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“MOVEdiabetes”:一项在阿曼初级卫生保健机构中开展的、针对2型糖尿病成年患者增加身体活动量的整群随机对照试验。

'MOVEdiabetes': a cluster randomized controlled trial to increase physical activity in adults with type 2 diabetes in primary health in Oman.

作者信息

Alghafri Thamra S, Alharthi Saud Mohamed, Al-Farsi Yahya, Alrawahi Abdul Hakeem, Bannerman Elaine, Craigie Angela M, Anderson Annie S

机构信息

Ministry of Health, Muscat, Oman.

University of Dundee, Dundee, UK.

出版信息

BMJ Open Diabetes Res Care. 2018 Oct 31;6(1):e000605. doi: 10.1136/bmjdrc-2018-000605. eCollection 2018.

Abstract

OBJECTIVE

This study examined the impact of a multicomponent intervention to increase physical activity (PA) in adults with type 2 diabetes (T2D) in Oman.

RESEARCH DESIGN AND METHODS

This is a cluster randomized controlled trial in eight primary health centers. Participants were physically inactive, aged ≥18 years, and with no contraindication to PA. Patients attending intervention health centers (n=4) received the 'MOVEdiabetes' intervention, which consisted of personalized, individual face-to-face consultations by dietitians. Pedometers and monthly telephone WhatsApp messages were also used. Patients attending comparison health centers received usual care. The primary outcome was change in PA [Metabolic Equivalent(MET).min/week] after 12 months assessed by the Global Physical Activity Questionnaire. The secondary outcomes were changes in daily step counts, sitting time, weight, body mass index, glycated hemoglobin, blood pressure and lipids.

RESULTS

Of the 232 participants (59.1% female, mean (SD) age 44.2 (8.1) years), 75% completed the study. At 12 months, the mean change in MET.min/week was +631.3 (95% CI 369.4 to 893.2) in the intervention group (IG) vs +183.2 (95% CI 83.3 to 283.0) in the comparison group, with a significant between-group difference of +447.4 (95% CI 150.7 to 744.1). The odds of meeting PA recommendations were 1.9 times higher in the IG (95% CI 1.2 to 3.3). Significant between-group differences in favor of IG were detected for mean steps/day (+757, 95% CI 18 to 1531) and sitting time hours/ per day (-1.5, 95% CI -2.4 to -0.7). Clinical measures of systolic and diastolic blood pressure and triglycerides also showed significant intervention effects.

CONCLUSIONS

'MOVEdiabetes' was effective in increasing PA, the likelihood of meeting PA recommendations, and providing cardioprotective benefits in adults with T2D attending primary care.

摘要

目的

本研究探讨了一项多组分干预措施对阿曼2型糖尿病(T2D)成年患者身体活动(PA)的影响。

研究设计与方法

这是一项在八个初级卫生中心进行的整群随机对照试验。参与者身体活动不足,年龄≥18岁,且无PA禁忌证。在干预卫生中心就诊的患者(n = 4)接受了“MOVEdiabetes”干预,该干预包括营养师进行的个性化一对一面对面咨询。还使用了计步器和每月一次的WhatsApp电话信息。在对照卫生中心就诊的患者接受常规护理。主要结局是12个月后通过全球身体活动问卷评估的PA变化[代谢当量(MET)·分钟/周]。次要结局是每日步数、久坐时间、体重、体重指数、糖化血红蛋白、血压和血脂的变化。

结果

在232名参与者中(59.1%为女性,平均(标准差)年龄44.2(8.1)岁),75%完成了研究。12个月时,干预组(IG)的MET·分钟/周平均变化为+631.3(95%可信区间369.4至893.2),而对照组为+183.2(95%可信区间83.3至283.0),组间差异显著,为+447.4(95%可信区间150.7至744.1)。IG组达到PA建议的几率高出1.9倍(95%可信区间1.2至3.3)。在每日平均步数(+757,95%可信区间18至1531)和每日久坐时间(- 1.5,95%可信区间-2.4至-0.7)方面,检测到有利于IG组的显著组间差异。收缩压、舒张压和甘油三酯的临床指标也显示出显著的干预效果。

结论

“MOVEdiabetes”在增加T2D成年初级保健患者的PA、达到PA建议的可能性以及提供心脏保护益处方面是有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e707/6235057/268b661b42b4/bmjdrc-2018-000605f01.jpg

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