| Aims:To facilite the personalized prescription of physical activity to older adults with diabetes,we conducted this study to identify the cut off value of physical activity required for satisfactory glycemic control of older patients with type 2 diabetes,quantify the effect size of sufficient physical activity,i.e.,higher than the cut off value,on glycemic control,and analyse the components of physical activity identified.Methods:This is a cross-sectional study,and the convience sampling was used to enroll older patients with type 2 diabetes living in 4 communties of Ji’nan,Shandong Province from July to November 2021.We used portable fingertip blood glucose monitor to test fasting blood glucose(FPG),2-hour postprandial blood glucose(2hPG)of breakfast and 2hPG of lunch,and used wGT3X-BT three-axis accelerometer to monitor daily physical activity of subjects.In addition,we used the Summary of Diabetes Self-care Activities Measure(SDSCA).the 4 item Morisky Medication Adherence Scale(MMAS-4),the Diabetes Health Literacy Scale(HLS-C),and the self-compiled general situation questionnaire to assess variables of self-management,medication adherence,diabetes health literacy,sociodemographic information etc.We used receiver operating characteristic(ROC)to identify the cut-off value of physical activity required for satisfactory glycemic control of older patients with type 2 diabetes,used binary logistic regression model to quantify its effect size on glycemic control,and used descriptive statistics to analyse the component of physical activity.Results:1.A total of 113 participants were enrolled in this study,excluding 27 of those with missing data,data from 85 participants were used in this analysis and the effective rate was 75.22%.2.The control rates of FPG,2hPG of breakfast and 2hPG of lunch were 54.12%(46/85),55.29%(47/85)and 67.06%(57/85),respectively.There were 31 participants who had satisfactory control in all three glycemic paramters,and the control rate was 36.47%.3.The median(quartile)of the average daily physical activity per kilogram of body weight was 4.19(2.62,5.78)kcal,and the values for men and women were 4.22(2.87,5.97)kcal and 4.11(2.61,5.77)kcal,respectively.4.Older adults with type 2 diabetes spent 67.07%of their time in sedentary behavior,28.87%(IQR=11.57%)of their time in lower-intensity physical activity,2.08%(IQR=4.23%)of their time in moderate-intensity physical activity,and none(IQR=0.00%)of their time in higher-intensity physical activity.5.The cut-off value of physical activity was 2.850kcal/kg/d.In the ROC curve,the sensitivity and specificity were 0.889 and 0.567,respectively,with the Youden index of 0.456.The area under the ROC curve was 0.730(P<0.001).There were 62 participants whose physical activity exceeded the cut-off value.6.Univariate analysis showed that that age(t=-3.930,P<0.01),self-rated economic status(χ2= 4.983,P<0.05)and the time to fall asleep(χ2=6.176,P<0.05)were significantly associated with glycemic control.7.Binary logistic regression analysis showed that factors significantly associated with glycemic control included age(OR=1.112,95%CI=1.004,1.231),the time to fall asleep(OR=0.233,95%CI=0.060,0.911)and physical activity(OR=7.250,95%CI=2.034,25.849).Conclusions:1.The glycemic control of older adults with type 2 diabetes in our research is not satisfactory.2.Low-intensity physical activity is the predominant form of daily activity in Community-dwelling elderly patients with type 2 diabetes.3.The cut-off value of physical activity for satisfactory glycemic control in older adults with type 2 diabetes is 2.850kcal/kg/d.4.Physical activity is a significant predictor of glycemic control in older adults with type 2 diabetes,and individuals whose physical activity exceeds 2.850kcal/kg/d were more likely to have satisfactory glycemic control. |
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