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Title |
In Patients With Type 2 Diabetes, Lifestyle Change Is Very Effective In Reducing Cardiovascular Disease |
Clinical Question |
In patients with Type 2 Diabetes, how effective is lifestyle change in reducing cardiovascular disease? |
Clinical Bottom Line |
For patients with Type 2 Diabetes, lifestyle change is effective in reducing cardiovascular disease. A systematic review and two randomized controlled trials prove that the risk of cardiovascular disease and the markers of cardiovascular disease decreases with increasing exercise and fitness. |
Best Evidence |
(you may view more info by clicking on the PubMed ID link) |
PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
#1) 22399699 | Balducci/2012 | 606 Italian patients with Type 2 Diabetes | RCT | Key results | HbA(1c), hs-CRP, and CHD risk score all improved with increasing fitness. | #2) 21525503 | Chudyk/2011 | Patients with Type 2 Diabetes | Meta Analysis | Key results | HbA(1c) was significantly improved by -0.6% and -0.67% by aerobic exercise alone and aerobic exercise combined with resistance training (RT), respectively. The 95% confidence interval went from -0.98 to -0.27 and -0.93 to -0.40, respectively. The confidence intervals for systolic blood pressure and triglycerides (clinical markers for CV) were as follows “systolic blood pressure (SBP) -6.08 and -3.59 mmHg, respectively (95% CI -10.79 to -1.36 and -6.93 to -0.24, respectively), and triglycerides -0.3 mmol/L (95% CI -0.48 to -0.11 and -0.57 to -0.02, respectively)”. | #3) 19614943 | Johnson/2009 | 41 patients with Type 2 Diabetes | RCT | Key results | After 12 weeks of using a pedometer to increase the daily steps, BMI, weight, and systolic and diastolic blood pressure improved (p<0.01 for all). After 24 weeks, patients assigned to basic lifestyle programme (BLP) had a higher PR (78 +/- 12 b.p.m.) than patients assigned to an enhanced lifestyle programme (EPL) with a PR of 71+/- 12 b.p.m. The adjusted p was 0.03. | |
Evidence Search |
(("Diabetes Mellitus, Type 2"[Mesh]) AND "Exercise"[Mesh]) AND "Cardiovascular Diseases"[Mesh] |
Comments on
The Evidence |
Validity: The first article was a randomized controlled trial with groups similar at the start. The groups were treated the same, and it was not disclosed if there was a greater than 80% completion rate. There was adequate follow-up and adequate compliance. Recall bias was unlikely, and there were no disclosed competing interests. It was not disclosed if the study was double blind.
The second article is a systematic review of randomized controlled trials, with a comprehensive, detailed search for relevant trials. The 34 articles were assessed for validity using specific inclusion criteria. A meta-analysis was not performed, and the number of patients was not disclosed.
The third article was a randomized controlled trial with groups similar at the start. The groups were treated the same, and was a greater than 80% completion rate. There was adequate follow-up and adequate compliance. Recall bias was unlikely, and there were no disclosed competing interests. It was not disclosed if the study was double blind.
|
Applicability |
The results of these studies will aid the dentist in counseling patients with Type 2 Diabetes. |
Specialty/Discipline |
(General Dentistry) (Dental Hygiene) |
Keywords |
Type 2 Diabetes Mellitus AND cardiovascular disease
|
ID# |
2404 |
Date of submission: |
02/27/2013 |
E-mail |
allinsonelizabeth@gmail.com |
Author |
Elizabeth Allinson |
Co-author(s) |
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Co-author(s) e-mail |
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Faculty mentor/Co-author |
Georgiana S. Gross, MPH |
Faculty mentor/Co-author e-mail |
grossg@uthscsa.edu |
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
None available | |
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Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
None available | |
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