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Obesity and Metabolic Syndrome in Football Players

An expert panel recently reported that obesity is “the single greatest threat to public health in this century” and urged Americans to reduce their caloric intake and increase their physical activity (1). We are in worse physical shape than any previous generation. We are more sedentary and heavier. The terms crisis, epidemic and war on obesity are routinely used to describe our society’s health problems. Extensive scientific research during the past century has highlighted the short- and long-term benefits of physical activity and the dangers of a sedentary lifestyle. However, the likelihood of a positive change in behaviour in the general population with regard to diet and exercise appears bleak (2).

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Joel Camilo, John H. Helzberg

Self-Reported Health Beliefs, Lifestyle and Health Behaviours in Community-Based Patients with Diabetes and Hypertension

OBJECTIVE: This study describes self-reported health and lifestyle behaviours and health risk beliefs among community patients diagnosed with type 2 diabetes and hypertension. METHODS: Patients with both type 2 diabetes and hypertension were recruited from community family practices across 3 Canadian Maritime provinces. Patients completed a survey targeting health risk beliefs, and health and lifestyle behaviours. Analyses examined differences in patient beliefs by age and sex, as well by health and lifestyle behaviour. RESULTS: Overall, 90.8% of patients believed that controlling both blood pressure and blood glucose were important, particularly women (p<0.01), and 92.8% felt that having both conditions put them at high risk for cardiovascular problems. Older patients reported higher antihypertensive medication adherence (p<0.0001). Most (90.8%) believed that prescription drug use was most helpful for controlling blood pressure, and this belief was associated with medication adherence (p<0.0001). Overall, patients who believed in the benefits of a given lifestyle behaviour were more likely to demonstrate the behaviour. CONCLUSION: The majority of patients surveyed were knowledgeable about their increased risk for cardiovascular problems. Patient lifestyle behaviours tended to mirror their health beliefs. These results provide important insight into the health beliefs and lifestyle behaviours of patients who receive the majority of their care in the community.

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Beverley Lawson, Kristine Van Aarsen, Celeste Latter, Wayne Putnam, Nandini Natarajan, Frederick Burge

Type 2 Diabetes in Vulnerable Populations: Community Healthcare Providers’ Perspectives on Health Service Needs and Policy Implications

OBJECTIVES: To identify a) ways of enhancing health services for vulnerable populations with type 2 diabetes, taking into account the social determinants of health; and b) health and social policy approaches to reducing the incidence of type 2 diabetes and improving its management. METHODS: Focus groups were held with 18 community healthcare providers at 3 community health centres in Toronto, Ontario. RESULTS: Community healthcare providers’ perspectives were organized under 3 themes: a) the compounding effects of social factors on the health of people with diabetes; b)the need for responsive support at multiple levels; and c) barriers to change. Participants showed a good understanding of the impact of social determinants of health on patients’ lives, and they had many ideas about prevention/health promotion and strategies to enhance health services. They seemed less aware of the important role that political advocacy can play. CONCLUSION: Assessment of the policy environment and political advocacy through coalition-building with communities and other health and social sector service providers should become part of healthcare professionals’ education and responsibility. Adequate income and access to proper resources would help with the prevention and optimal management of diabetes.

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F. Beryl Pilkington, Isolde Daiski, Elizabeth Lines, Toba Bryant, Dennis Raphael, Mihaela Dinca-Panaitescu, Serban Dinca-Panaitescu

Management of Unmet Needs in Type 2 Diabetes Mellitus: The Role of Incretin Agents

The leading cause of morbidity and mortality in type 2 diabetes mellitus is cardiovascular disease. There is a need for type 2 diabetes therapies that act in concert with available agents to provide adequate glycemic control without causing hypoglycemia and weight gain, which are associated with increases in cardiovascular risk. Incretin-based agents—dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 receptor agonists—are the newest class of antihyperglycemic therapies. Liraglutide and exenatide, glucagon-like peptide-1 receptor agonists recently approved in Canada, have been shown to effectively lower blood glucose levels while also having beneficial effects on body weight and systolic blood pressure. The objective of this article is to review and discuss incretin-based agents, with a focus on their effects on blood glucose control, body weight and cardiovascular risk factors in patients with type 2 diabetes. Relevant data were obtained by literature search using the EMBASE, MEDLINE and PubMed databases.

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Ronald M. Goldenberg

Volume 35 Author, Title and Keyword Indexes

Volume 35 Author, Title and Keyword Indexes

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