Fryer, Bradley James (2016-03)
an extensive research into the pathophysiological mechanisms, and to some extent, the management
of T2DM, healthcare systems are still not able to adequately deal with the increasing number of
patients being diagnosed with the disease. Professional- and community-led lifestyle interventions
have recently showed the most promise in combating T2DM. There is however, a paucity of data on
comprehensive lifestyle interventions in communities of low socio-economic status (SES), where
the incidence of T2DM and its related complications is high.
The primary aim of this study was to determine the effectiveness of a community-based, 10-week
lifestyle intervention on physiological, psychological and health-related outcomes in adults
suffering with T2DM in a low SES community.
Forty-three participants completed the study (age 59.5 ± 12.2 years, 25 Women; 18 Men), of which
23 made up the experimental group (EXP; BMI: 33.8 ± 7.5; HbA1c: 8.8 ± 2.1) and 20 made up the
control group (CON; BMI: 34.4 ± 9.7; HbA1c: 9.4 ± 2.3). The control group completed a pre- and
post-testing session, while experimental completed an additional post-testing retention session. The
experimental group participated in a 10-week comprehensive lifestyle intervention. A number of
anthropometric, cardiovascular and functional measurements were carried out, and questionnaires
related to health-related quality of life (HRQoL), social support, dietary habits and lifestyle
behaviours, as well as health professional usage were also administered.
Following the 10-week comprehensive lifestyle intervention, there was a positive change in the
outcome variables measured. There was a statistically significant decrease (p < 0.05) in body fat
percentage, diastolic blood pressure and HbA1c, with a statistically significant increase in the total
distance walked during the six-minute walk test (6MWT) (p < 0.05). Furthermore, there was a
statistically significant improvement (p < 0.05) in all but three of the HRQoL domains. Dietary
habits and lifestyle behaviours improved significantly (p < 0.05), with the exception of eating times
where there was no change. The frequency at which the participants actively sought professional
assistance with the management of their T2DM did not change significantly (p > 0.05). The results
from the retention period, obtained 10-weeks after the conclusion of the intervention, suggest that the changes as a result of the program were maintained, however, it is uncertain if those results can
be attributed to the use of the post-intervention guide.
The findings of this study indicate that a 10-week comprehensive lifestyle intervention is effective
in improving physiological, psychological and health-related outcomes in adults with T2DM living
in a low SES community. The use of a post-intervention guide as an assistive device to maintain
these improvements requires further investigation and revision. Furthermore, this study reveals the
opportunity for community-based interventions to assist the primary healthcare sector in the
management and prevention of T2DM.
AFRIKAANSE OPSOMMING : Die toeneemende voorkoms en geassosieerde las van tipe-twee diabetes mellitus (T2DM), global en
in Suid Afrika, affekteer beide mans en vrouens van alle ouderdomme. Alhoewel daar ekstensiewe
navorsing gedoen is in patofisologiese meganismes en tot sekere mate die bestuur van T2DM,
sukkel gesondheidsorg stestels nogsteeds met ‘n toename in pasïente gediagnoseerd met die siekte.
Onlangs is dit bewys dat professionele- en geemeenskap begeleide leefstyl intervensies toon die
hoogste potensiaal om T2DM teen te werk. Daar is egter min data oor volledige leefstyl
intervensies in geemeenskappe van lae-ekonomiese status (LES) waar die voorkoms van T2DM en
sy verwante komplikasies hoog is.
Die primêre doel van die studie was om die effektiwiteit van ‘n gemeenskap-gebaseerde 10-weke
leefstyl intervensie op fisiologiese, sielkundige en gesonheids-verwante uitkomste in volwassenes
met T2DM in LES gemeenskap te bepaal.
Drie en veertig deelnemers het die studie voltooi (ouderdom 59.5 ± 12.2 jaar, 25 Vrouens; 18
Mans). 23 deelnemers was deel van die eksperimentele groep (EKS; LMI: 33.8 ± 7.5; HbA1c: 8.8 ±
2.1) en 20 deelnemers het gedien as die kontrole groep (KON; LMI: 34.4 ± 9.7; HbA1c: 9.4 ± 2.3).
Die kontrole groep het voor en na toetsing vooltooi, terwyl die eksperimentele groep ‘n addisionele
toetsing na ‘n retensie periode afgelê het. Die eksperimentele groep het deelgeneem in ‘n 10-weke
volledige leefstyl intervensie. Antropometriese, kardiovaskulêre en funksionele metings is geneem,
en vraelyste aangaande gesondheids verwante lewens kwaliteit (HRQoL), sosiale bystand, dieet en
leefstyl gewoontes, asook gebruik van mediese dienste was geadministreer.
Daar was positiewe uitkomsveranderlikes na die 10-weke volledige leefstyl intervensie. Daar was
‘n statistiese beduidende daling (p < 0.05) in liggaamsvet persentasie, diastoliese bloeddruk, en
HbA1c, met ‘n statistiese beduidende toename (p < 0.05) in die totale afstand gestap gedurende die
ses minute stap toets (6MST). Verder, was daar ‘n statistiese beduidende verbetering (p < 0.05) in
almal behalwe drie van die HRQoL domeine. Dieet en leefstyle gewoontes het statisties beduidende
verbeter (p < 0.05) met die uitsondering van etenstye waar geen verandering plaasgevind het nie.
Daar was geen statistiese beduidende verandering (p > 0.05) in die gebruik van mediese dienste om
T2DM te bestuur nie. Na gelang van die 10-weke retensie periode blyk dit dat die uitkomste van die intervensie behoue gebly het, alhoewel dit onseker is of dit toegesryf kan word aan die oefenings
Die bevindinge van die studie bewys dat ‘n 10-weke volledige leefstyl intervensie effektief is om
fisiologiese, sielkundige en gesonheids-verwante uitkomste in volwassenes met T2DM in LES
gemeenskappe te verbeter. Die oefenings handleiding as ‘n addisionele hulpbron om die verbetering
te behou verg verdere ondersoek. Die studie toon die geleentheid vir verder gemeenskap
gebasseerde intervensies om die primêre gesonheidsdiens sektor by te staan met die bestuur en
voorkoms van T2DM.
Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/98537
This item appears in the following collections: Doctoral Degrees (Sport Science)27
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