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People with type 2 diabetes are at high risk of diabetes complications. Optimal glycemic control is required and could be achieved by lifestyle modification, particularly through regular exercise. This quasi-experimental study used secondary data analysis to compare the effects of Traditional and Modified Arm Swing Exercise programs on blood glucose level and nutritional status among people with type 2 diabetes. Seventy-six people with type 2 diabetes were from two previous datasets and divided into three groups: 26 for the Traditional Arm Swing Exercise, 24 for the Modified Arm Swing Exercise, and 26 for the control group. Data were gathered using a demographic questionnaire and measurements of fasting capillary blood glucose, hemoglobin A1c, and for nutritional status, we measured body mass index, waist circumference, visceral fat and skeletal muscle using measuring tape, body composition monitor and blood glucose monitor at baseline and after the Programs. Data were also analyzed using t-test, one-way ANOVA, and ANCOVA.
The results revealed that after the Programs both Traditional and Modified Arm Swing Exercise groups had statistically lower fasting capillary blood glucose, hemoglobin A1c, body mass index, waist circumference, and visceral fat, but higher skeletal muscle than before the Program. The Traditional Arm Swing Exercise group had a statistically lower average hemoglobin A1c when compared with the control group and also had statistically lower average waist circumference than the Modified Arm Swing Exercise and control groups. Average hemoglobin A1c and waist circumference were not different between the Modified Arm Swing Exercise and control groups. Results suggest that the Traditional Arm Swing Exercise is the most effective. Nurses can apply the Traditional Arm Swing Exercise Program to improve blood glucose and nutritional status in people with type 2 diabetes.
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2. International Diabetes Federation. IDF Western Pacific members [Internet]. 2020 [cited 2020 Nov 19]. Available from: https://www.idf.org/our-network/regions-members/ western-pacific/members/115-thailand.html
3. Aekplakorn W, Chariyalertsak S, Kessomboon P, Assanangkornchai S, Taneepanichskul S, Putwatana P. Prevalence of diabetes and relationship with socioeconomic status in the Thai population: National Health Examination Survey, 2004–2014. J Diabetes Res. 2018; 2018:1-8. https://doi.org/10.1155/2018/1654530
4. American Diabetes Association. Classification and diagnosis of diabetes: standards of medical care in diabetes-2020. Diabetes Care. 2020; 43(Suppl 1): S14-S31. doi.org/ 10.2337/dc20-S002.
5. Thewjitcharoen Y, Chotwanvirat P, Jantawan A, Siwasaranond N, Saetung S, Nimitphong H, et al. Evaluation of dietary intakes and nutritional knowledge in Thai patients with type 2 diabetes mellitus. J Diabetes Res. 2018; 2018: 1-11. https://doi.org/10.1155/2018/ 9152910
6. Papier K, D’este C, Bain C, Banwell C, Seubsman S, Sleigh A, et al. Consumption of sugar sweetened beverages and type 2 diabetes incidence in Thai adults: results from an 8-year prospective study. Nutr Diabetes. 2017; 7(6): 1-6. doi: 10.1038/nutd.2017.27.
7. Sowattanangoon N, Kotchabhakdi N, Petrie KJ. The influence of Thai culture on diabetes perceptions and management. Diabetes Res Clin Pract. 2009; 84(3): 245-51. doi: 10.1016/j.diabres.2009.02.011.
8. Lundberg PC, Thrakul S. Type 2 diabetes: how do Thai Buddhist people with diabetes practise self-management? J Adv Nurs. 2012; 68(3): 550-8. doi: 10.1111/j.1365- 2648.2011.05756.x.
9. Liangruenrom N, Suttikasem K, Craike M, Bennie JA, Biddle SJH, Pedisic Z. Physical activity and sedentary behaviour research in Thailand: a systematic scoping review. BMC Public Health. 2018;18(733): 1-24. https://doi.org/10.1186/s12889-018-5643-y
10. Lambadiari V, Triantafyllou K, Dimitriadis GD. Insulin action in muscle and adipose tissue in type 2 diabetes: the significance of blood flow. World J Diabetes. 2015; 6(4): 626-33. doi: 10.4239/wjd.v6.i4.626.
11. Terathongkum S. Arm swing exercise for diabetes control. TJNMP. 2017; 4(1): 36-44 (in Thai).
12. Thai Health Promotion Foundation. Manual for decrease in abdominal fat, disease reduced. [Internet]. 2017 [cited 2018 Oct 19]. Available from: http://drs.oop.cmu.ac.th/ nana/downloads/24.pdf. (in Thai)
13. Khamsom S, Terathongkum S, Kittipimpanon K. Effects of arm swing exercise program on HbA1C and nutritional status in community dwelling older adults with type 2 diabetes. TJNMP. 2017; 4(2): 46-60 (in Thai).
14. Wanna J, Terathongkum S, Thipsuwannakool V. Effects of arm swing exercise program on HbA1c and nutritional status in adults with type 2 diabetes in community. BKK Med J. 2018; 14(1): 23-8. https://doi.org/10.31524/ bkkmedj.2018.02.005
15. Songsaengrit B, Benjapornlert P, Pisprasert V, Aneknan P, Kanpettha Y, Sespheng A, et al. Effects of traditional and modified arm swing exercise on abdominal obesity, hemodynamics and quality of life in patients with metabolic syndrome. JEP online. December 2017; 20(6): 83-93.
16. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977; 84: 191-215.
17. Alharbi M, Gallagher R, Neubeck L, Bauman A, Prebill G, Kirkness A, et al. Exercise barriers and the relationship to self-efficacy for exercise over 12 months of a lifestyle-change program for people with heart disease and/or diabetes. Eur J Cardiovasc Nurs. 2017;16(4): 309-17. doi: 10.1177/ 1474515116666475.
