Walking for exercise--does three times per week influence risk factors in type 2 diabetes?

In order to assess the effects of regular walking on metabolic control and cardiovascular risk factors in type 2 diabetes 26 patients from one primary care clinic, aged 60.0+/-7.3 years, participated in a walking program during 4 months. Prescribed exercise was walking for 45-60 min three times weekly. A control group of 26 patients from a neighboring primary care clinic, aged 59.3+/-6.2 years, received no exercise instructions. Thus, randomization was not performed. There were no improvements of blood pressure, body mass index, physical fitness, glycated hemoglobin A1c, fasting plasma glucose or insulin by intention-to-treat analysis. Seventeen patients in the intervention group increased their physical activity and improved systolic blood pressure; -7.6 mmHg (-15 to -0.2), diastolic blood pressure; -4.3 mmHg (-7.4 to -1.2), body mass index; -0.6 kg/m2 (-1.1 to -0.1) and total plasma cholesterol; -0.6 mmol/l (-0.9 to -0.3), (mean difference, with 95% CI). We could observe no effects on glucose metabolism in either group. Our results suggest that an increase of regular physical activity equivalent to 45 min of walking 3 days/week may suffice to improve systolic and diastolic blood pressure, lipid metabolism and BMI in patients with type 2 diabetes.

Development of nocturia in relation to health, age and the menopause.

OBJECTIVES: To analyse the relationship between nocturia, age, the menopausal transition, parturition and hormone replacement treatment (HRT) in women. MATERIAL AND METHODS: A questionnaire study was carried out in 3669 randomly selected women (out of 6000 invited) in the County of Jämtland, Sweden. Questions were asked about health, the occurrence of somatic diseases and symptoms, habits, health care and medication. RESULTS: In univariate analyses age, menopausal state and HRT, but not parturition, were associated with increased nocturia. In a multiple logistic regression analysis, independent correlates for two or more nocturnal micturition episodes versus no more than one episode were: health, poor versus good 2.9 (2.1-3.8); <5 years after the menopause versus before 1.8 (1.3-2.5); 5-9 years after the menopause versus before 2.1 (1.5-3.0); > or =10 years after the menopause versus before 3.1 (2.3-4.2). Age and HRT were deleted by the logistic regression model. CONCLUSION: The present data indicate that menopausal state, but not age, parturition and HRT are independent correlates of nocturia in 40-64-year-old women.

Oral dryness, nocturia and the menopause.

OBJECTIVE: To analyse the relationship between oral dryness (OD), nocturia, the menopausal transition and some medical conditions and medications in women. METHODS: A questionnaire study was carried out in 3669 randomly selected women (out of 6000 invited) in the County of Jämtland, Sweden. Questions were asked about occurrence of somatic diseases and symptoms, nocturia, nocturnal thirst and drinking, and the use of drugs. RESULTS: The occurrence of oral dryness was 17.8% in women before the menopause, 23.3% during the first 5 years after, 29.2% 5-9 years after and 34.5% 10 or more years after the menopause (P < 0.0001). In a multiple logistic regression analysis independent correlates for oral dryness were: nocturnal micturition, one episode versus none 1.7 (1.4-2.1); two versus none 2.4 (1.7-3.2); > or = 3 versus none 3.3 (2.1-5.2); menopausal state: <5 years after the menopause versus before 1.2 (0.9-1.6); 5-9 years after the menopause versus before 1.6 (1.2-2.1); > or = 10 years after the menopause versus before 1.7 (1.3-2.2); musculo-skeletal pain 1.6 (1.3-2.1) being on one or more prescribed drugs 1.8 (1.5-2.1). CONCLUSION: The present data show that OR is a common and disregarded symptom in women with nocturia independent of menopausal state, musculo-skeletal symptoms and medication with analgesics, diuretics, hypnotics and hormonal replacement therapy (HRT).

Smoking during pregnancy: comparison of self-reports and cotinine levels in 496 women.

OBJECTIVE: To validate self-reported smoking habits in smoking pregnant women and estimate the prevalence of substantial exposure to passive smoking in non-smoking pregnant women. DESIGN: Retrospective, quantitative study, consecutively collected samples. SETTING: One antenatal clinic in Blekinge County, Sweden. SUBJECTS: 509 pregnant women. METHOD: Information about smoking habits were taken from the antenatal records of 496 women (97%). Serum samples from these women were tested for cotinine, a nicotine metabolite. MAIN OUTCOME MEASURES: Self-reported smoking habits and cotinine levels in ng/mL. RESULTS: Of 407 women, reporting to be non-smokers, 6% were most likely smokers, and 3% had cotinine levels suggesting exposure to substantial passive smoking. Of 60 women, reporting smoking 1-10 cigarettes per day, 32% were likely to smoke more. CONCLUSION: If the true facts about exposure to tobacco smoke are not revealed, a number of women who might benefit from information and support at the antenatal clinic will miss the opportunity of such assistance, resulting in increased risks for both the woman and her fetus.

Locus of control in relation to smoking cessation during pregnancy.

AIMS: This study was carried out to investigate how the locus of control (LOC) varies between those who stop smoking in connection with pregnancy and those who do not. The LOC reflects the extent to which a person is in control of her or his life events. METHODS: One hundred and two women who were regular smokers at the time of conception and paid their first visits to the antenatal clinic (ANC) on account of the current pregnancy participated. The study was quantitative and questionnaire based, covering background factors, smoking habits, and the LOC. One hundred of the women were met a second time after the delivery. Smoking habits were monitored by the content of carbon monoxide in expired air. The LOC was recorded on a VAS scale (0-10). A lower index was consistent with a more internal LOC and a higher with a more external LOC. RESULTS: The median LOC found was 4.0 (range 1.1-7.9). The LOC was not correlated to the CO in expired air. Younger age was linked to a more internal LOC, while worse sleep was correlated to a more external LOC (p<0.05). No differences were found between those who stopped smoking and those who did not. This was the case in both light and heavy smokers. CONCLUSION: The LOC does not seem to influence the ability to stop smoking during pregnancy.