Low Physical Activity Among Chinese American Immigrants with Prediabetes and Type 2 Diabetes

“…compared with the general population, people who have or are at risk for type 2 diabetes are significantly less likely to engage in regular physical activity.”

On this month’s cover, group practices tai chi during snowfall in Shenyang, China. ©Photo Reuters/Stringer.

We all know that physical activity is important for maintaining health—for everyone. It’s especially important to prevent or manage prediabetes and type 2 diabetes.

AJN’s February research feature, “Physical Activity Among Chinese American Immigrants with Prediabetes or Type 2 Diabetes,” takes a special look at the issue among Chinese American immigrants. Diabetes is the fifth leading cause of death among Asian Americans, so researchers wanted to investigate what this population’s knowledge of and barriers to physical activity might be.

Recruiting from a community health center in New York City, researchers conducted interviews with 100 foreign-born Chinese American adults having a diagnosis of prediabetes or type 2 diabete

According to the study authors:

“Chinese American immigrants with prediabetes or type 2 diabetes tend to be sedentary and are less likely to perform moderate or vigorous physical activity than the general population . . . .The findings also highlight some of the barriers to such activity and suggest a need for greater involvement by nurses.”

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Metabolic Syndrome: Lifestyle Factors and Prevention

Metabolic syndrome: one-third of U.S. adults.

Cycling Mother and Daughter, Netherlands/via Wikimedia CommonsConversations about health—whether between neighbors or between clinicians and patients—often revolve around weight problems, blood pressure, blood sugar, and cholesterol levels. Taken together, these are the cardiovascular risk factors referred to as metabolic syndrome.

In the United States, more than one-third of all adults have metabolic syndrome. This is an astonishing figure, especially because these risk factors can be modified.

What keeps some who are obese or overweight ‘metabolically healthy’?

In recent years, researchers have learned that some people who are overweight or obese do not demonstrate the other risk factors that are part of metabolic syndrome, and therefore these people have a lower-than-expected risk of cardiovascular disease. In a study reported in this month’s AJN (“Examining the Links Between Lifestyle Factors and Metabolic Syndrome“), a group of Taiwanese nurse researchers set out to learn whether there might be lifestyle factors that keep this subgroup of people “metabolically healthy,” protecting them from the other cardiovascular risk factors that usually come with extra weight.

Lifestyle factors associated with prevention.

Dr. Shu-Hung Chang and colleagues performed community-based physical exams on more than 700 people in northern Taiwan and questioned them about lifestyle factors including smoking, drinking, exercise, and the foods they ate. The researchers found that overweight and obese people who […]

Are the Benefits of Nutrition for Cardiovascular Health Being Undersold ?

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

By Eric Hunt/via Wikimedia Commons By Eric Hunt/via Wikimedia Commons

A nutrition conference at which physicians and medical students outnumber either nurses or dietitians is a rare event. This was the case at last month’s International Conference on Nutrition in Medicine: Cardiovascular Disease in Washington, DC, cosponsored by the Physicians Committee for Responsible Medicine (PCRM) and George Washington University.

The speakers, shared a wealth of data on the influence of different types of diets on weight, blood pressure, lipids, serum inflammatory markers, hemoglobin A1c levels, and diseased coronary arteries. More than one pointed out that we too often overestimate the benefits of drugs and medical procedures and discount the effectiveness of diet and lifestyle changes. Some highlights:

Does heart disease begin in utero? Children who are large for gestational age (> 95th percentile) and those born to overweight mothers are at increased risk for cardiovascular disease (CVD). Vascular physiologist Michael Skilton, PhD, associate professor at the University of Sydney in Australia, has also identified microscopic lesions in aortic endothelium of babies born small for gestational age (< 10th percentile). He suggests that their diets include the American Heart Association’s recommendations for omega-3 fatty acid intake beginning in childhood (breast milk, flax seeds, walnuts, or child-friendly omega 3 supplements can be used in lieu of fish-derived omega 3s when mercury is a concern).

Children and heart […]

Paired Glucose Testing With Telehealth Support to Empower Type 2 Diabetes Patients

Jacob Molyneux, senior editor

bloodglucosetestingType 2 diabetes is challenging for those trying to meet blood glucose target ranges, often requiring one or more daily medications, increases in exercise, changes in eating habits, and self-monitoring of glucose level. Those who are willing and able to learn about factors affecting their glucose level and to make small daily efforts in one or more areas have the potential to radically improve their sense of control over their diabetes.

This month’s Diabetes Under Control column, “Better Type 2 Diabetes Self-Management Using Paired Testing and Remote Monitoring” (free until April 1), presents a successful story of patient engagement in diabetes self-management. It describes the case of a participant in a clinical trial who, with clinician support, incorporated paired glucose testing (self-testing before and after meals) and telehealth (remote patient monitoring, or RPM).

The article is easy to follow and gives a series of biweekly updates on the patient’s progress. Before the study starts, she’s not very engaged in self-management. For example, she’s only testing her own glucose level three to four times a month. To get a sense of how much more empowered she’s come to feel by week 12 of the protocol, consider this brief excerpt: […]

AJN in February: Rapid Response Teams, Complications of CHD Repair, Managing Type 2 Diabetes, More

AJN0215 Cover OnlineAJN’s February issue is now available on our Web site. Here’s a selection of what not to miss.

Rapid response teams (RRTs) are teams of expert providers who can be called on in an emergency to treat patients before their condition deteriorates. The success of an RRT depends on whether it is activated properly, a task that often falls to staff nurses. The original research article, “Hospital System Barriers to Rapid Response Team Activation: A Cognitive Work Analysis,” describes the factors affecting nurses’ decisions to activate RRTs. This CE feature offers 3 CE credits to those who take the test that follows the article.

Further explore this topic by listening to a podcast interview with the author (this and other free podcasts are accessible via the Behind the Article podcasts page on our Web site, in our iPad app, or on iTunes).

Long-term complications after congenital heart defect (CHD) repair. Nurses often encounter patients with complications that occurred years after CHD repair. “Long-Term Outcomes After Repair of Congenital Heart Disease: Part 2” reviews four common CHDs, their repairs, common long-term outcomes, and implications for nurses in both cardiac and noncardiac settings. This article offers 2.5 CE credits to those who take the test that follows the article.

Making nurses full partners in reforming health care. The Institute of Medicine’s report, The Future […]