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Áhrif endurhæfingar á þrek, holdafar og heilsueflandi hegðun hjartasjúklinga með sykursýki af tegund 2

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Authors
Karl Kristjánsson
Magnús R. Jónasson
Sólrún Jónsdóttir
Hjalti Kristjánsson
Marta Guðjónsdóttir
Issue Date
2015

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Other Titles
Effects of rehabilitation on functional capacity, obesity and health behavior, among cardiac patients with DM2
Citation
Læknablaðið 2015, 101(9): 405-410
Abstract
Inngangur: Sykursýki af tegund 2 er vel þekktur áhættuþáttur hjarta- og æðasjúkdóma. Mikilvægt er að þróa og meta leiðir til að draga úr áhættu- þáttum og bæta heilsu þeirra hjartasjúklinga sem jafnframt hafa sykursýki. Efniviður og aðferðir: Framskyggn hóprannsókn meðal sjúklinga með sykursýki af tegund 2 sem komu til hjartaendurhæfingar á Reykjalundi frá 1/7 2011 til 31/12 2012. Algengi sykursýki af tegund 2 meðal sjúklinga í hjartaendurhæfingu var borið saman við algengi í rannsókn Hjartaverndar. Rannsóknarhópurinn með sykursýki var borinn saman við aðra sjúklinga í hjartaendurhæfingu á sama tímabili hvað varðar holdafar og þrek fyrir og eftir meðferð. Fylgst var með lífsháttabreytingum rannsóknarhópsins í þriggja og sex mánaða eftirfylgd, meðal annars varðandi reykleysi, hreyfivenjur og göngugetu. Niðurstöður: Algengi sykursýki af tegund 2 í hjartaendurhæfingu var miklu meira en í samanburðarþýði Hjartaverndar. Rannsóknarhópurinn var þyngri, hærra hlutfall hans hafði offitu, mittismál var meira og þrek minna, miðað við aðra hjartasjúklinga. Breyting varð hjá báðum hópunum á meðferðartímanum, þeir léttust, mittismál minnkaði, en þó jókst þrek minna hjá rannsóknarhópnum. Eftir 6 mánuði hafði þyngd og blóðsykur rannsóknarhópsins farið í fyrra horf, en mittismál var minna og hópurinn hélt aukinni hreyfingu og göngugetu miðað við upphaf meðferðar. Ályktun: Sykursýki af tegund 2 er algengari í hjartaendurhæfingu en í almennu þýði á Íslandi. Hjartasjúklingar með sykursýki eru að jafnaði feitari og með heldur lélegra þrek og minni svörun við þjálfun en aðrir hjartasjúklingar. Eftirfylgd í 6 mánuði sýndi hins vegar að aukning varð í reglulegri hreyfingu meðal hópsins og það endurspeglaðist í bættri göngugetu.
Objective: Present study examines the prevalence of type 2 diabetes (DM2) in patients attending cardiac rehabilitation (CR) compared to the general population utilising data from the Icelandic Heart Association population study. The study also examined the efficacy of CR for promoting health behaviors. Material and methods: A prospective study among DM2 patients attending CR at Reykjalundur Rehabilitation centre. The DM2 group was compared to other cardiac patients, with respect to obesity and exercise capacity at the beginning and end of 4-6 weeks of CR. Additionally, in the DM2 group, weight, smoking cessation, physical activity and walking capacity were assessed at 3 and 6 months follow-ups. Results: The prevalence of DM2 was 2-4 times higher in CR participants than in the general population. Compared to other CR participants, the DM2 group was heavier, with increased waist circumference and less exercise capacity. During the CR both groups lost weight and waist circumference decreased to similar extent, but the exercise capacity increased less in the DM2 group. In follow up after 6 months the DM2 group´s weight and glucose values were back to same level as before CR, but waist circumference was still decreased and they retained increased physical activity and walking capacity. Conclusion: DM2 is more prevalent among patients in cardiac rehabilitation than in the general population. The DM2 group was more obese, had lower exercise capacity and responded somewhat less to CR than other cardiac patients. Follow up after 6 months did however show that they continued their regular exercise and walking capacity was still retained.
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