Masuda Hiroaki, Ishiyama Daisuke, Yamada Minoru, Iwashima Fumiko, Kimura Yosuke, Otobe Yuhei, Tani Naoki, Suzuki Mizue, Nakajima Hideki
Department of Rehabilitation, Toshima Hospital, Tokyo Metropolitan Health and Hospitals Corporation, Tokyo, Japan.
Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan.
Diabetes Metab Syndr Obes. 2021 May 7;14:2057-2063. doi: 10.2147/DMSO.S307070. eCollection 2021.
Increasing physical activity (PA) improves glycemic control in patients with type 2 diabetes mellitus (T2DM). However, whether long-term objectively measured PA is related to glycemic control remains unclear. The aim of this study was to investigate the relationship between long-term objectively measured PA and glycemic control in T2DM patients.
This prospective cohort study recruited T2DM patients admitted to a hospital-based diabetes management and education program. The primary outcome was glycemic control by hemoglobin A1c at 6 months after discharge. We defined poor glycemic control according to the Japanese Clinical Practice Guidelines. The PA was objectively measured using a three-axis accelerometer during 6 months' period after discharge. The representative value of PA was the average daily steps during the measurement period and was divided into quartiles. To determine the relationship between the daily steps and poor glycemic control, we performed a multivariate logistic regression analysis.
Ninety-four participants were enrolled in the study. Their median age was 59 years, and 38 (40.0%) of them showed poor glycemic control. Multivariate logistic regression analysis showed that the first (Q1, ≤ 6106 steps/day) and second quartiles (Q2, 6107-8258 steps/day) had significantly elevated risks of poor glycemic control compared to Q4 (≥ 10,542 steps/day), with odds ratios of 8.55 [95% confidence intervals (CI) =1.43-51.23] and 15.62 (95% CI 2.63-92.87), respectively.
We found that lesser PA was significantly associated with poor glycemic control in T2DM patients. This finding may be beneficial for clinicians while providing long-term advice to diabetic patients.
增加身体活动（PA）可改善2型糖尿病（T2DM）患者的血糖控制。然而，长期客观测量的PA与血糖控制之间的关系尚不清楚。本研究的目的是调查T2DM患者长期客观测量的PA与血糖控制之间的关系。
这项前瞻性队列研究招募了参加医院糖尿病管理和教育项目的T2DM患者。主要结局是出院后6个月时糖化血红蛋白的血糖控制情况。我们根据日本临床实践指南定义血糖控制不佳。出院后6个月期间使用三轴加速度计客观测量PA。PA的代表值是测量期间的平均每日步数，并分为四分位数。为了确定每日步数与血糖控制不佳之间的关系，我们进行了多因素逻辑回归分析。
94名参与者纳入研究。他们的中位年龄为59岁，其中38名（40.0%）血糖控制不佳。多因素逻辑回归分析显示，与第四四分位数（≥10542步/天）相比，第一四分位数（Q1，≤6106步/天）和第二四分位数（Q2，6107-8258步/天）血糖控制不佳的风险显著升高，优势比分别为8.55[95%置信区间（CI）=1.43-51.23]和15.62（95%CI 2.63-92.87）。
我们发现PA较少与T2DM患者血糖控制不佳显著相关。这一发现可能对临床医生为糖尿病患者提供长期建议有益。
