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Yıl 2015, Cilt: 7 Sayı: 2, 93 - 98, 01.08.2015
https://doi.org/10.18521/ktd.04842

Öz

Objective: In this study, we aimed to examine the effects of diet and exercise on diabetes control in type 2 diabetics (NIDDM) who use only oral antidiabetic drugs (OAD). Methods: 217 patients with the diagnosis of NIDDM and using OAD, who admitted to family medicine outpatient clinic between December 2012 and February 2013, were included in the study. Patients were divided into four groups according to their regular diet and exercise. Group 1: Only dieting, Group 2: Only exercising, Group 3: Both dieting and exercising, Group 4: Neither dieting nor exercising. Age, duration of diabetes, body mass index (BMI) and hemoglobin A1c (HbA1c) levels were compared between groups. Results: The mean age of patients participating in the study was 54.5±10.0 years (p=0.878). 62.7% were women and 37.3% were men. The median duration of diabetes, mean BMI, median HbA1c levels were 36 months, 30.2±4.6 kg/m2 and 7.1. Statistically significant difference was not detected (diabetes duration; p=0.188, BMI; p=0,163 and HbA1c; p=0,290). Median HbA1c levels of groups were 7.0; 7.3; 6.8 and 7.2 respectively. No other difference was observed in the other comparisons between groups (p>0.05). Conclusion: There are positive effects of diet and exercise on diabetes control in type 2 diabetics who use only OAD. Diet and exercise have better control in diabetes patients on OAD. However these effects are more noticeable in patients who tackle implement diet and exercise together

