People with diabetes are also at increased risk of Type-2 diabetes is most common in people over 40. years of age. that people with diabetes were …
Exercise for type-2 diabetes
Diabetes is a metabolic disorder where your body either does not produce or is insensitive to insulin As a result blood sugar glucose levels are high Processing of carbohydrates, fats and protein are all affected This can cause long-term health problems that involve the eyes retinopathy, kidneys nephropathy and peripheral nerve endings as in the legs and feet neuropathy People with diabetes are also at increased risk of coronary artery disease, heart attack and stroke cardiovascular disease Type-2 diabetes is most common in people over 40 years of age Dietary changes, exercise and behaviour modification are all recommended as a way of reducing these problems Any reduction in blood glucose levels and of blood pressure is likely to reduce the risks
The evidence - what pooled research says
Exercise for type 2 diabetes mellitus improves blood sugar control and decreases body fat content This review found that exercise improves blood sugar control and that this effect is evident even without weight loss Furthermore, exercise decreases body fat content, thus the failure to lose weight with exercise programs is probably explained by the conversion of fat to
muscle Exercise improved the bodys reaction to insulin and decreased blood lipids No significant difference was found between groups in blood levels of cholesterol or blood pressure How it was tested In the Cochrane review the researchers thoroughly searched the medical literature A total of 14 randomised controlled trials were assessed These included 377 participants comparing exercise against no exercise The
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duration of the interventions in the studies ranged from eight weeks to one year Two studies reported follow-up information, one at six months after the end of the six months of exercise and one at twelve months after the trial finished Exercising clearly improved glycaemic control as indicated by a decrease in glycated haemoglobin levels of 06
Exercise for type 2 diabetes mellitus Cochrane Database of Systematic Reviews 2006, Issue 3 Art No: CD002968 DOI: 101002/ 14651858CD002968pub2 by Thomas DE, Elliott EJ, Naughton GA
Side effects and general cautions
No study reported adverse effects in the exercise group or diabetic complications Generally, the clinical trials were well-conducted The relatively short duration of trials meant that any long term
complications of having diabetes could not be reported on The Cochrane Collaboration is an international organisation that sets out to help people make wellinformed decisions about healthcare It is a not-for-profit organization To achieve its goals and objectives The Cochrane Collaboration is made up of groups working with a particular disease or health problem
Prepared by the Cochrane Consumer Network, supported by Australian Government funding for Cochrane Groups in Australia
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Self-monitoring your blood glucose levels you have diabetes and are not on insulin
When you have diabetes your body has problems with responding to or making insulin Insulin is a hormone that is needed for body cells to take blood sugars glucose up from the blood as a source of energy This means that blood sugars rise Type-2 diabetes is the most common type of diabetes and the risk of having it increases with age, being overweight and lack of physical activity The risk of cardiovascular disease increases with high blood pressure hypertension, high blood cholesterol LDL cholesterol and increased blood clotting This can cause heart disease, stroke and poor blood circulation
including peripheral vascular disease that in the long-term damages the eyes, kidneys or feet A large study in the UK showed that people with diabetes were less likely to have eye, kidney and foot microvascular complications if they rigidly controlled their blood glucose levels, and their blood pressure Your doctor uses glycated haemoglobin HbA1c measurements to follow blood sugar levels over a two to three month period the half life of red blood cells This is possible because glucose binds to haemoglobin, the oxygencarrying protein in red blood cells As part of self-managing, you can monitor your own blood glucose levels This helps you to see how the levels change over a day and with different food and levels of exercise, activities and stresses You can then make lifestyle changes, take your medications regularly and keep to treatment and care plans Knowing how your glucose levels change can also help your doctor with your treatment On the other hand, there is some concern that for
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some people self-monitoring may make them anxious, frustrated or cause physical discomfort - as it involves pricking your finger
The evidence - what pooled research
says
Self-monitoring of blood glucose levels might be effective in improving glycaemic control in people with type-2 diabetes who are not using insulin Only six eligi 
ble randomised controlled trials were found to provide information In one high-quality recent study the glycated haemaglobin levels decreased 08 in those who were self monitoring and 06 in the control group The trials did not provide any evidence that self monitoring improves fasting blood glucose levels, number of serious low blood glucose hypoglycaemic episodes, quality of life in terms of personal satisfaction, impact on life, worry; sense of wellbeing, or satisfaction with treatment These outcomes were measured in only a few trials
How it was tested
In the Cochrane review the researchers made a thorough search of the medical literature and found six eligible clinical trials A total of 1285 people with diabetes were randomly assigned to self monitoring their blood glucose levels or usual care without self monitoring They did this for at least 6 months
Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin The Cochrane Database of Systematic Reviews 2005, Issue 2 Art
No: CD005060 DOI: 101002/ 14651858CD005060pub2 by Welschen LMC, Bloemendal E, Nijpels G, Dekker JM, Heine RJ, Stalman WAB, Bouter LM
Side effects and general cautions
Changes to behaviour, lifestyle or medication would be essential to show benefits of measuring blood glucose levels The trials did not have a lot of participants yet some people may respond better to self monitoring than Prepared by the Cochrane Consumer Network, supported by Australian Government funding for Cochrane Groups in Australia
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Group sessions improve your self management of type-2 diabetes
People from a wide range of ethnic and cultural groups and at all levels of society are affected by type-2 diabetes This type of diabetes is more commonly diagnosed in people over 40 years of age It carries a risk of disabling but potentially preventable complications, coronary heart disease and stroke Any reduction in blood glucose levels and controlling blood pressure is likely to reduce the risks Self-management skills help with medications, changes in diet and lifestyle including exercise programs Ongoing education, emotional and psychological support helps by providing a knowledge base with
the skills, attitudes and motivation to keep to a care plan Doctors, nurses, dietitians and others can instruct you on diet, medication and healthy practices Patient-centred education is the close involvement of patients and their carers or family in the planning of the education by soliciting their opinions, concepts, ideas, feelings and questions, offering support, and allowing the individual to be involved in decision making The skills of the educator, the place where sessions take place, interaction and rapport between participants, and the number of hours involved all contribute to what a person gets out of a program
The evidence - what pooled research says
Group-based, patient-centred educational programs improve health outcomes for people with type-2 diabetes Glycated haemoglobin was reduced at 4 to 6 months six trials, 924 people and at 12 months eight trials If additional annual group education sessions were
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provided, the improvements continued two trials and diabetic retinopathy may be reduced Fasting blood glucose levels one trial and diabetes knowledge four trials, 708 participants were improved Medication usage was reduced five trials, 654
people so that for every five people attending a groupbased education program one person could reduce their medication use over a year People were able to increase their healthy living skills five trials, selfempowerment one trial and food-related aspects of quality of life one trial They were more able to eat or drink and enjoy food Only small changes in blood pressure and body weight were evident Where the programs were delivered, by who, and in small 4 to 6 people or large groups 16 to 18 did not appear to alter the effectiveness of the course
How it was tested
In the Cochrane review the researchers thoroughly searched the medical literature for the 11 trials with 1532 participants from around the world Groupbased diabetes education programs were compared against routine individual appointments with health professionals The average age was 51 to 65 years People had diabetes for between six to nine years in seven of the trials; in one trial it was less than a year and in another the people were newly diagnosed
Side effects and general cautions
Group-based diabetes education programs varied a lot with the least intensive being three or four hours per year for two to four years
Young people with type-2 diabetes and pregnant women were not included as participants in the trials
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Source:cochrane.org
