Correlates of physical activity and sitting time in adults with type 2 diabetes attending primary health care in Oman

Abstract Background Despite evidence of the benefits of physical activity in the management of type 2 diabetes, it is poorly addressed in diabetes care. This study aimed to identify the prevalence and correlates of meeting ≥600MET-min/wk. (150 min/wk) of physical activity and sitting time in adults with type 2 diabetes in Oman. Approaches to encourage physical activity in diabetes care were explored. Methods A cross-sectional study using the Global Physical Activity Questionnaire was conducted in 17 randomly selected primary health centres in Muscat. Clinical data including co-morbidities were extracted from the health information system. Questions on physical activity preferences and approaches were included. Patients were approached if they were ≥18 years, and had been registered in the diabetes clinic for >2 years. Results The questionnaire was completed by 305 people (females 57% and males 43%). Mean age (SD) was 57 (10.8) years and mean BMI (SD) was 31.0 (6.0) kg/m2. Duration of diabetes ranged from 2 to 25 (mean 7.6) years. Hypertension (71%) and dyslipidaemia (62%) were common comorbidities. Most (58.4%) had an HbA1c ≥7% indicating poor glycaemic control (55% in males vs 61% in females). Physical activity recommendations were met by 21.6% of the participants, mainly through leisure activities. Odds of meeting the recommendations were significantly higher in males (OR 4.8, 95% CI 2.5–9.1), individuals ≤57 years (OR 3.0, 95% CI 1.6–5.9), those at active self-reported stages of change for physical activity (OR 2.2, 95% CI 1.2–4.1) and those reporting no barriers to performing physical activity (OR 2.7, 95% CI 1.4–4.9). Median (25th, 75th percentiles) sitting time was 705 (600, 780) min/d. Older age (>57 years) was associated with longer sitting time (>705 min/d) (OR 2.8, 95% CI 1.7–4.6). Preferred methods to support physical activity in routine diabetes care were consultations (38%), structured physical activity sessions (13.4%) and referrals to physical activity facilities (5.6%) delivered by a variety of health care providers. Conclusions The results suggest that intervention strategies should take account of gender, age, opportunities within daily life to promote active behaviour and readiness to change. Offering physical activity consultations is of interest to this study population, thus development and evaluation of interventions are warranted

Is 25-Hydroxyvitamin D Associated with Glycosylated Hemoglobin in Patients with Type 2 Diabetes Mellitus in Saudi Arabia? A Population Based Study

Background: Saudi Arabia has a high burden of diabetes mellitus and vitamin D deficiency. The objective of this study was to explore the association between glycosylated hemoglobin and 25-hydroxyvitamin D in patients with type 2 diabetes mellitus (T2DM) in Riyadh, Saudi Arabia. Methods: An interview based cross-sectional study was conducted on 606 patients with type 2 diabetes, aged 30–75 years, visiting primary health care centers. Blood samples were collected for measuring HbA1c, 25(OH)D and bone and lipid markers. Multivariable linear regression analysis was conducted to explore the association between HbA1c and 25(OH)D. Results: The mean (±SD) levels for HbA1c and 25(OH) D were 7.69 (±1.77) and 44.28 (±23.06), respectively. Around 55% of patients had uncontrolled HbA1c (>7.0), whereas vitamin D deficiency (<50 nmol/L) was found in 52.3% (=317). Multiple linear regression analysis found that a unit increase in vitamin D levels and parathyroid hormone levels was associated with −0.17 (−0.02, −0.01, p < 0.001) and −0.20 (−2.66, −1.18, p < 0.001) unit decrease in levels of HbA1c, respectively. Similarly, increasing age was associated with −0.15 (−0.01, −0.04, p = 0.002) unit decrease in HbA1c levels, whereas unit increases in serum alkaline phosphatase, calcium and diabetes duration were associated with 0.22 (0.01, 0.02, p < 0.001), 0.14 (1.03, 3.88, p = 0.001) and 0.26 (0.42, 0.78, p < 0.001) unit increase in HbA1c levels, respectively. Conclusion: HbA1c levels are associated with 25-hydroxyvitamin D levels. For better control of HbA1c levels, it is important to maintain 25-hydroxyvitamin D level and bone markers within normal range

Prevalence of Anemia and Associated Factors in Child Bearing Age Women in Riyadh, Saudi Arabia

Objective. To determine the prevalence and risk factors for anemia in child bearing age women in Riyadh, Saudi Arabia. Design. Cross-sectional survey was conducted using two-stage cluster sampling. 25 clusters (primary health care centers (PHCC)) were identified from all over Riyadh, and 45–50 households were randomly selected from each cluster. Eligible women were invited to PHCC for questionnaire filling, anthropometric measurements, and complete blood count. Blood hemoglobin was measured with Coulter Cellular Analysis System using light scatter method. Setting. PHCC. Subjects. 969 (68%) women out of 1429 women were included in the analysis. Results. Mean hemoglobin was 12.35 (±1.80) g/dL, 95% CI 12.24–12.46 with interquartile range of 1.9. Anemia (Hb <12 g/dL) was present in 40% (390) women. Mean (±SD) for MCH, MCV, MCHC, and RDW was 79.21 (±12.17) fL, 26.37 (±6.21) pg, 32.36 (±4.91) g/dL, and 14.84 (±4.65)%, respectively. Multivariate logistic regression revealed that having family history of iron deficiency anemia (OR 2.91, 95% CI 1.78–4.76) and infrequent intake of meat (OR 1.54, 95%CI 1.15–2.05) were associated with increased risk of anemia, whereas increasing body mass index (OR 0.95, 95% CI 0.92–0.97) was associated with reduced risk of anemia. Conclusion. Women should be educated about proper diet and reproductive issues in order to reduce the prevalence of anemia in Saudi Arabia

Barriers to a healthy lifestyle among patients attending primary care clinics at a university hospital in Riyadh

<b>Background And Objectives: </b> The occurrence and progress of chronic non-communicable diseases (NCDs) is associated with unhealthy lifestyles and behaviors. Modification of barriers to healthy lifestyle can produce great benefits. The objective of this study was to identify barriers to physical activity and healthy eating among patients attending primary health care clinics in Riyadh city. <b> Patients and Methods: </b> A cross-sectional study was conducted at King Khalid University Hospital (KKUH) in Riyadh city. Four hundred and fifty participants attending primary health care clinics (PHCC) from 1 March to 30 April 2007 were randomly selected. A questionnaire about barriers to physical activity and healthy eating was adapted from the CDC web site. <b> Results: </b> The prevalence of physical inactivity among the Saudi population in the study was 82.4&#x0025; (371/450). Females were more physically inactive (87.6&#x0025;, 268/306) compared to males (71.5&#x0025;, 103/144) (P&#60; .001). The most common barrier to physical activity was lack of resources (80.5&#x0025;, 326/405), which was significantly higher among females than males and among the lower income versus the higher income group. The most common barrier to healthy diet was lack of willpower. More than four-fifths (80.3&#x0025;, 354/441) of the study group stated that they did not have enough will to stick to a diet. <b> Conclusion: </b> Lack of resources was the most important barrier for physical activity, while lack of willpower and social support were both barriers for adherence to physical activity and a healthy diet