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Role of mental health and quality of life in adherence and effectiveness of a motivational exercise program to improve weight and functionality: “The way to change diabetes”.

Published online by Cambridge University Press:  27 August 2024

J. M. Pelayo-Terán*
Affiliation:
1Psiquiatría y Salud Mental 2Unidad de Calidad y Seguridad del Paciente, Hospital El Bierzo. Gerencia de Asistencia Sanitaria del Bierzo (GASBI). Gerencia Regional de Salud (SACYL), Ponferrada 3Área de Medicina Preventiva y Salud Pública. Departamento de Ciencias Biomédicas, Universidad of León, León 4Grupo CB07/09/2001, Centro de Investigacion Biomédica en Red de Salud Mental (CIBERSAM), Madrid
S. Vega-García
Affiliation:
1Psiquiatría y Salud Mental
Z. Gutiérrez-Hervás
Affiliation:
1Psiquiatría y Salud Mental
M. E. García-Llamas
Affiliation:
5Hospital El Bierzo. Gerencia de Asistencia Sanitaria del Bierzo (GASBI). Gerencia Regional de Salud (SACYL), Ponferrada, Spain
A. Díez-Hernández
Affiliation:
6Servicio de Endocrinología, Hospital El Bierzo. Gerencia de Asistencia Sanitaria del Bierzo (GASBI). Gerencia Regional de Salud (SACYL), Ponferrada, Spain
M. E. López Crespo
Affiliation:
7Bas van de Goor Foundation, Arnhem, Netherlands
D. J. Durán Román
Affiliation:
7Bas van de Goor Foundation, Arnhem, Netherlands 8Delegación Ponferrada, Asociación Salud Mental León, Ponferrada, Spain
H. J. Bilo
Affiliation:
7Bas van de Goor Foundation, Arnhem, Netherlands 9University Medical Center Groningen, Department of Internal Medicine, University of Groningen, Groningen 10Isala Diabetes Research Center, Zwolle, Netherlands
Y. Zapico Merayo
Affiliation:
1Psiquiatría y Salud Mental
*
*Corresponding author.

Abstract

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Introduction

Exercise and other lifestyles are key treatment strategies to improve diabetes outcome, prevent cardiovascular risk and may also result in further results in quality if life and emotional symptoms.

Objectives

To evaluate the effectiveness of an exercise intervention program for people with diabetes or cardiovascular risk.

To evaluate the influence of previous metal health and quality of life status in the results.

Methods

61 people with a type 2 diabetes or cardiovascular risk factors were recruited from health primary health centers in Ponferrada (EL Bierzo), including patients from the mental health association. After informed consent they were included in a 20 week, twice a week supervised walking training program to improve exercise and other lifestyles. A poster used for advertisement of the adtivity (“the way/walk to change diabetes”) is displayed in image 1). Baseline and after 20 weeks BMI and Waist perimeter were assessed, quality of life was evaluated with EQ-5D-5L and WHO-5 scales and the weekly steps walked were recorded previously and after the intervention with the subject usual mobile device.

Differences in the variables were compared with Paired Ts and repeated ANCOVAs measures adjusted by gender, age and initial steps.

Results

46 subjects (75.4%) completed more than 90% of the sessions and 3 more 70-90%. The 19.7% that did not complete had worse scores in SF-12 Role Physical (t 2.261, p=0.041) and Role Emotional (t:2.048, p=0.045) and Mental Component Summary (t:2,313; p=0,036) and WHO5 Total Score (t:2.101; p=0,040) at Baseline. Main reasons for dropout (Image 2) were health related problems (50%) and adherence to exercise and motivation problems (31.25%).

Those who completed the training improve number of weekly steps (baseline: 42022,92 +- 18836,35, final: 66448.06 +-28914,58; t:5.038; p<0.001), BMI (29.45 +-4.66 to 28.25 +-4.09 kg/m2; t:5.629; p<0.001), waist (from 107,34 + 9.98 to 102,88 +9,79 cm; t:6,840; p<0.001) and the EoQ-5D-EL VAS (form 72.88 to 82.42; t:6.122; p<0.001, image 3). The increase in the steps correlated directly with the improvement in the EoQ VAS (r:0.308; p=0.033).

Image:

Image 2:

Image 3:

Conclusions

Exercise and lifestyle supervised intervention programs appear to be useful to improve physical health, wellbeing, emotional symptoms and quality of life in people with diabetes and cardiovascular risk.

Factors associated to higher dropout rates were previous limited quality of life scores and mental health worse status. These could be related with limited motivation and adherence to the program and may be of interest to develop specific strategies for these high-risk groups.

Studies focused on the long-term effect of the program are warranted.

Disclosure of Interest

None Declared

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of European Psychiatric Association
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