糖尿病(Diabetes mellitus)是指個體因體內胰島素分泌不足所導致一系列的綜合病徵,自1987年後在國人十大死因中即居前五位,是台灣地區一項盛行率相當高的慢性疾病。研究目的:本研究之主要目的為運用劑量反應關係解釋糖尿病患者在接受藥治療制期間之身體活動量與病情控制之機轉,並運用劑量反應關係概念解釋研究結果,藉以提供糖尿病患日常照護身體活動量之建議量參考準則。研究方法:本研究以屏東地區持續就診且接受糖尿病醫療照護之民眾共210人(平均年齡為62.3±9.65歲)為受試對象,平均血糖值142.51±48.33mg/dl、糖化血色素為7.63±1.56%。研究工具採國際身體活動量問卷 (International Physical Activity Questionairre, IPAQ) ,並交叉比較受試對象之就診病歷資料與血液生化檢測數值。研究結果:結果顯示糖尿病受試對象之身體活動量與血糖控制間,糖化血色素控制良好與不良之受試對象平均每週進行走路活動未達顯著水準(3.61±3.16次、3.10±3.13次);走路時間達顯著差異水準(132.74±167.50分鐘、87.35±92.6分鐘),換算之代謝當量為7 Met h/week;平均每次走路時間則分別為37分鐘與28分鐘,勝算比為1.23。研究者並經由IPAQ評估,將所有受試對象的生活型態進行分類為低度、中度及高度動態生活;不同生活型態在血糖控制控制上,中度與高度動態生活之糖尿病患明顯優於低度動態生活者,在糖化血色素控制上,中度動態生活者明顯優於其他兩類型生活型態。結論:本研究提出糖尿病患閒暇時間身體活動建議量;每週走路次數五天、並推估50% 最大耗氧量或以乳酸閾值為運動強度臨界點、每次步行最少時間為37分鐘,在糖化血色素控制上較易得到顯著成效。相關研究結果配合「運動即良藥(Excreise is medicine)」之原則,可提供代謝症候群相關診療過程中開之立運動處方建議量依據。
Diabetes mellitus is a metabolic disorder characterized by high blood sugar (glucose) levels. It has been ranked at top five among Cause-specific Mortality Rates since 1987 in Taiwan. Purpose: The purpose of this study was to investigate the association between physical activity and the status of diabetes mellitus, and applied the theory of dose-response relationships to explain the interaction among these factors. Method: A total of 210 patients were recruited (mean age was 62.3±9.65; blood glucose 142.51±48.33mg/dl and HbA1c 7.63±1.56 %) in this study and the International Physical Activity Questionnaire (IPAQ) was used as a structured interview to determine a subject’ physical activity. These subjects’ were divided into two groups that depended on their glycated hemoglobin (HbA1c) control: an HbA1c under-control group and a beyond-control group. ANOVA and logistic regression were used to estimate relationships among subjects’ physical activity with physiological measures and blood biochemical parameters in this study. Results: The results indicated that the moderate/vigorous lifestyle might play an important role in the treatment of type 2 diabetes. Additionally, the average duration of walking time/per day was 37 min in the HbA1c under-control group, while only 28 minutes in the HbA1c beyond-control group with the odds ratio was 1.23. Conclusions: In conclusion, for those patients who need to control their HbA1c and glucose level, the appropriate physical activity is walking, with 5 days/week, 37 min/per walking, may achieve the expectable goals.