daily stress tied to being lesbian, gay, bisexual or questioning,”

The researchers explain that LGBQ youth may be at increased risk for developing type 2 diabetes mellitus compared to heterosexual youth. They suggest future studies should characterize diabetes prevalence among non‐heterosexual youth (Source: OnMedica).

The full press release is available at OnMedica

The study has now been published in the journal Pediatric Diabetes 
Abstract

Low physical activity (PA), high sedentary behavior (SB), and overweight and obesity have been shown to associate with increased Type 2 diabetes risk among adolescents. We investigated PA, SB, and overweight and obesity among Youth Risk Behavior Survey (YRBS) respondents to determine if non‐heterosexual youth may be at increased diabetes risk compared to heterosexual youth.

Weighted city and state YRBS data were pooled across 44 jurisdictions biennially from 2009‐2015, resulting in a sample size of 350,673 students. Overall, 88.4% identified as heterosexual, 2.1% as gay or lesbian, 5.7% as bisexual, and 3.7% as unsure.

With the exception of lesbian female students, after adjusting for age, race/ethnicity, BMI, and survey year, all non‐heterosexual youth reported significantly fewer days per week of PA compared to their sex‐matched heterosexual counterparts. Similarly, compared to heterosexual female youth, bisexual and not sure female youth reported significantly more hours per day of SB. These PA and SB findings remained significant after adjustment for depressive symptoms and in‐school bullying among bisexual female youth only. In fully adjusted models, lesbian students were 1.85 times more likely to be overweight and lesbian, bisexual, and not sure female youth were 1.55‐2.07 times more likely to be obese than heterosexual female students. No significant differences in SB, overweight, or obesity were found among gay, bisexual, or unsure male youth compared to heterosexual male youth.

Non‐heterosexual youth may be at increased risk for developing type 2 diabetes mellitus compared to heterosexual youth. Future studies should characterize diabetes prevalence among non‐heterosexual youth.

Full reference: Beach, L. B., Turner, B. , Felt, D. , Marro, R. and Phillips, G. L. |2018| Risk Factors for Diabetes are Higher among Non‐Heterosexual US High School Students| Pediatr Diabetes.| Accepted Author Manuscript| doi:10.1111/pedi.12720

Rotherham NHS staff are able to request this article here