Department of Behavioural Science and Health, University College London, London, UK.
Sci Rep. 2018 Nov 16;8(1):16938. doi: 10.1038/s41598-018-35238-1.
Healthy lifestyle is key for type 2 diabetes (T2D) management. It is unclear whether individuals change health behaviours in response to T2D diagnosis. We compared smoking, physical activity, fruit and vegetable intake and alcohol consumption at three times (pre-diagnosis, at diagnosis, 2-4 years post-diagnosis) in individuals who developed T2D and controls. Behaviours were assessed in 6877 individuals at waves 3-7 of the English Longitudinal Study of Ageing. Generalized estimating equations were used to examine differences by group and time and group-by-time interactions. The T2D group were less active (p < 0.001) and consumed less alcohol (p < 0.001). Smoking (p < 0.001), alcohol consumption (p = 0.037) and physical activity (p = 0.042) decreased over time in the overall sample, fruit and vegetable intake (p = 0.012) and sedentary activity (p < 0.001) increased. A group-by-time interaction was found for smoking, with the T2D group having greater reductions in smoking over time (p < 0.001). No significant interactions were detected for other behaviours. We found limited evidence that T2D diagnosis encourages behaviour change, other than a reduction in smoking. Given the importance of lifestyle for T2D outcomes, strategies for motivating behaviour change need to be identified.
健康的生活方式是 2 型糖尿病（T2D）管理的关键。目前尚不清楚个体是否会根据 T2D 的诊断结果改变健康行为。我们比较了患有 T2D 和对照组个体在三个时间点（诊断前、诊断时、诊断后 2-4 年）的吸烟、身体活动、水果和蔬菜摄入量以及饮酒情况。行为评估是在英国老龄化纵向研究的第 3-7 波中对 6877 名个体进行的。广义估计方程用于检查组间和时间差异以及组间时间交互作用。T2D 组的活动量较少（p<0.001），饮酒量也较少（p<0.001）。在整个样本中，吸烟（p<0.001）、饮酒（p=0.037）和体力活动（p=0.042）随时间推移而减少，而水果和蔬菜摄入量（p=0.012）和久坐活动量（p<0.001）增加。吸烟行为存在组间时间交互作用，T2D 组随时间推移吸烟量减少幅度更大（p<0.001）。其他行为未检测到显著的交互作用。我们发现，T2D 诊断鼓励行为改变的证据有限，除了吸烟量减少。鉴于生活方式对 T2D 结局的重要性，需要确定激励行为改变的策略。
