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PG-42
Fostering regular exercise behavior to improve metabolic
control in patients with diabetes
Tok Fai Vincent YEUNG
1
*, Jo Jo KWAN
1
, Sau Ping Grace YEUNG
1
.
1
Our Lady of Maryknoll Hospital, Hongkong
Background:
Research evidence consistently supports the
benefits of exercise on people living with diabetes. In addition,
regular exercise is crucial for the prevention of diabetes and
other related metabolic disorders. In order to understand the
exercise pattern among patients with diabetes, a survey was
conducted and a set of exercise in the form of a dance going
with a song, was promulgated in our Hospital to facilitate
patients to perform safe and appropriate exercise.
Method:
The program was conducted in two phases. Phase 1
was a cross-sectional survey to understand exercise behavior
and metabolic control in patients with type 2 diabetes. Phase 2
was a feasibility study to test the effectiveness of a Diabetes
Dance training program. The Diabetes Dance as a safe and
appropriate exercise for people with diabetes had been
endorsed by a panel of experts, including physiotherapists
and diabetes educators. The diabetes nurses who conduct the
exercise programhad received specific professional training to
do the coaching. In addition, the precautions about performing
exercise (e.g., hypoglycaemia, heart conditions) were well
explained for alertness at the beginning of the exercise
program. A DVD containing the exercise movement and
important messages on self-management through the mean-
ingful lyrics and delightful melody was given to patients for
take-home practice.
Results:
A total of 328 subjects were recruited in the exercise
behavioral survey with mean age 64% and 45% were male. The
mean hemoglobin A1c level was 7.6% and mean body mass
index (BMI) 27. 113 subjects (36%) reported they had less than
150 minutes exercise per week and other 35% even did not
have any exercise at all. For Phase 2 study, eighteen patients
were recruited (female = 17) with mean age 54 and mean BMI
31.9. Blood glucose level was significantly lower after the 30-
min dance (P < 0.01). Improvement of exercise knowledge was
also noted after the training.
Conclusion:
Although the beneficial effect of regular exercise
on metabolic control is highly acknowledged, there are still
many barriers, such as lack of time and low motivation, for
people to initiate exercise habit. The exercise program of this
study was established based on the use of dance and music in
order to facilitate the enjoyment of exercise and improve
exercise habit adherence. It is suggested to develop large-scale
and structured study in future to evaluate the effectiveness of
exercise activity on long term glycemic and metabolic
outcomes.
PG-43
Factors associated with self-care behavior among community-
dwelling elderly Taiwanese with diabetes mellitus: findings
from the 2009 national health interview survey
Shih-Chun LIN
1
*, Kun-Wei TSAI
1
, Malcolm KOO
2
.
1
Division of
Geriatrics, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical
Foundation,
2
Department of Medical Research, Dalin Tzu Chi
Hospital, Buddhist Tzu Chi Medical Foundation, Taiwan
Purpose:
To investigate the factors associated with self-care
behavior, including both adherence behavior and self-man-
agement behavior, among community-dwelling elderly
Taiwanese with diabetes mellitus, using data from a nation-
wide, population-based health survey.
Methods:
Individuals aged 65 years and older were identified
from the dataset of the 2009 National Health Interview Survey.
Seven adherence behavior indicators and seven self-manage-
ment behavior indicators were evaluated. Three composite
scores were calculated to represent better adherence behavior,
self-management behavior, and self-care behavior. Separate
logistic regression analyses were conducted to investigate
independent factors associated with adherence behavior
scores, self-management behavior scores, and self-care
behavior scores, dichotomized with their respective medians
as the cut-off values.
Results:
Of the 2,399 respondents (sampling weight-adjusted)
aged 65 years and older, 434 (18%) had diabetes. The mean age
of these patients was 74.1 years (range 65.0
–
93.2 years). Of
them, 46.2% were males. Multivariate logistic regression
analysis revealed that an educational level of senior high
school or above (adjusted odds ratio [aOR] = 3.04, p = 0.001) and
having difficulty with mobility or immobile (aOR = 2.36, p =
0.005) were significantly associated with better adherence
behavior. Moreover, older age (aOR = 1.54, p = 0.043), being
married or having a partner (aOR = 2.17, p = 0.001), and residing
in urban areas (aOR = 2.30, p < 0.001) were significantly asso-
ciated with better self-management behavior. Finally, for the
overall self-care behavior, older age (aOR = 1.54, p = 0.039),
living with someone (aOR = 2.23, p = 0.029), and residing in
urban areas (aOR = 2.05, p = 0.001) were its three significant
independent associated factors.
Conclusions:
Findings from this secondary data analysis of a
population-based heath survey revealed that older age, living
with someone, and residing in urban areas were significant
factors associated with better self-care behavior in commu-
nity-dwelling elderly Taiwanese with diabetes.
PG-44
The effect of dietary intervention in T2DM patients who could
not succeed in losing body weight after taking Dapagliflozin
Jeong Min PARK
1
, Kyung Wan MIN
2
, Kyung Ah HAN
2
*.
1
Eulji
Hospital,
2
Eulji University College of Medicine, Korea
New oral hypoglycemic agents, Dapagliflozin, highly selective
inhibitor of sodium-glucose co-transporter 2 (SGLT2), has been
reported to reduce body weight, which appears to be attribut-
able to the loss of glucose energy with no effects on appetite.
By the way, body weight is also related to dietary intake, which
motivated us to observe add-on effects of diet therapy for
persons with T2DM whose body weights were not reduced
despite taking dapagliflozin.
We enrolled 31 T2DM patients who failed to lose their
weights on dapagliflozin for 2 months. A trained clinical
dietitian offered individually-tailored dietary advice based on
their eating habits and recommended calories, and assessed
dietary intake by 24-hr recall. We investigated the changes in
weight, BMI, WHR, and FBS before and after dietary
intervention. The subjects
’
undesirable eating habits were
categorized into 4 main findings; having large meal, frequent
snacking, eating too much fruits, and frequent drinking
alcohol.
The mean age and duration of diabetes were 62.3 ± 1.6 years
and 13.3 ± 1.5 years. From the first day of taking dapagliflozin
to the intervention day, the mean weight and BMI change
were 0.30 ± 0.19 kg and 0.12 ± 0.08 kg/m
2
. According to the
dietary assessment, the subjects had 127.9 ± 7.4% more
excessive calories when compared with the individually
recommended level. At the follow-up day, 61.3% of subjects
(n = 19) were succeeded in losing weight, and the mean
weight and BMI change during 2 months after diet therapy
were
−
1.19 ± 0.38 kg and
−
0.44 ± 0.13 kg/m
2
, which were
significantly lower than those before the intervention
(P < 0.01, respectively). There were no differences in dosing
period, FBS and WHR change, and other antidiabetic treat-
ment before and after the intervention. According to gender,
men (n = 13) showed significant weight and BMI change
(
−
2.12 ± 0.72 kg and
−
0.75 ± 0.25 kg/m
2
, P = 0.03), but women
didn
’
t. When compared with the individually recommended
level, men had higher (P < 0.01) percentage of calorie intake
(152.4 ± 10.1% in men vs. 115.8 ± 5.3% in women). Having large
meal and frequent drinking alcohol were more common in
men than in women (P = 0.04, and P = 0.01, respectively).
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65
–
S211
S173