Kaynakça

  • Zimmet P, Williams J, de Courten M. Diagnosis and classification 1. of diabetes mellitus. Eds: Wass JAM, Shalet SM, Gale E, Amiel S. Oxford Textbook of Endocrinology and Diabetes. New York: Oxford University Press, 2002: 1635-46.
  • International Diabetes Federation. Diabetes Atlas, 4th Edition, Brussels: IDF, 2009.
  • Sekikawa A, LaPorte RE. Epidemiology of insulin dependent diabetes mellitus. Eds: KGMM 3. Alberti, P Zimmet, RA DeFronzo, H Keen, International Textbook of Diabetes Mellitus, 2nd Ed., Volume I, New York: John Wiley & Sons Ltd, 1997: 89-96.
  • Prospective evidence for physical activity protecting Turkish adults from metabolic disorders. Türk Kardiyol Dern Arşivi - Arch Turk Soc Cardiol 2007; 35(8): 467-74.
  • Pan X-R, Li G-W, Hu Y-H, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care 1997; 20(4): 537-44.
  • Tuomilehto J, Lindstrom J, Eriksoon JK, et al. Prevention of type 2 diabetes by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001; 344(18): 1343-50.
  • Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346(6): 393-403.
  • American Diabetes Association, Nutrition Recommendations and Interventions for Diabetes. Diabetes Care 2008; 31(1): 61-78.
  • American Diabetes Association. Standards of Medical Care in Diabetes-2012. Diabetes Care 2012; 35(1): 11-63.
  • American Diabetes Association. Standards of medical care in diabetes. Diabetes Care 2008; 31(1): 12–54.
  • Kirk A, Mutrie N, Maclntyre P, Fisher M. Increasing physical activity in people with type 2 diabetes. Diabetes Care. 2003; 26(4): 1186–92.
  • Sato Y, Nagasaki M, Nakai N, Fushimi T. Physical exercise improves glucose metabolism in lifestyle- related diabetes. Exp Biol Med (Maywood) 2003; 228(10): 1208–12.
  • Greenland P, Alpert JS, Beller GA, et al. 2010 ACCF/ AHA guideline for assesment of cardiovascular risk in asymptomatic adults: executive summary: a report of the American College of Cardiology Foundation\ American Heart Association Task Force on practice guidelines Circulation. 2010; 122(25): 2748-64.
  • DeFronzo RA. Glucose intolerance and aging. Diabetes Care 1981; 4(4): 493–501.
  • Rowe JW, Minaker KL, Pallotta JA, Flier JS. Characterization ofthe insulin resistance of aging. J Clin Invest 1983; 71(6): 1581–7.
  • Rimbert V, Boirie Y, Bedu M, Hocquette JF, Ritz P, Morio B. Muscle fat oxidative capacity is not impaired by age but by physical inactivity: association with insulin sensitivity. FASEB J 2004; 18(6): 737–9.
  • Demirel M, Şatır E, Uçak S, et al. İnsülin tedavisi başlanan diabet hastalarında kilo değişimi ve bunu etkileyen parametrelerin irdelenmesi. Şişli Etfal Hastanesi Tıp Bülteni 2009; 43(1): 14-9.
  • Kartal A, Çağırgan M, Tığlı H, ve ark. Tip 2 diyabetli hastaların bakım ve tedaviye yönelik tutumları ve tutumu etkileyen faktörler. TAF Preventive Medicine Bulletin 2008; 7(3): 223-230.
  • American Diabetes Association: Standards of medical care in diabetes-2011. Diabetes Care 2011; 34(1): 11- 61.
  • Pittas AG, Das SK, Hajduk CL, et al .A low-glycemic load diet facilitates greater weight loss in overweight adults with high insulin secretion but not in overweight adults with low insulin secretion in the CALERIE Trial. Diabetes Care 2005; 28(12): 2939–41.
  • Rizkalla SW, Taghrid L, Laromiguiere M, et al. Improved plasma glucose control, whole-body glucose utilization, and lipid profile on a low-glycemic index diet in type 2 diabetic men: a randomized controlled trial. Diabetes Care 2004; 27(8): 1866–72.
  • Pereira MA, Swain J, Goldfine AB, Rifai N, Ludwig DS. Effects of a low-glycemic load diet on resting energy expenditure and heart disease risk factors during weight loss. JAMA 2004; 292(20):2482–90.
  • McKeown NM, Meigs JB, Liu S, et al. Dietary carbohydrates and cardiovascular disease risk factors in the Framingham offspring cohort. J Am Coll Nutr 2009; 28(2): 150–8.
  • Monnier L, Lapinski H, Colette C. Contributions of fasting and postprandial plasma glucose increments to the overall diurnal hyperglycemia of type 2 diabetic patients. Diabetes Care 2003; 26(3): 881-5.
  • Holman RR, Paul SK, Bethel MA, Neil HAW, Matthews DR. Long-term follow-up after tight control of blood pressure in type 2 diabetes. N Engl J Med 2008; 359(15): 1565-76.
  • American Diabetes Association: Standards of medical care in diabetes-2010. Diabetes Care 2010; 33(1): 11- 61.
  • Çıtıl R, Öztürk Y, Günay O. Kayseri İl Merkezinde Bir Sağlık Ocağına Başvuran Diyabetik Hastalarda Metabolik Kontrol Durumu ve Eşlik Eden Faktörler. Erciyes Tıp Dergisi 2010; 32(2): 111-122.
  • Papadopoulos AA, Kontodimopoulos N, Frydas A, Ikonomakis E, ÊNiakas D. Predictors of health–related quality of life in type 2 diabetic patients in Greece. BMC Public Health 2007; 7: 186.
  • Hernández-Ronquillo L, Téllez-Zenteno JF, Garduño-Espinosa J, et al. Factors associated with therapy noncompliance in type-2 diabetes patients. J Salud Publica Mex 2003; 45(3): 191-7.
  • Gözaydın M, Duygun T, Saygılarlı İ. Tip 2 Diabetes Mellituslu Hastalarda Glisemi İle Yaşam Kalitesi Arasındaki İlişki. Medikal Network Klinik Bilimler & Doktor 2003; 9(6): 670-4.
  • Acik Y, Bulut HY, Gulbayrak C, Ardicoglu O, Ilhan N. Effectiveness of a diabetes education and intervention program on blood glucose control for patients with type 2 diabetes in a Turkish community. Southeast Asian J Trop Med Public Health 2004; 35(4): 1012-8.
  • Kaplan RM, Hartwell SL, Wilson DK, et al Effects of diet and exercise interventions on control and quality of life in non-insulin-dependent diabetes mellitus. J Gen Intern Med 1987; 2(4): 220-8.
  • Khan S, Rupp J. The effect of exercise conditioning, diet, and drug therapy on glycosylated hemoglobin levels in type 2 (NIDDM) diabetics. J Sports Med Phys Fitness 1995; 35(4): 281-8.
  • International Diabetes Federation. Studies. http://www.idf.org/studies (08.08.2011 tarihinde erişilmiştir).

