This document summarizes research on the impact of exercise for individuals with and without a family history of diabetes. It finds that while both groups improved their fitness and saw reductions in weight and waist size from a 6-month exercise program, those with a family history of diabetes did not see as much benefit and exercised more intensely. This suggests tailored exercise programs may be needed to most effectively reduce diabetes risk based on individual genetic factors.
Renée Wilson, Registered Dietitian and PhD Candidate at University of Otago, New Zealand. Presented at the 1st International Symposium on Kiwifruit and Health: http://www.kiwifruitsymposium.org/presentations/diet-microbiota-and-metabolic-health/
This cross-sectional pilot study aims to determine whether or not there are any differences between the gut microbiota of people with normal glucose tolerance, pre-diabetes and type 2 diabetes.
Microbiota, leaky gut syndrome and gut-related diseasesMaurizio Salamone
Lecture on "Microbiota, Leaky gut Syndrome and gut-related disease" at the 7° International workshop on Immunonutrition "Eating for preventing" Carovigno (BA) May 1st-3th 2014
Myths and legacy of exercisemedicine in chronic diseasesAnn Gates
London Sports and Exercise Medicine Presentation.
December 2015.
Copyright Exercise Works Ltd. All rights reserved.
Contact ann@exercise-works.org for permissions.
Renée Wilson, Registered Dietitian and PhD Candidate at University of Otago, New Zealand. Presented at the 1st International Symposium on Kiwifruit and Health: http://www.kiwifruitsymposium.org/presentations/diet-microbiota-and-metabolic-health/
This cross-sectional pilot study aims to determine whether or not there are any differences between the gut microbiota of people with normal glucose tolerance, pre-diabetes and type 2 diabetes.
Microbiota, leaky gut syndrome and gut-related diseasesMaurizio Salamone
Lecture on "Microbiota, Leaky gut Syndrome and gut-related disease" at the 7° International workshop on Immunonutrition "Eating for preventing" Carovigno (BA) May 1st-3th 2014
Myths and legacy of exercisemedicine in chronic diseasesAnn Gates
London Sports and Exercise Medicine Presentation.
December 2015.
Copyright Exercise Works Ltd. All rights reserved.
Contact ann@exercise-works.org for permissions.
This 6th edition of the IDF Diabetes Atlas once again sets the standard for evidence on the global epidemiology of diabetes. The new estimates build on the groundwork laid by previous editions, and confirm the precipitous rise in diabetes over
the last few years. An astounding 382 million people are estimated to have diabetes, with dramatic increases seen in countries all over the world. The overwhelming burden of the disease continues to be shouldered by low- and middleincome
countries, where four out of five people with diabetes are living. Socially and economically disadvantaged people in every country carry the greatest burden of diabetes and are often the most
affected financially.
My seminar Obesity by Hani
Obesity is a public health and policy problem because of its increase prevalence, costs and health effect. (WHO, 2012, National heart lung and blood institute. 2012)
. The risk factor for chronic disease are highly prevalence (Zindah, Belbeisi, Walke & Makdad 2008)
The obesity and the overweight are risk for number of chronic disease include diabetes cardio vascular disease and cancer (WHO,2010)
Guidelines in Obesity management
By Dr. Usama Ragab Youssif
Obesity-related counseling should be offered to those with BMI ≥25 kg/m2
A 3% to 5% weight loss can result in meaningful reductions in triglycerides, blood glucose, hemoglobin A1c, and the risk of developing type 2 diabetes
Set an initial weight loss goal of 5% to 10% of current body weight over 6 mo
After 6 mo, focus on weight maintenance before attempting further weight loss
Participating in a weight loss program long-term can help improve weight maintenance
Health outcomes of Aboriginal individuals with early onset diabetesKelli Buckreus
2010 (Oct) 3rd Conference on Recent Advances in the Prevention and Treatment of Childhood and Adolescent Obesity, poster presentation by BRAID Research
Risk Factors Associations of Metabolic SyndromeAI Publications
Background: Metabolic syndrome (syndrome x) A clustering of dyslipidemia , elevated blood pressure , impaired glucose tolerance , and central obesity which was varied somewhat in specific elements ,but in general they include a combination of multiple and metabolic risk factors. The most widely recognized risk factors are elevated blood pressure, atherogenic dyslipidemia, and elevated plasma glucose. Regardless of the cause, the syndrome recognized individuals at an elevation of these risk factors. The magnitude of increased risk can vary according to the components of the syndrome present as well as the other, non-metabolic syndrome risk factors in a particular person. The association of the metabolic syndrome with demographic characteristics and the metabolic syndrome risk increased with age, BMI and weight gain which are another important risk factors. Obesity has consistently been reported as a risk factor for metabolic syndrome, it is an important, easily observed, and measurable risk factor .it was the only fact that remained significantly associated with metabolic syndrome in all age, race and sex groups. Higher BMI and weight gain over time are associated with poorer blood pressure, higher fasting blood glucose, and dyslipidemia with the remaining atherosclerotic changes complications (hypertension CVD, and nephropathy) have been found to be associated with this syndrome.
