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老年病学步行诊所改善了 2 型糖尿病老年退伍军人的糖化血红蛋白 A1c 和计时步态。

A geriatrics walking clinic improves hemoglobin A1c and timed gait in older veterans with type 2 diabetes.

机构信息

School of Nursing, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, Mail Code 7875, San Antonio, TX 78229, USA; Geriatric Research, Education and Clinical Center (GRECC), South Texas Veterans Health Care System, San Antonio, TX, USA.

Geriatric Research, Education and Clinical Center (GRECC), South Texas Veterans Health Care System, San Antonio, TX, USA; Department of Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio, TX, USA; Sam and Ann Barshop Institute for Longevity and Aging Studies, University of Texas Health Science Center at San Antonio, TX, USA.

出版信息

Geriatr Nurs. 2021 Mar-Apr;42(2):566-569. doi: 10.1016/j.gerinurse.2020.10.001. Epub 2020 Nov 4.

Abstract

Over one quarter of older adults in the U.S. has diabetes; and, physical activity is important for the promotion of healthy aging in this population. The purpose of this clinical demonstration project is to evaluate the effect of physical activity in the form of walking on glycemic control and timed gait in older Veterans with type 2 diabetes (T2D). Veterans aged ≥60 years were enrolled in the Geriatrics Walking Clinic (GWC), a clinical demonstration project, at South Texas Veterans Health Care System. GWC is a 6-week clinical program that promotes physical activity and is delivered by a registered nurse/diabetes educator and geriatrician. Veterans were recruited from the VA clinics. Enrolled patients received a pedometer at an initial face-to-face visit, were followed with weekly phone calls to monitor steps/day, received encouragement, and participated in a final face-to-face visit at the end of 6 weeks. In a sub-set of patients with T2D, we performed a chart review and recorded Hemoglobin A1c (HbA1c) at 3, 6, and 12 months after completion of the program. Timed Gait, a major characteristic of frailty, was measured at baseline and after completing the program. Change in HbA1c and timed gait compared to baseline was examined using paired t-tests. Sixty-two patients had HbA1c values available and were included in this analysis. Of these, 36, 52, and 61 patients had repeat HbA1c at 3, 6, and 12 months after the intervention, respectively. Mean age was 68 ± 6 years, 58% were Hispanic, and 92% males. HbA1c improved at 3 months (-0.49, 95% CI: -0.87 to -0.12, p=0.013), at 6 months (-0.40, 95% CI: -0.68 to -0.12, p=0.006), and at 12 months (-0.30, 95% CI: -0.57 to -0.029, p=0.031) compared to baseline. Timed Gait also improved (9.3 ±1.7 vs. 10.2 ±1.8, p<0.001). The finding highlights that older patients with T2D benefit from a GWC with improved glycemic control and timed gait.

摘要

超过四分之一的美国老年人患有糖尿病;而,身体活动对于促进这一人群的健康老龄化非常重要。本临床示范项目的目的是评估以步行形式进行身体活动对患有 2 型糖尿病(T2D)的老年退伍军人血糖控制和计时步态的影响。年龄≥60 岁的退伍军人在南德克萨斯退伍军人医疗保健系统参加老年病学步行诊所(GWC),这是一个临床示范项目。GWC 是一个为期 6 周的临床项目,由注册护士/糖尿病教育者和老年病学家提供,旨在促进身体活动。退伍军人从退伍军人事务部诊所招募。入组患者在初次面对面就诊时收到计步器,通过每周电话随访监测每日步数,接受鼓励,并在 6 周结束时进行最后一次面对面就诊。在一小部分患有 T2D 的患者中,我们进行了病历回顾,并记录了完成项目后 3、6 和 12 个月的血红蛋白 A1c(HbA1c)。在基线和完成项目后测量计时步态,这是脆弱性的一个主要特征。使用配对 t 检验检查 HbA1c 和计时步态与基线相比的变化。62 名患者有 HbA1c 值可供分析,其中 36、52 和 61 名患者分别在干预后 3、6 和 12 个月重复进行 HbA1c 检测。平均年龄为 68±6 岁,58%为西班牙裔,92%为男性。HbA1c 在 3 个月时改善(-0.49,95%CI:-0.87 至-0.12,p=0.013),在 6 个月时改善(-0.40,95%CI:-0.68 至-0.12,p=0.006),在 12 个月时改善(-0.30,95%CI:-0.57 至-0.029,p=0.031),与基线相比。计时步态也有所改善(9.3±1.7 对 10.2±1.8,p<0.001)。这一发现表明,患有 T2D 的老年患者从 GWC 中受益,血糖控制和计时步态得到改善。

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