Oral Antidiyabetik İlaç Kullanan Tip 2 Diyabetes Mellitus Hastalarında Diyet ve Egzersizin Hemoglobin A1c Düzeylerine Etkisi

Yıl 2015, Cilt: 7 Sayı: 2, 93 - 98, 01.08.2015
https://doi.org/10.18521/ktd.04842

Öz

Amaç: Bu çalışmada tip 2 Diabetes Mellitus (T2DM) nedeniyle sadece oral antidiyabetik (OAD) kullanan hastalarda diyet ve egzersizin diyabet kontrolü üzerine etkilerini incelemeyi amaçladık. Yöntem: Çalışmaya Aralık 2012 - Şubat 2013 ayları arasında Aile hekimliği polikliniğine başvuran, bilinen T2DM tanısı olan ve OAD kullanan 217 hasta alındı. Hastalar düzenli diyet ve egzersiz yapma durumlarına göre dört gruba ayrıldı. Grup 1: Sadece diyet yapan, Grup 2: Sadece egzersiz yapan, Grup 3: Hem diyet hem de egzersiz yapan, Grup 4: Diyet ve egzersiz yapmayan grup. Grupların yaş, diyabet süreleri, beden kitle indeksi (BKİ) ve Hemoglobin A1c (HbA1c) düzeyleri karşılaştırıldı. Bulgular: Çalışmaya katılan hastaların yaş ortalaması 54,5±10,0 yıl idi (p=0.878). Hastaların 136’sı (%62,7) kadın, 81’ i (%37,3) erkek idi. Olguların medyan diyabet süresi, ortalama BKİ ve medyan HbA1c düzeyleri sırasıyla 36 ay (min: 0 - maks: 360), 30,2±4.6 kg/m2 ve 7.1 (min: 4.1-maks: 13.3) idi ve istatistiksel olarak farklılık saptanmadı (diyabet süresi; p=0,188, BKİ; p=0,163 ve HbA1c; p=0,290). Grupların medyan HbA1c seviyeleri sırasıyla 7,0; 7,3; 6,8 ve 7,2 olarak bulundu. Diğer gruplar arası karşılaştırmalarda fark gözlenmedi (p>0,05). Sonuç: T2DM olan ve sadece OAD kullanan hastalarda diyet ve egzersizin diyabet kontrolü üzerine olumlu etkisi vardır. Ancak bu etkinlik hem diyet hem de egzersizi birlikte yapan hastalarda daha belirgin olmaktadır

