Exercise and type 2 diabetes

Proefschrift dat onder andere een tweejarig interventie-onderzoek beschrijft naar het effect van een bewegingsprogramma bij personen met type 2 diabetes

Reduced oxidation rates of ingested glucose during prolonged exercise with low endogenous CHO availability.

Reduced oxidation rates of ingested glucose during prolonged exercise with low endogenous CHO availability. Jeukendrup AE, Borghouts LB, Saris WH, Wagenmakers AJ. Department of Human Biology, University Maastricht, The Netherlands. [email protected] This study investigated the effect of endogenous carbohydrate (CHO) availability on oxidation rates of ingested glucose during moderate-intensity exercise. Seven well-trained cyclists performed two trials of 120 min of cycling exercise in random order at 57% maximal O2 consumption. Preexercise glycogen concentrations were manipulated by glycogen-lowering exercise in combination with CHO restriction [low-glycogen (LG) trial] or CHO loading [moderate-to-high-glycogen (HG) trial]. In the LG and HG trials, subjects ingested 4 ml/kg body wt of an 8% corn-derived glucose solution of high natural 13C abundance at the start, followed by boluses of 2 ml/kg every 15 min. The third trial, in which potato-derived glucose was ingested, served as a control test for background correction. Exogenous glucose oxidation rates were calculated from the 13C enrichment of the ingested glucose and of the breath CO2. Total CHO oxidation was lower in the LG trial than in the HG trial during 60-120 min of exercise [84 +/- 7 (SE) vs. 116 +/- 8 g; P < 0.05]. Exogenous CHO oxidation in this period was 28% lower in the LG trial compared with the HG trial. Maximal exogenous oxidation rates were also lower (P < 0.05) in the LG trial (0.64 +/- 0.05 g/min) than in the HG trial (0.88 +/- 0.04 g/min). This decreased utilization of exogenous glucose was accompanied by increased plasma free fatty acid levels (2-3 times higher) and lower insulin concentrations. It is concluded that glycogen-lowering exercise, performed the evening before an exercise bout, in combination with CHO restriction leads to a reduction of the oxidation rate of ingested glucose during moderate-intensity exercise. Publication Types: Clinical Trial Randomized Controlled Tria

Toetsing en motivatie: Synergie en balans in formatief handelen en summatief toetsen beïnvloeden vanuit een systemisch perspectief

Leraren in het voortgezet onderwijs die formatief handelen geven informatie over hoe het beoogde doel te bereiken. Leraren die summatief toetsen geven een geïnformeerd oordeel over prestaties. Formatief handelen heeft een motiverende werking, terwijl summatief toetsen niet per se schadelijk is voor de motivatie van leerlingen. Op basis van de resultaten uit het proefschrift van Krijgsman (2021) adviseren we formatief handelen en summatief toetsen te combineren, zodat beide functies elkaar versterken (synergie) zonder eenzijdig de nadruk op een van beiden te leggen (balans). Tot op heden blijft deze synergie en balans uit. Factoren in het gehele onderwijs-ecosysteem beïnvloeden dit. Scholen hebben bijvoorbeeld een grote mate van autonomie op het gebied van toetsing. Tegelijk ontbreekt er een eenduidig landelijk kader voor toetsbeleid en is er behoefte aan professionele ontwikkeling voor schoolleiders, teamleiders en leraren op het gebied van toetsdeskundigheid. Daarnaast worden de behoeften van leerlingen rondom toetsing veelal niet geïnventariseerd bij de ontwikkeling van toetsvisie en -beleid. We pleiten voor een samenwerking tussen leerlingen, leraren, teamleiders, schoolleiders, regionale of nationale leiders, beleidsmakers en wetenschappers, om vanuit een systemisch perspectief dit complexe vraagstuk aan te pakken

The Effect Of Interface Type On Visual Error Checking Behavior

During data entry tasks, small errors can result in catastrophe, for instance adding an extra zero to a drug dose when programming an infusion in a hospital. For this reason understanding users’ error checking behavior is highly important. One aspect that can affect error checking is the interface that a user must interact with to enter data. Often user interaction with interfaces is evaluated based on speed or error rate. In this paper, in addition to this, we also explore how different types of interface can affect a user’s error checking behavior in a multitasking environment. We show that a fast to use and familiar interface discourages users from carrying out thorough visual checking in a number transcription task. We also found that having participants perform an additional secondary task while doing the number entry task made participants less likely to check the inputted numbers for errors

Uncoupling protein 3 content is decreased in skeletal muscle of patients with type 2 diabetes.

Diabetes 2001 Dec;50(12):2870-3 Related Articles, Books, LinkOut Uncoupling protein 3 content is decreased in skeletal muscle of patients with type 2 diabetes. Schrauwen P, Hesselink MK, Blaak EE, Borghouts LB, Schaart G, Saris WH, Keizer HA. Department of Human Biology, Maastricht University, Maastricht, the Netherlands. [email protected] Recently, a role for uncoupling protein-3 (UCP3) in carbohydrate metabolism and in type 2 diabetes has been suggested. Mice overexpressing UCP3 in skeletal muscle showed reduced fasting plasma glucose levels, improved glucose tolerance after an oral glucose load, and reduced fasting plasma insulin levels. However, data regarding the expression of UCP3 in patients with type 2 diabetes is inconsistent, and so far, there have been no reports of UCP3 protein content. Here we compared, for the first time, the protein levels of UCP3 in vastus lateralis muscle in 14 male type 2 diabetic patients (age 49.8 +/- 2.1 years; BMI 27.2 +/- 1.2 kg/m(2); mean +/- SE) with 16 male control subjects (age 48.0 +/- 1.9 years; BMI 23.4 +/- 0.6 kg/m(2)). We found that UCP3 protein levels were twice as low in patients with type 2 diabetes compared with control subjects (117 +/- 16 vs. 58 +/- 12 AU; P = 0.007). There was no correlation between UCP3 content and BMI. In conclusion, UCP3 content is lower in type 2 diabetic patients compared with healthy control subjects. These results are consistent with a role for UCP3 in glucose homeostasis and suggest a role for UCP3 in type 2 diabetes