18. D’Souza MS, Karkada S, Parahoo K, Venkatesaperumal R, Achora S, Cayaban ARR. Self-efficacy and self-care behaviours among adults with type 2 diabetes. Appl Nurs Res. 2017; 36: 25-32. doi:10.1016/j.apnr.2017.05.004.
19. Tharek Z, Ramli AS, Whitford DL, Ismail Z, Zulkifli MM, Sharoni SKA, et al. Relationship between self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting. BMC Fam Pract. 2018; 19(39): 1-10. https:// doi.org/10.1186/s12875-018-0725-6
20. Tan CCL, Cheng KKF, Hwang SW, Zhang N, Holroyd E, Wang W. Effect of a diabetes self-efficacy enhancing program on older adults with type 2 diabetes: a randomized controlled trial. Clin Nurs Res. 2018; 29(5): 293-303. https://doi.org/10.1177/1054773818792480
21. Jiang X, Wang J, Lu Y, Jiang H, Li M. Self-efficacy focused education in persons with diabetes: a systematic review and meta-analysis. Psychol Res Behav Manag. 2019;12: 67- 79. doi: 10.2147/PRBM.S192571.
22. Brown SA, García AA, Brown A, Becker BJ, Conn VS, Ramírez G, et al. Biobehavioral determinants of glycemic control in type 2 diabetes: a systematic review and meta analysis. Patient Educ Couns. 2016; 99(10): 1558-67. doi: 10.1016/j.pec.2016.03.020.
23. Tunkamnerdthai O, Auvichayapat P, Donsom M, Leelayuwat N. Improvement of pulmonary function with arm swing exercise in patients with type 2 diabetes. J Phys Ther Sci 2015;27(3): 649-54. doi: 10.1589/jpts.27.649.
24. Phonyiam R, Terathongkum S, Lininger J. Effects of arm swing exercise program on blood sugar level, nutritional status and perceived self-efficacy for exercise in persons with uncontrolled type 2 diabetes mellitus. BKK Med J. 2018; 14(2): 34-9. https://doi.org/10.31524/bkkmedj.2018. 09.007.
25. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007; 39(2): 175-91.
26. Saelao K, Kanungsukkasem V. Effects of arm swing exercise, walking and walking exercise combined with arm swing exercise on health-related physical fitness of the elderly women. J Sports Science and Health. 2012; 13(1): 92- 103 (in Thai).
27. Terathongkum S, Wangpitipanit S, Kraithaworn P, Vallibhakara SA. A community-based lifestyle modification for prevention diabetes in pre-diabetes: a quasi-experimental study. J Med Assoc Thai, 2018; 101(3): 297–304.
28. Wang T, Lu J, Shi L, Chen G, Xu M, Xu Y, et al. Association of insulin resistance and β-cell dysfunction with incident diabetes among adults in China: a nationwide, population based, prospective cohort study. Lancet Diabetes Endocrinol. 2020; 8(2): 115-24. doi: 10.1016/S2213-8587 (19)30425-5.
29. Han TS, Al-Gindan YY, Govan L, Hankey CR, Lean MEJ. Associations of BMI, waist circumference, body fat, and skeletal muscle with type 2 diabetes in adults. Acta Diabetol. 2019; 56(8): 947-54. doi: 10.1007/s00592-019-01328-3.
30. Blüher M, Laufs U. New concepts for body shape-related cardiovascular risk: role of fat distribution and adipose tissue function. Eur Heart J. 2019; 40(34): 2856-8. https://doi.org/10.1093/eurheartj/ehz411
31. Chait A, den Hartigh LJ. Adipose tissue distribution, inflammation and its metabolic consequences, including diabetes and cardiovascular disease. Front Cardiovasc Med. 2020; 7(22): 1-41. doi: 10.3389/fcvm.2020. 00022.
32. Janochova K, Haluzik M, Buzga M. Visceral fat and insulin resistance--what we know? Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2018; 163(1): 19-27. doi: 10.5507/bp.2018.062.
33. Verkouter I, Noordam R, le Cessie S, van Dam RM, Lamb HJ, Rosendaal FR, et al. The association between adult weight gain and insulin resistance at middle age: mediation by visceral fat and liver fat. J Clin Med. 2019; 8(10): 1-14. doi: 10.3390/jcm8101559.
34. Prasertsri P, Kaewaram J, Naravoratham K, Trongtosak P. Influence of arm swing exercise training on blood pressure regulation of cardiac autonomic function and cardiovascular risks in hypertensive elderly subjects. JEP online. 2018; 21(4): 162-76.
35. Hesselink MKC, Schrauwen-Hinderling V, Schrauwen P. Skeletal muscle mitochondria as a target to prevent or treat type 2 diabetes mellitus. Nat Rev Endocrinol. 2016 Nov; 12(11): 633-45. doi: 10.1038/nrendo.2016. 104.
36. Mizgier ML, Casas M, Contreras-Ferrat A, Llanos P, Galgani JE. Potential role of skeletal muscle glucose metabolism on the regulation of insulin secretion. Obes Rev. 2014;15(7): 587-97. doi: 10.1111/obr.12166.
37. Sjøberg KA, Frøsig C, Kjøbsted R, Sylow L, Kleinert M, Betik AC, et al. Exercise increases human skeletal muscle insulin sensitivity via coordinated increases in microvascular perfusion and molecular signaling. Diabetes. 2017; 66(6):1501-10. doi: 10.2337/db16-1327.
38. Lee J, Kim D, Kim C. Resistance training for glycemic control, muscular strength, and lean body mass in old type 2 diabetic patients: a meta-analysis. Diabetes Ther. 2017; 8(3): 459-73. doi: 10.1007/s13300-017-0258-3.