Kaynakça

  • Zimmet P, Williams J, de Courten M. Diagnosis and classification 1. of diabetes mellitus. Eds: Wass JAM, Shalet SM, Gale E, Amiel S. Oxford Textbook of Endocrinology and Diabetes. New York: Oxford University Press, 2002: 1635-46.
  • International Diabetes Federation. Diabetes Atlas, 4th Edition, Brussels: IDF, 2009.
  • Sekikawa A, LaPorte RE. Epidemiology of insulin dependent diabetes mellitus. Eds: KGMM 3. Alberti, P Zimmet, RA DeFronzo, H Keen, International Textbook of Diabetes Mellitus, 2nd Ed., Volume I, New York: John Wiley & Sons Ltd, 1997: 89-96.
  • Prospective evidence for physical activity protecting Turkish adults from metabolic disorders. Türk Kardiyol Dern Arşivi - Arch Turk Soc Cardiol 2007; 35(8): 467-74.
  • Pan X-R, Li G-W, Hu Y-H, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care 1997; 20(4): 537-44.
  • Tuomilehto J, Lindstrom J, Eriksoon JK, et al. Prevention of type 2 diabetes by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001; 344(18): 1343-50.
  • Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346(6): 393-403.
  • American Diabetes Association, Nutrition Recommendations and Interventions for Diabetes. Diabetes Care 2008; 31(1): 61-78.
  • American Diabetes Association. Standards of Medical Care in Diabetes-2012. Diabetes Care 2012; 35(1): 11-63.
  • American Diabetes Association. Standards of medical care in diabetes. Diabetes Care 2008; 31(1): 12–54.
  • Kirk A, Mutrie N, Maclntyre P, Fisher M. Increasing physical activity in people with type 2 diabetes. Diabetes Care. 2003; 26(4): 1186–92.
  • Sato Y, Nagasaki M, Nakai N, Fushimi T. Physical exercise improves glucose metabolism in lifestyle- related diabetes. Exp Biol Med (Maywood) 2003; 228(10): 1208–12.
  • Greenland P, Alpert JS, Beller GA, et al. 2010 ACCF/ AHA guideline for assesment of cardiovascular risk in asymptomatic adults: executive summary: a report of the American College of Cardiology Foundation\ American Heart Association Task Force on practice guidelines Circulation. 2010; 122(25): 2748-64.
  • DeFronzo RA. Glucose intolerance and aging. Diabetes Care 1981; 4(4): 493–501.
  • Rowe JW, Minaker KL, Pallotta JA, Flier JS. Characterization ofthe insulin resistance of aging. J Clin Invest 1983; 71(6): 1581–7.
  • Rimbert V, Boirie Y, Bedu M, Hocquette JF, Ritz P, Morio B. Muscle fat oxidative capacity is not impaired by age but by physical inactivity: association with insulin sensitivity. FASEB J 2004; 18(6): 737–9.
  • Demirel M, Şatır E, Uçak S, et al. İnsülin tedavisi başlanan diabet hastalarında kilo değişimi ve bunu etkileyen parametrelerin irdelenmesi. Şişli Etfal Hastanesi Tıp Bülteni 2009; 43(1): 14-9.
  • Kartal A, Çağırgan M, Tığlı H, ve ark. Tip 2 diyabetli hastaların bakım ve tedaviye yönelik tutumları ve tutumu etkileyen faktörler. TAF Preventive Medicine Bulletin 2008; 7(3): 223-230.
  • American Diabetes Association: Standards of medical care in diabetes-2011. Diabetes Care 2011; 34(1): 11- 61.
  • Pittas AG, Das SK, Hajduk CL, et al .A low-glycemic load diet facilitates greater weight loss in overweight adults with high insulin secretion but not in overweight adults with low insulin secretion in the CALERIE Trial. Diabetes Care 2005; 28(12): 2939–41.
  • Rizkalla SW, Taghrid L, Laromiguiere M, et al. Improved plasma glucose control, whole-body glucose utilization, and lipid profile on a low-glycemic index diet in type 2 diabetic men: a randomized controlled trial. Diabetes Care 2004; 27(8): 1866–72.
  • Pereira MA, Swain J, Goldfine AB, Rifai N, Ludwig DS. Effects of a low-glycemic load diet on resting energy expenditure and heart disease risk factors during weight loss. JAMA 2004; 292(20):2482–90.
  • McKeown NM, Meigs JB, Liu S, et al. Dietary carbohydrates and cardiovascular disease risk factors in the Framingham offspring cohort. J Am Coll Nutr 2009; 28(2): 150–8.
  • Monnier L, Lapinski H, Colette C. Contributions of fasting and postprandial plasma glucose increments to the overall diurnal hyperglycemia of type 2 diabetic patients. Diabetes Care 2003; 26(3): 881-5.
  • Holman RR, Paul SK, Bethel MA, Neil HAW, Matthews DR. Long-term follow-up after tight control of blood pressure in type 2 diabetes. N Engl J Med 2008; 359(15): 1565-76.
  • American Diabetes Association: Standards of medical care in diabetes-2010. Diabetes Care 2010; 33(1): 11- 61.
  • Çıtıl R, Öztürk Y, Günay O. Kayseri İl Merkezinde Bir Sağlık Ocağına Başvuran Diyabetik Hastalarda Metabolik Kontrol Durumu ve Eşlik Eden Faktörler. Erciyes Tıp Dergisi 2010; 32(2): 111-122.
  • Papadopoulos AA, Kontodimopoulos N, Frydas A, Ikonomakis E, ÊNiakas D. Predictors of health–related quality of life in type 2 diabetic patients in Greece. BMC Public Health 2007; 7: 186.
  • Hernández-Ronquillo L, Téllez-Zenteno JF, Garduño-Espinosa J, et al. Factors associated with therapy noncompliance in type-2 diabetes patients. J Salud Publica Mex 2003; 45(3): 191-7.
  • Gözaydın M, Duygun T, Saygılarlı İ. Tip 2 Diabetes Mellituslu Hastalarda Glisemi İle Yaşam Kalitesi Arasındaki İlişki. Medikal Network Klinik Bilimler & Doktor 2003; 9(6): 670-4.
  • Acik Y, Bulut HY, Gulbayrak C, Ardicoglu O, Ilhan N. Effectiveness of a diabetes education and intervention program on blood glucose control for patients with type 2 diabetes in a Turkish community. Southeast Asian J Trop Med Public Health 2004; 35(4): 1012-8.
  • Kaplan RM, Hartwell SL, Wilson DK, et al Effects of diet and exercise interventions on control and quality of life in non-insulin-dependent diabetes mellitus. J Gen Intern Med 1987; 2(4): 220-8.
  • Khan S, Rupp J. The effect of exercise conditioning, diet, and drug therapy on glycosylated hemoglobin levels in type 2 (NIDDM) diabetics. J Sports Med Phys Fitness 1995; 35(4): 281-8.
  • International Diabetes Federation. Studies. http://www.idf.org/studies (08.08.2011 tarihinde erişilmiştir).
Toplam 34 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Sönmez B Bu kişi benim

