ABSTRACT
Background. Exercise training intervention is underused in the management of type 2 diabetes mellitus in East Africa. Methods. 41 physically-active males with type 2 diabetes mellitus living in Mozambique were recruited and randomly assigned to 12 weeks of supervised exercise of low intensity exercise (LEX), vigorous intensity exercise (VEX), or to a control group (CON). Since there were no differences for any outcome variables between the exercise groups, VEX and LEX were combined into one exercise group (EX). Results. Age and baseline body weight were similar between EX and CON. Plasma glucose at 120 min following glucose load (Glu 120) was significantly reduced in the EX group after training (Glu 120 : 17.3 mmol/L to 15.0 mmol/L, P < 0.05), whereas Glu 120 remained unchanged in the CON (Glu 120 : 16.6 mmol/L to 18.7 mmol/L). After controlling for baseline blood pressure (BP), posttraining systolic BP and diastolic BP were lower in the EX group than in the CON group (EX: 129/77 mm Hg, CON: 152/83 mm Hg, P < 0.05). Conclusion. Adding exercise to already active African men with type 2 diabetes improved glucose control and BP levels without concomitant changes in weight.
ABSTRACT
O artigo apresenta resultados de um estudo cujo objectivo era determinar o peso da Diabetes Mellitus (DM) tipo 1 entre os doentes com patologia endócrina e a prevalência de hipertensão arterial e complicações oculares no Hospital Central de Maputo (HCM). Do ponto de vista metodológico, a população de estudo foi constituída por cerca de 191 doentes consecutivos com diabetes mellitus tipo 1, observados na consulta de endocrinologia do HCM e na Associação Moçambicana dos Diabéticos, no período de Março de 2006 e Março 2011. A análise estatística dos dados foi feita com recurso ao pacote estatístico SPSS for windows 17.0. Como Resultado, observa-se que a DM tipo 1 representou cerca de 10% dos casos de DM observados no HCM durante o período em referência. Observa-se ainda uma prevalência relativamente elevada da hipertensão arterial (9,9% sistólica e 8,9% diastólica); diferentes tipos de complicações oculares em 14,7% dos doentes de estudo. Também conclui-se que os principais factores de risco para a HTA constituíram a idade em anos e o índice de massa corporal, enquanto que os principais factores de risco para as complicações oculares foram a idade e a duração da doença para a retinopatia diabética (p <.000) e duração da doença para a catarata (p< .001). A Diabetes mellitus tipo 1 constitui um importante problema endócrino nas consultas de especialidade no HCM e apresenta-se com elevada taxa de HTA e complicações oculares.
The article presents results from a study aimed at determining the weight of Diabetes Mellitus (DM) type 1 among patients with endocrine pathologies and the prevalence of hypertension and sight complications in the Maputo Central Hospital (HCM). The research population consisted of 191 consecutive patients with diabetes mellitus type 1 who were observed during endocrinology consultation at the HCM and the Diabetic Mozambican Association, between March 2006 and March 2011. The statistical data was analyzed using SSPS for Windows 17.0. Results showed that DM type 1 represented about 10% of the DM observed cases at the HCM during the period in question. A relatively high prevalence of hypertension was also observed (9.9% systolic and 8.9% diastolic); different types of sight complications were observed in 14.7% of the patients. The study concluded that the main risk factors that cause HTA are age and the body mass index, while that main risk factors for sight complications are age and the duration of the pathology for diabetes retinopathy (p <.000) and the duration of the pathology for cataract (p <.001). the DM type 1 constitutes the most important endocrine problem in the specialized consultations at the HCM and it shows a high rate of HTA and sight complications.
Subject(s)
Humans , Male , Female , Patients , Body Mass Index , Risk Factors , Diabetes Mellitus, Type 1 , Pathology , Disease , Prevalence , Endocrinology , Hospitals , Hypertension , MozambiqueABSTRACT
The authors examined whether the blockage of angiotensin II receptors by irbesartan (IRB) can reverse the "non-dipper" circadian rhythm of blood pressure (BP) to a "dipper" pattern in black salt-sensitive hypertensive patients submitted to a high-sodium loading. Twelve black salt-sensitive hypertensive patients (seven men; age, 35-58 years) on a high-sodium diet (300 mmol Na+ per day) were followed for 8 weeks. A placebo was given during the first 2 weeks, followed by 2 weeks on IRB 150 mg/d, 2 weeks on placebo, and 2 weeks on IRB 300 mg/d. On the last day of placebo, IRB 150 mg/d, and IRB 300 mg/d treatments, 24-hour BP and urinary 24-hour excretion of Na+ and potassium were measured. On placebo, ambulatory mean arterial pressure (MAP) was 112 mm Hg+/-2 (24 h), 112 mm Hg+/-2 (daytime), and 111 mm Hg+/-2 (nighttime), showing a clear circadian non-dipper profile. Versus placebo, IRB 150 mg/d reduced MAP by 4.2 mm Hg+/-1.1 (24 h), 2.6 mm Hg+/-0.8 (daytime) and 6.0 mm Hg+/-1.3 (nighttime; P<0.05 vs. placebo) and IRB 300 mg/d reduced MAP by 7.8 mm Hg+/-1.4 (24 h), 3.9 mm Hg+/-1.1 (daytime), and 11.8 mm Hg+/-2.1 mm Hg (all P<0.02 vs. placebo); nighttime/daytime MAP decrease was 0.7+/-0.8% on placebo, 3.5+/-2.1% on IRB 150 mg/d, and 7.0+/-1.2% on IRB 300 mg/d (P<0.02 for trend). Compared with placebo, IRB significantly increased serum potassium and plasma renin activity and reduced fractional excretion of potassium and plasma aldosterone levels in a dose-dependent manner. Body weight and urinary sodium excretion did not change throughout the study. It was concluded that the angiotensin receptor blocker IRB can reverse the BP non-dipper profile in salt-sensitive hypertensive patients on a high-salt diet, restoring nocturnal BP decline by a predominantly dose-dependent reduction of nighttime BP. Although the increment of potassium balance and reduction of aldosterone may account for this effect, it occurs independently of increased natriuresis. It is speculated that blunting of nighttime BP decrease in black salt-sensitive hypertensive patients may be related to a deficient suppression of the renin-angiotensin system during the night.
