Risk analysis and effect of physical activity on type 2 diabetes in a population of Oujda-Eastern Morocco following a physical activity program

Abstract

Introduction: Among the subjects of concern is type 2 diabetes, and the effect of physical activity (PA) on their diabetic balance stands out. Thus, it is known that physical activity increases the effectiveness of insulin by improving the sensitivity of body tissues to its action; it generally allows for better control of glycemia. In addition to the advantages mentioned, the regular practice of physical activity even allows one to normalize glycemia and thus to avoid the use of medication or, if necessary, to reduce the dose.Objectives: The main objective of the present study is to evaluate the impact of physical activity on the management of type 2 diabetes as a function of time and to analyze the risk factors associated with it.Methods: This is a prospective interventional study covering a period of five months. We recruited 47 patients, ranging in age from 18 to 77 years and with a mean HbA1c of 8.2% (6.6% - 13.2%), through random sampling among diabetic individuals, using two structured and well-established questionnaires. Glycemic and lipid measurements (HbA1c-HDL-LDL-TR...) were taken by rapid result devices; on the other hand, physical parameters were measured by an impedance meter. We evaluated the patient's sedentary lifestyle by measuring the number of steps they took each day with a pedometer over the course of a week. The exclusion of subjects with associated and severe diseases was essential, as this would prevent them from participating in the physical activity program. These individuals followed a moderate-intensity PA regimen according to the criteria developed by the WHO and a well-monitored diet. We measured all parameters at T0, T1 (1 month after T0), and T2 (3 months after T0).Results: Results showed that 72% were female, and only 9% of the study population were considered non-sedentary. Analysis of variance (ANOVA1) showed a highly significant difference after 3 months of physical activity on Hba1c (p=0.000), cholesterol, HDL, and LDL (p=0.006), fasting blood glucose (p=0.000), and fat levels (p=0.003). The Hba1c level improved by 1.36%, and the mean went from T0.
The score increased from 8.28 to 6.92 three months after the diet. However, we found no significant difference in weight and muscle mass (p > 0.05). The triglyceride level showed a decrease, although it was not statistically significant (p = 0.14).
The odds ratio for having a fat rate higher than 30% in women is 0.22 times higher than in men. A sedentary lifestyle was found to be a risk factor for Hdl, Hba1c, TR, and Ldl. The odds ratio for having an Hdl rate > 0.4 g/l was 1.87 times higher than for someone who wasn't active. The odds ratio for having an Hba1c > 7% was 1.162 times higher than for someone who wasn't active. The odds ratio for having a TR > 1.5 g/l was 1.95 times higher than for someone who wasn't active. Sedentary people face a risk of having a HbA1c level higher than 7, which multiplies by 1.162. However, the age factor confirmed a risk for cholesterol, according to Cramer's value (0.505 < 0.6), so we can conclude that the relationship between age and cholesterol is medium (50%).The results also show a high sedentary rate, likely due to the predominance of women who have historically been less active in daily life. It was found that the modified exercise program helped improve the changes in HbA1c, HDL, LDL, and the fat rate. This is because the exercise increases lipid metabolism, makes it easier for muscles to transport and use glucose during exercise, and lowers insulin resistance.
Conclusions: Physical activity has confirmed its effectiveness in restoring several glycemic and lipidic parameters for type 2 diabetics, making it a better means of preventing complications related to this type of diabetes, in addition to drug treatments and a balanced diet.