Dit proefschrift doet verslag van een onderzoek in hoeverre de mediache adviezen aan kinderen met diabetes worden opgevolgd en welke psycho-sociale factoren daarbij van belang zijn. Daarbij stond de context waarin het kind opgroeit (in gezin, familie, op school) centraal.
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Comparisons of visual perception, response-selection, and response-execution performance were made between Type 2 diabetes mellitus patients and a matched nondiabetic control group. 10 well-controlled male patients with Type 2 diabetes without diabetic complications (M age 58 yr.) and an age and IQ-matched non-diabetic control group consisting of 13 male healthy volunteers (M age 57 yr.) were included. Significant differences were found only between the two groups on response-selection performance, which concerns the selection and preparation of an appropriate motor action.
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Proefschrift dat onder andere een tweejarig interventie-onderzoek beschrijft naar het effect van een bewegingsprogramma bij personen met type 2 diabetes.
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From the publisher's site: "Trial design: Self-management plays a central role in diabetes management. However, not all patients are able to translate the health care providers’ recommendations for effective self-management in daily life. Diabetes Education and Self-management to Increase Empowerment (DESTINE) primarily investigates the effects of group education program Proactive Interdisciplinary Self-Management (PRISMA) in primary care treated people with Type 2 Diabetes Mellitus (T2DM) on the use of an online care platform. Methods: The DESTINE study has a randomized controlled design (1:1). 200 patients with T2DM using an online care platform called e-Vita will receive either PRISMA in addition to usual care or usual care only. The primary endpoint of this study is usage of the e-Vita platform. The secondary endpoints are participation in the consultation with the care provider, adherence to oral diabetes medications, and a selection of self-reported and clinical measures. After six months, both groups will receive PRISMA in a 6 month extension phase. Discussion: PRISMA focuses on aligning treatment goals from different health care providers while the individual patient remains in the lead. The goal is to shift patients from being an information receiver towards applying self-management and becoming empowered health care participants. Though recognized as important; theoretically based group education is still not routinely offered in the Netherlands. In the future, depending on the study results, e-Vita and PRISMA could be implemented in regular diabetes care. Trial registration: Current Controlled Trials NTR4693. (aut. ref.)"
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The studies in this thesis aim to increase understanding of the effects of various characteristics of scientific news about a common chronic disease, i.e., diabetes, on the cognitive responses (e.g., emotions, attitudes, intentions) of diabetes patients. The research questions presented in this thesis are guided by the Health Belief Model, a theoretical framework developed to explain and predict healthrelated behaviours based on an individual’s beliefs and attitudes. The model asserts that perceived barriers to a recommended health behavior, advantages of the behavior, self-efficacy in executing the behavior, and disease severity and personal susceptibility to the disease are important predictors of a health behavior. Communication is one of the cues to action (i.e., stimuli) that may trigger the decision-making process relating to accepting a medical or lifestyle recommendation.
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In Voeten en Diabetes geeft drs. Margreet van Putten antwoord op de vraag wat diabetes mellitus precies is en welke complicaties zich daarbij (kunnen) voordoen aan de voet. Zij heeft zich hierbij gericht tot voetverzorgers/pedicures. De signalerende functie van dit boek leent zich echter ook uitstekend voor andere disciplines die zich met voeten bezig-houden. Voeten en Diabetes is zeer geschikt als leerboek. Dankzij een opgenomen register kan het ook als naslagwerk worden gebruikt. Gezien de verhelderende informatie, met waar nodig verklarende tekst, is Voeten en Diabetes tevens zeer toegankelijk voor de geonteresseerde diabetes patiknt zelf. Drs. Margreet van Putten is arts en onderzoeker en als docent verbonden aan de Paramedische opleiding van Fontys Hogescholen in Eindhoven. Achterin het boek staan praktijkvoorbeelden (casuostiek), vragen en stellingen, gevolgd door de antwoorden, gerangschikt per hoofdstuk. Het boek is vanuit de optiek van de voetverzorger geschreven, maar in feite bedoeld voor alle disciplines die met diabetespatiknten te maken hebben. Voeten en Diabetes is doorspekt met kleurenfoto's en vormt een document dat tevens als naslagwerk dienst kan doen. In dit kader is ook een woordenregister opgenomen.
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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.
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Zelf gegenereerde gezondheidsinformatie speelt steeds vaker een rol in het zorgproces. Deze trend komt enerzijds door het gemak waarmee mensen zelf met wearables en apps data over zichzelf kunnen verzamelen. Anderzijds wordt deze trend door zorgverleners en de overheid gestimuleerd om de klinische observaties met data uit de thuissituatie te kunnen verrijken, of omdat door reorganisatie of bezuiniging zelfmanagement is gewenst. Ondanks positieve verwachtingen is er nog weinig onderzoek gedaan naar de implementatie en effectiviteit van zelfmeting en hieraan gerelateerde producten en diensten.
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Both exercise training and a lifestyle-intervention program increase UCP3 protein content inskeletal muscle of subjects with reduced glycaemic control, indicating a restoration towards normal UCP3 levels. These data support the idea that UCP3 has a role in the aetiology of type 2 diabetes mellitus
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The purpose of this study was to determine the efficacy of an online self-tracking program on physical activity, glycated hemoglobin, and other health measures in patients with type 2 diabetes. Seventy-two patients with type 2 diabetes were randomly assigned to an intervention or control group. All participants received usual care. The intervention group received an activity tracker (Fitbit Zip) connected to an online lifestyle program. Physical activity was analyzed in average steps per day from week 0 until 12. Health outcome measurements occurred in both groups at baseline and after 13 weeks. Results indicated that the intervention group significantly increased physical activity with 1.5 ± 3 days per week of engagement in 30 minutes of moderate-vigorous physical activity versus no increase in the control group (P = .047). Intervention participants increased activity with 1255 ± 1500 steps per day compared to their baseline (P < .010). No significant differences were found in glycated hemoglobin A1c, with the intervention group decreasing -0.28% ± 1.03% and the control group showing -0.0% ± 0.69% (P = .206). Responders (56%, increasing minimally 1000 steps/d) had significantly decreased glycated hemoglobin compared with nonresponders (-0.69% ± 1.18% vs 0.22% ± 0.47%, respectively; P = .007). To improve effectiveness of eHealth programs, additional strategies are needed.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
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