Yayımlanma Tarihi 1 Ağustos 2015
Yayımlandığı Sayı Yıl 2015 Cilt: 7 Sayı: 2

Kaynak Göster

APA B, S. (2015). Oral Antidiyabetik İlaç Kullanan Tip 2 Diyabetes Mellitus Hastalarında Diyet ve Egzersizin Hemoglobin A1c Düzeylerine Etkisi. Konuralp Medical Journal, 7(2), 93-98. https://doi.org/10.18521/ktd.04842
AMA B S. Oral Antidiyabetik İlaç Kullanan Tip 2 Diyabetes Mellitus Hastalarında Diyet ve Egzersizin Hemoglobin A1c Düzeylerine Etkisi. Konuralp Medical Journal. Ağustos 2015;7(2):93-98. doi:10.18521/ktd.04842
Chicago B, Sönmez. “Oral Antidiyabetik İlaç Kullanan Tip 2 Diyabetes Mellitus Hastalarında Diyet Ve Egzersizin Hemoglobin A1c Düzeylerine Etkisi”. Konuralp Medical Journal 7, sy. 2 (Ağustos 2015): 93-98. https://doi.org/10.18521/ktd.04842.
EndNote B S (01 Ağustos 2015) Oral Antidiyabetik İlaç Kullanan Tip 2 Diyabetes Mellitus Hastalarında Diyet ve Egzersizin Hemoglobin A1c Düzeylerine Etkisi. Konuralp Medical Journal 7 2 93–98.
IEEE S. B, “Oral Antidiyabetik İlaç Kullanan Tip 2 Diyabetes Mellitus Hastalarında Diyet ve Egzersizin Hemoglobin A1c Düzeylerine Etkisi”, Konuralp Medical Journal, c. 7, sy. 2, ss. 93–98, 2015, doi: 10.18521/ktd.04842.
ISNAD B, Sönmez. “Oral Antidiyabetik İlaç Kullanan Tip 2 Diyabetes Mellitus Hastalarında Diyet Ve Egzersizin Hemoglobin A1c Düzeylerine Etkisi”. Konuralp Medical Journal 7/2 (Ağustos 2015), 93-98. https://doi.org/10.18521/ktd.04842.
JAMA B S. Oral Antidiyabetik İlaç Kullanan Tip 2 Diyabetes Mellitus Hastalarında Diyet ve Egzersizin Hemoglobin A1c Düzeylerine Etkisi. Konuralp Medical Journal. 2015;7:93–98.
MLA B, Sönmez. “Oral Antidiyabetik İlaç Kullanan Tip 2 Diyabetes Mellitus Hastalarında Diyet Ve Egzersizin Hemoglobin A1c Düzeylerine Etkisi”. Konuralp Medical Journal, c. 7, sy. 2, 2015, ss. 93-98, doi:10.18521/ktd.04842.
Vancouver B S. Oral Antidiyabetik İlaç Kullanan Tip 2 Diyabetes Mellitus Hastalarında Diyet ve Egzersizin Hemoglobin A1c Düzeylerine Etkisi. Konuralp Medical Journal. 2015;7(2):93-8.