ABSTRACT
Introduction: Moderate-to-high physical activity participation is associated with a reduced risk of infertility. Yet, exercise interventions that target cardiorespiratory fitness, independent of weight loss, are lacking in obesity and female fertility research. Purpose: The primary objective of the PRO-FIT-CARE (PROmoting FITness for CArdiometabolic & REproductive Health) study was to assess the feasibility of a moderate-to-high-intensity online exercise program for persons with obesity and female infertility. Methods: Feasibility, safety, acceptability, and efficacy were assessed by examining: (1) recruitment and consent rate, (2) study retention, (3) adverse events, (4) participant satisfaction, (5) adherence, and (6) cardiorespiratory fitness. Results: Eleven of thirty-two women contacted agreed to participate in the program (34.4% consent rate). Eight participants (72.7%) completed the study. One musculoskeletal injury was reported. There was a 30% adherence rate based on prescribed exercise intensity (60%-80% of heart rate maximum). One of eleven participants attended 80% of the exercise intervention. Based on a weekly satisfaction survey, the program had an overall high level of satisfaction. Compared to sex and age normative data, post-intervention, two of eight participants improved their cardiorespiratory fitness percentile rank. Conclusion: The study highlights challenges with adherence to an online exercise program. While the program was safe and participants reported high levels of program satisfaction, approaches to improve adherence must be incorporated.
ABSTRACT
AIM: To examine the patient characteristics associated with early initiation of insulin after a diagnosis of Type 2 diabetes. METHODS: We analysed cross-sectional data from the 2012 Canadian Community Health Survey conducted by Statistics Canada. Multivariable logistic regression was used to explore the association between patient sociodemographic and health status characteristics and initiating insulin within 1 year of a diagnosis of Type 2 diabetes (early insulin use). RESULTS: Weighted estimates for the Canadian population showed that 32% of patients with Type 2 diabetes initiated insulin within 1 year of their diagnosis. Of the insulin initiators, 52% were female and 68% were aged ≥60 years. Factors strongly associated with early initiation of insulin were age (60-69 years: adjusted odds ratio 1.89, 95% CI 1.84-1.94; ≥ 70 years, odds ratio 2.08, 95% CI 2.01-2.15, both vs 40-49 years); smoking (smoker vs never: odds ratio 2.39, 95% CI 2.32-2.46); geography (Western Canada: odds ratio 2.75, 95% CI 2.69-2.81; Quebec: odds ratio 2.20, 95% CI 2.13-2.27, both vs Ontario); mental health (poor vs excellent: odds ratio 1.98, 95% CI 1.92-2.04); BMI (overweight vs normal/underweight: odds ratio 1.63, 95% CI 1.58-1.67); oral antidiabetic medication use (yes vs no: odds ratio 0.66, 95% CI 0.65-0.68); and alcohol use (regular vs non-drinker: odds ratio 0.66, 95% CI 0.65-0.68). CONCLUSION: One-third of the study population with Type 2 diabetes initiated insulin within their first year of diagnosis. Age, smoking status, geographical location, mental health, BMI, education, oral antidiabetic medication use, employment, physical activity, language, doctor visits and alcohol consumption were associated with timing of insulin initiation.