Alternative Oxidase Dependent Respiration Leads to an Increased Mitochondrial Content in Two Long-Lived Mutants of the Ageing Model Podospora anserina

The retrograde response constitutes an important signalling pathway from mitochondria to the nucleus which induces several genes to allow compensation of mitochondrial impairments. In the filamentous ascomycete Podospora anserina, an example for such a response is the induction of a nuclear-encoded and iron-dependent alternative oxidase (AOX) occurring when cytochrome-c oxidase (COX) dependent respiration is affected. Several long-lived mutants are known which predominantly or exclusively respire via AOX. Here we show that two AOX-utilising mutants, grisea and PaCox17::ble, are able to compensate partially for lowered OXPHOS efficiency resulting from AOX-dependent respiration by increasing mitochondrial content. At the physiological level this is demonstrated by an elevated oxygen consumption and increased heat production. However, in the two mutants, ATP levels do not reach WT levels. Interestingly, mutant PaCox17::ble is characterized by a highly increased release of the reactive oxygen species (ROS) hydrogen peroxide. Both grisea and PaCox17::ble contain elevated levels of mitochondrial proteins involved in quality control, i. e. LON protease and the molecular chaperone HSP60. Taken together, our work demonstrates that AOX-dependent respiration in two mutants of the ageing model P. anserina is linked to a novel mechanism involved in the retrograde response pathway, mitochondrial biogenesis, which might also play an important role for cellular maintenance in other organisms

Does inter-vertebral range of motion increase after spinal manipulation? A prospective cohort study.

Background: Spinal manipulation for nonspecific neck pain is thought to work in part by improving inter-vertebral range of motion (IV-RoM), but it is difficult to measure this or determine whether it is related to clinical outcomes. Objectives: This study undertook to determine whether cervical spine flexion and extension IV-RoM increases after a course of spinal manipulation, to explore relationships between any IV-RoM increases and clinical outcomes and to compare palpation with objective measurement in the detection of hypo-mobile segments. Method: Thirty patients with nonspecific neck pain and 30 healthy controls matched for age and gender received quantitative fluoroscopy (QF) screenings to measure flexion and extension IV-RoM (C1-C6) at baseline and 4-week follow-up between September 2012-13. Patients received up to 12 neck manipulations and completed NRS, NDI and Euroqol 5D-5L at baseline, plus PGIC and satisfaction questionnaires at follow-up. IV-RoM accuracy, repeatability and hypo-mobility cut-offs were determined. Minimal detectable changes (MDC) over 4 weeks were calculated from controls. Patients and control IV-RoMs were compared at baseline as well as changes in patients over 4 weeks. Correlations between outcomes and the number of manipulations received and the agreement (Kappa) between palpated and QF-detected of hypo-mobile segments were calculated. Results: QF had high accuracy (worst RMS error 0.5o) and repeatability (highest SEM 1.1o, lowest ICC 0.90) for IV-RoM measurement. Hypo-mobility cut offs ranged from 0.8o to 3.5o. No outcome was significantly correlated with increased IV-RoM above MDC and there was no significant difference between the number of hypo-mobile segments in patients and controls at baseline or significant increases in IV-RoMs in patients. However, there was a modest and significant correlation between the number of manipulations received and the number of levels and directions whose IV-RoM increased beyond MDC (Rho=0.39, p=0.043). There was also no agreement between palpation and QF in identifying hypo-mobile segments (Kappa 0.04-0.06). Conclusions: This study found no differences in cervical sagittal IV-RoM between patients with non-specific neck pain and matched controls. There was a modest dose-response relationship between the number of manipulations given and number of levels increasing IV-RoM - providing evidence that neck manipulation has a mechanical effect at segmental levels. However, patient-reported outcomes were not related to this

The value of competitive employment:In-depth accounts of people with intellectual disabilities

BackgroundIncreasing the societal participation of people with intellectual disabilities via competitive employment requires a full understanding of what this means to them. This paper aims to provide an in‐depth examination of the lived experiences of people with intellectual disabilities in competitive employment.MethodInterviews were conducted with six participants with mild intellectual disability or borderline functioning and good verbal communication skills. Interviews were analysed according to the guidelines of interpretative phenomenological analysis (IPA). Member checks were conducted.ResultsAnalysis yielded three main themes: (a) Building on my life experiences, (b) My place at work and (c) Being a valuable member of society, like everyone else.ConclusionsCompetitive employment could make a substantial contribution to the sense of belonging to society and quality of life of people with intellectual disabilities. Nevertheless, they must cope with stigma‐related obstacles and feelings of being dependent on others in the work environment