Our aim is to alleviate human suffering related to diabetes and its complications among those least able to withstand the burden of the disease. From 2002 to March 2017, the World Diabetes Foundation provided USD 130 million in funding to 511 projects in 115 countries. For every dollar spent, the Foundation raises approximately 2 dollars in cash or as in-kind donations from other sources. The total value of the WDF project portfolio reached USD 377 million, excluding WDF’s own advocacy and strategic platforms.
DIABETES AND CARDIOVASCULAR DISEASE - THE CONTINUUMPraveen Nagula
DIABETES IS ONE OF THE MOST COMMON NONCOMMUNICABLE DISEASES WORLD WIDE.
EVERY 6 SECONDS ONE PERSON IS AFFECTED BY DIABETES..
THEME FOR 2014-2016
LETS UNITE FOR DIABETES
This 6th edition of the IDF Diabetes Atlas once again sets the standard for evidence on the global epidemiology of diabetes. The new estimates build on the groundwork laid by previous editions, and confirm the precipitous rise in diabetes over
the last few years. An astounding 382 million people are estimated to have diabetes, with dramatic increases seen in countries all over the world. The overwhelming burden of the disease continues to be shouldered by low- and middleincome
countries, where four out of five people with diabetes are living. Socially and economically disadvantaged people in every country carry the greatest burden of diabetes and are often the most
affected financially.
My seminar Obesity by Hani
Obesity is a public health and policy problem because of its increase prevalence, costs and health effect. (WHO, 2012, National heart lung and blood institute. 2012)
. The risk factor for chronic disease are highly prevalence (Zindah, Belbeisi, Walke & Makdad 2008)
The obesity and the overweight are risk for number of chronic disease include diabetes cardio vascular disease and cancer (WHO,2010)
Guidelines in Obesity management
By Dr. Usama Ragab Youssif
Obesity-related counseling should be offered to those with BMI ≥25 kg/m2
A 3% to 5% weight loss can result in meaningful reductions in triglycerides, blood glucose, hemoglobin A1c, and the risk of developing type 2 diabetes
Set an initial weight loss goal of 5% to 10% of current body weight over 6 mo
After 6 mo, focus on weight maintenance before attempting further weight loss
Participating in a weight loss program long-term can help improve weight maintenance
Health outcomes of Aboriginal individuals with early onset diabetesKelli Buckreus
2010 (Oct) 3rd Conference on Recent Advances in the Prevention and Treatment of Childhood and Adolescent Obesity, poster presentation by BRAID Research
Risk Factors Associations of Metabolic SyndromeAI Publications
Background: Metabolic syndrome (syndrome x) A clustering of dyslipidemia , elevated blood pressure , impaired glucose tolerance , and central obesity which was varied somewhat in specific elements ,but in general they include a combination of multiple and metabolic risk factors. The most widely recognized risk factors are elevated blood pressure, atherogenic dyslipidemia, and elevated plasma glucose. Regardless of the cause, the syndrome recognized individuals at an elevation of these risk factors. The magnitude of increased risk can vary according to the components of the syndrome present as well as the other, non-metabolic syndrome risk factors in a particular person. The association of the metabolic syndrome with demographic characteristics and the metabolic syndrome risk increased with age, BMI and weight gain which are another important risk factors. Obesity has consistently been reported as a risk factor for metabolic syndrome, it is an important, easily observed, and measurable risk factor .it was the only fact that remained significantly associated with metabolic syndrome in all age, race and sex groups. Higher BMI and weight gain over time are associated with poorer blood pressure, higher fasting blood glucose, and dyslipidemia with the remaining atherosclerotic changes complications (hypertension CVD, and nephropathy) have been found to be associated with this syndrome.
Our aim is to alleviate human suffering related to diabetes and its complications among those least able to withstand the burden of the disease. From 2002 to March 2017, the World Diabetes Foundation provided USD 130 million in funding to 511 projects in 115 countries. For every dollar spent, the Foundation raises approximately 2 dollars in cash or as in-kind donations from other sources. The total value of the WDF project portfolio reached USD 377 million, excluding WDF’s own advocacy and strategic platforms.
DIABETES AND CARDIOVASCULAR DISEASE - THE CONTINUUMPraveen Nagula
DIABETES IS ONE OF THE MOST COMMON NONCOMMUNICABLE DISEASES WORLD WIDE.
EVERY 6 SECONDS ONE PERSON IS AFFECTED BY DIABETES..
