第二類型糖尿病人之身體活動建議量初探

A Preliminary Study of Recommendations for Physical Activity for Patients with Type 2 Diabetes

徐錦興(Chin-Hsing Hsu) ； 曹德弘(Te-Hsung Tsao) ； 張蕙雯(Hui-Wen Chang)

《台灣公共衛生雜誌》 30卷1期 (2011/02) Pp. 72-81

https://doi.org/10.6288/TJPH2011-30-01-08

摘要

目標：本研究目的在探討糖尿病人身體活動量與病情控制的關係，並運用劑量反應關係解釋研究結果，以提供糖尿病照護上對身體活動的建議量。方法：研究採橫斷性調查設計，初期招募220名糖尿病人為預備受試對象。研究工具為國際身體活動量表；以12個月為期，對所有受試對象進行身體活動量前後調查。在確認一年間維持同一生活型態的前提下，選擇210位為正式受試對象，再依糖化血色素控制情形分為控制良好與控制不良組。身體活動資料並與生理及血液生化檢測值進行羅吉斯迴歸分析。結果：不同生活型態的糖尿病人在血糖與糖化血色素控制上，其劑量反應關係圖形皆呈“反J”曲線，顯示中度與高度身體活動之糖尿病人的病情控制顯著優於低度身體活動者。糖化血色素控制良好組平均每天步行時間為37分鐘、控制不良組為28分鐘；其勝算比值為1.26。結論：建議糖尿病人可用「走路」為提高身體活動量的主要模式，頻率為每週6天、每天至少37分鐘，在病情控制上較易得到顯著成效。

關鍵字

身體活動 ； 糖化血色素 ； 走路時間 ； 劑量反應關係

並列摘要

Objectives: The aims of this study were to investigate the association between physical activity and the status of diabetes mellitus control and to provide recommendations for physical activity for patients with type 2 diabetes. Methods: In this cross-sectional study, 220 patients were recruited in the initial phase. The International Physical Activity Questionnaire was used to determine the level of physical activity for each subject. The study was carried out over 12 months with a pretest/posttest design to determine if patients still maintained the same lifestyle; 210 patients met this criterion. These subjects were then divided into two groups based on their glycated hemoglobin (HbA1c) control: an HbA1c under-control group and an out-of-control group. Logistic regression analysis was used to estimate relationships among subjects' physical activity, physiological measures, and blood biochemical parameters on the posttest. Results: The results indicated that there was an inverse-J shape relationship between lifestyle and blood glucose/HbA1c. This demonstrated that moderate/vigorous physical activity might play an important role in the treatment of type 2 diabetes. The average duration of walking time/per day was 37 min in the HbA1c under-control group, while only 28 minutes in the HbA1c out-of-control group; the odds ratio was 1.26. Conclusions: We suggest that an appropriate physical activity for patients with type 2 diabetes is walking, 6 days/week, at least 37 min per day. This produced significant effects in HbA1c control.

並列關鍵字

physical activity ； glycated hemoglobin ； walking time ； dose-response relationship

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