Perfil biopsicossocial e o efeito agudo do exercício físico sobre as variáveis cardiometabólicas em pessoas com diabetes tipo 2
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2021-07-22
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Universidade Federal de Goiás
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Diabetes Melittus is a chronic and metabolic condition that affects a large part of the world population, and Brazil is one of the countries with the highest prevalence of the disease. Hyperglycemia causes chronic micro and macro vascular complications that are associated with increased morbidity and reduced quality of life. There is also evidence that type 2 diabetes (DM2) seems to be related to impaired mental health, especially symptoms of depression and anxiety. Physical exercise is an important ally, acting on glycemic control and other comorbidities, in addition to attenuating anxiety levels and depressive symptoms, improving quality of life in patients with DM. In view of the possible bidirectional association between diabetes and depression, and the scarce literature on the acute effect of exercise on the health of this population, it is necessary to analyze the most appropriate protocols, and also, to investigate the biopsychosocial aspects among people with DM in order to contribute for the treatment, prognosis and improvement of the quality of life of this population.
The aim of the present study was to assess the biopsychosocial profile, the health-related quality of life and the impact of acute physical exercise on cardiometabolic variables in patients with DM2. It consists of a collection of articles, the first being a systematic review, the second a cross-sectional study, and the third an experimental study, of the randomized clinical trial type. The first study included randomized controlled trials and case studies that reported the acute effect of high-intensity interval training (HIIT) on the general health status of people with diabetes. In studies 2 and 3, patients were recruited in the 3rd Diabetes Task Force, including sedentary patients with DM2; older than 40 years (Participants’ age of study 2 and 3 respectively: 56.2 ± 9.6; 55.9 ± 1.25). For study 2, anthropometric and biochemical assessments were performed, including waist circumference (WC), body mass index (BMI) and fasting blood glucose. In addition, biopsychosocial questionnaires were applied to assess quality of life and symptoms of depression and anxiety. For study 3, clinical evaluation, cardiopulmonary stress testing and intervention with acute protocols were also performed. Patients were randomly randomized between 3 training protocols: HIIT 2: 2 (long), HIIT 30:30 (short) and continuous training of moderate intensity (TCMI), and a training session was held with each participant. Blood pressure, heart rate and blood glucose were measured ten minutes before, at the peak of the exercise (immediately after the last shot / minute) and 10 minutes after the end of the session; and during exercise, the subjective effort perception values were recorded. Study 1 showed that HIIT seems to be a safe and effective alternative in glycemic control and associated factors, with an acute effect superior to TCMI in markers such as capillary and fasting glucose, 24-hour glycemic profile, post-prandial glucose, incidence and prevalence of hyperglycemia, vascular function and pressure response, and control of inflammatory markers. Study 2 showed that the majority of individuals with diabetes are overweight and altered WC. In addition, that the prevalence of depression (34.1%), and the levels of trait and state anxiety (63.3% and 77%) are high in this population. The study also showed that people with diabetes and symptoms of depression have a worse quality of life, high anxiety and changes in WC. Study 3, on the other hand, showed that the HIIT 30:30 and HIIT 2: 2 protocols are effective in controlling glycemic and acute blood pressure in patients with DM2. In addition, that long HIIT protocols are more effective than short HIIT. It is concluded that physical exercise has several acute beneficial effects on the health of the diabetic population, and that HIIT seems to be a safe and effective alternative in controlling glycemic and associated factors, being superior to continuous training of moderate intensity. It is also concluded that diabetes is directly related to biopsychosocial factors, mainly quality of life and depression, thus requiring greater attention to these aspects in the treatment of the disease. It is expected that the identification of the safest and most efficient exercise protocols, and that the investigation of the most common biopsychosocial aspects among people with diabetes will contribute to the treatment and improve the quality of life of this population.
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TELES, G. O. Perfil biopsicossocial e o efeito agudo do exercício físico sobre as variáveis cardiometabólicas em pessoas com diabetes tipo 2. 2021. 119 f. Dissertação (Mestrado em Educação Física) - Universidade Federal de Goiás, Goiânia, 2021.