THEME FOR 2014-2016
LETS UNITE FOR DIABETES
Navigating the Health Insurance Market_ Understanding Trends and Options.pdfEnterprise Wired
From navigating policy options to staying informed about industry trends, this comprehensive guide explores everything you need to know about the health insurance market.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
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The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
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2. International Diabetes Federation. IDF Diabetes Atlas, 6th edn. Brussels, Belgium, 2013. http://www.idf.org/diabetesatlas
Type 1 diabetes Type 2 diabetes Gestational diabetes
• Lack of insulin
• Autoimmune
• Usually children
• Defect insulin
secretion
• Insulin resistance
• Lifestyle factors
• Usually adults
• Insulin resistance
• During pregnancy
• Risks to mother
and child
Main “types” of diabetes
3. The risk of complications is reduced by good glycaemic control
25 times higher
risk of
eye problems
6 times higher
risk for
stroke
5 times higher
risk of kidney
disease
20 times higher
risk of
lower limb
amputation
2-4 times
higher risk for
heart attack
High blood glucose leads to long term
complications
International Diabetes Federation. IDF Diabetes Atlas, 6th edn. Brussels, Belgium, 2013. http://www.idf.org/diabetesatlas
4. Seshasai et al. N Engl J Med 2011;364:829-41
.
0
7
6
5
4
3
2
1
0
40 50 60 70 80 90
Age (years)
Yearsoflifelost
Men
7
6
5
4
3
2
1
0
40 50 60 70 80 900
Age (years)
Women
Non-vascular
deaths
Vascular deaths
On average, a 50-year-old individual with diabetes and no history
of vascular disease will die 6 years earlier compared to someone
without diabetes
Diabetes is associated with significant loss
of life years
5. • Not curable
• But can be controlled with
Education Healthy Diet Proper
Medications
Regular Check
ups
Regular
Exercise
Diabetes management
7. 2014 2040
WORLD
41
5
millio
n
WORLD
642
million
people living
with diabetes
Middle East and North Africa 85%
South East Asia 64%
South and Central America 55%
Western Pacific 46%
North America and Caribbean 30%
Europe 33%
Africa 93%
55%
Diabetes: A global
emergency
International Diabetes Federation. IDF Diabetes Atlas, 6th edn. Brussels, Belgium, 2013. http://www.idf.org/diabetesatlas
8. Diabetes is a human and economic burden
4.9 million deaths per
year
50% of deaths under
60 years of age
Intersects with all
dimensions of
development
US$612 billion
11% of worldwide healthcare
expenditure
… and the costs to society are high and
escalating
International Diabetes Federation. IDF Diabetes Atlas, 6th edn. Brussels, Belgium, 2013. http://www.idf.org/diabetesatlas
9. Lifestyle (diet and exercise) is better
than drugs in preventing diabetes…
Knowler W.C. et al., N Engl J
Med. , 2002
10. …but we don´t respond to exercise in
the same way
Bouchard, C., et al., J Appl Physiol (1985),
1999
11. The Malmö exercise intervention study
(50 ♂)
FH - FH +
Age (years) 37,8 ± 4,7 38,4 ± 3,9
weight (kg) 94,8 ± 10,2 92,4 ± 12,8
BMI (kg/m2) 29,0 ± 2,9 28,4 ± 2,8
Waist (cm) 101,0 ± 7,8 98,1 ± 8,2
VO2max (ml/kg/
min)
30,5 ± 4,7 32,5 ± 4,6
HbA1c (%) 4,3 ± 0,3 4,3 ± 0,4
Glucose, 2h (mM) 5,8 ± 1,4 5,8 ± 1,2
Do individuals with a genetic predisposition
for diabetes respond in the same way to
exercise?
Elgzyri et al., JCEM,
2012
12. Exercise at “Friskis och Svettis”
Screening
•Health declaration
•Physical
examination
•Blood tests
•Submax bike
ergometer test
•OGTT
Pre-training
•Anthropometric
measurements
•Blood tests
•Max exercise
test
•Muscle & fat
biopsies
•BIA
•Actiheart
recording
Mid-training
•Anthropometric
measurements
•Submax bike
ergometer test
•Actiheart recording
Post-
training
•Anthropometric
measurements
•Blood tests
•Max exercise test
•Muscle & fat
biopsies
•BIA
•OGTT
•Actiheart
recording
6 months
Ekman et al., JAP, 2015
15. How much did the fitness improve?
FH- FH+
Ekman et al., JAP, 2015
16. … and the same for weight and waist!
Ekman et al., JAP, 2015
17. Conclusions
• Even a relatively modest increase in physical activity
during 6 months improves physical fitness and thereby
some cardiometabolic risk factors
• The FH+ group took part in ~45% more exercise sessions
and spent ~60% more energy compared to the FH-
• However, individuals with FH did not benefit from the
exercise intervention to the same extent as those without
a FH
? Should individuals at risk of diabetes
exercise in a specific way to reduce the
risk.
? How can we tailor exercise for the
individual for the most effective health
improvement
? Biomarkers
18. Albert Szent-Györgyi
(Nobel prize, 1937)
”Biological
structures
and living
systems are
worn out by
inactivity and
developed by
use”By the courtesy of Bengt Saltin
Thank you to all participants
in the study!
