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      Preventing Diabetes Mellitus in Nigeria: Effect of Physical Exercise, Appropriate Diet, and Lifestyle Modification

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          Abstract

          In this systematic review, we explored the effects of physical activity, diet, and lifestyle on the prevention of diabetes mellitus in Nigeria. Diabetes is an autoimmune disease which occurs when the body does not produce or respond properly to insulin, a hormone essential for daily life. Diabetes is an incurable disease, which has no racial, social, or sex barrier. The risk factors include a poor diet, lack of physical activity, obesity, and an unhealthy lifestyle. About 100 million people in the United States have diabetes mellitus, and the total economic costs of diabetes exceed USD 132 billion a year. Diabetes accounts for 1 of every 10th USD spent on health care in the United States, and an estimated 48 million Americans may develop diabetes by 2050. However, it is estimated that in 90% of the patients with type 2 diabetes the disease could be prevented if people adopted a healthy lifestyle, including regular physical activity, a moderate-good diet, and modest weight. Because of the deleterious health consequences which include blindness; kidney damage; cardiovascular disease; and reduced life span, as well as high treatment costs, prevention of the disease in Nigeria, where you are confronted with a poor health care system, poverty, and ignorance, but also have ample opportunities for physical activity and rich local nutrients to supply an ideal diet, is a viable option. Consequent upon this, the paper recommends, among others, that available local resources be used for this purpose.

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          Most cited references10

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          Exercise and insulin sensitivity: a review.

          Physical activity has a beneficial effect on insulin sensitivity in normal as well as insulin resistant populations. A distinction should be made between the acute effects of exercise and genuine training effects. Up to two hours after exercise, glucose uptake is in part elevated due to insulin independent mechanisms, probably involving a contraction-induced increase in the amount of GLUT4 associated with the plasma membrane and T-tubules. However, a single bout of exercise can increase insulin sensitivity for at least 16 h post exercise in healthy as well as NIDDM subjects. Recent studies have accordingly shown that acute exercise also enhances insulin stimulated GLUT4 translocation. Increases in muscle GLUT4 protein content contribute to this effect, and in addition it has been hypothesized that the depletion of muscle glycogen stores with exercise plays a role herein. Physical training potentiates the effect of exercise on insulin sensitivity through multiple adaptations in glucose transport and metabolism. In addition, training may elicit favourable changes in lipid metabolism and can bring about improvements in the regulation of hepatic glucose output, which is especially relevant to NIDDM. It is concluded that physical training can be considered to play an important, if not essential role in the treatment and prevention of insulin insensitivity.
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            Associations of diabetes mellitus with total life expectancy and life expectancy with and without cardiovascular disease.

            Diabetes mellitus is a recognized risk factor for cardiovascular disease (CVD) and mortality. However, limited information exists on the association of diabetes with life expectancy with and without CVD. We aimed to calculate the association of diabetes after age 50 years with life expectancy and the number of years lived with and without CVD. Using data from the Framingham Heart Study, we built life tables to calculate the associations of having diabetes with life expectancy and years lived with and without CVD among populations 50 years and older. For the life table calculations, we used hazard ratios for 3 transitions (healthy to death, healthy to CVD, and CVD to death), stratifying by the presence of diabetes at baseline and adjusting for age and confounders. Having diabetes significantly increased the risk of developing CVD (hazard ratio, 2.5 for women and 2.4 for men) and of dying when CVD was present (hazard ratio, 2.2 for women and 1.7 for men). Diabetic men and women 50 years and older lived on average 7.5 (95% confidence interval, 5.5-9.5) and 8.2 (95% confidence interval, 6.1-10.4) years less than their nondiabetic equivalents. The differences in life expectancy free of CVD were 7.8 and 8.4 years, respectively. The increase in the risk of CVD and mortality from diabetes represents an important decrease in life expectancy and life expectancy free of CVD. Prevention of diabetes is a fundamental task facing today's society in the pursuit of healthy aging.
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              Type-II diabetes and pancreatic cancer: a meta-analysis of 36 studies

              Pancreatic cancer is the eighth major form of cancer-related death worldwide, causing 227 000 deaths annually. Type-II diabetes is widely considered to be associated with pancreatic cancer, but whether this represents a causal or consequential association is unclear. We conducted a meta-analysis to examine this association. A computer-based literature search from 1966 to 2005 yielded 17 case–control and 19 cohort or nested case–control studies with information on 9220 individuals with pancreatic cancer. The age and sex-adjusted odds ratio (OR) for pancreatic cancer associated with type-II diabetes was obtained from each study. The combined summary odds ratio was 1.82 (95% confidence interval (95% CI) 1.66–1.89), with evidence of heterogeneity across the studies (P=0.002 for case–control and P=0.05 for cohort studies) that was explained, in part, by higher risks being reported by smaller studies and studies that reported before 2000. Individuals in whom diabetes had only recently been diagnosed (<4 years) had a 50% greater risk of the malignancy compared with individuals who had diabetes for ⩾5 years (OR 2.1 vs 1.5; P=0.005). These results support a modest causal association between type-II diabetes and pancreatic cancer.
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                Author and article information

                Journal
                IJD
                10.1159/issn.2073-5944
                International Journal of Diabetes and Metabolism
                S. Karger AG
                1606-7754
                2073-5944
                2019
                October 2020
                29 July 2019
                : 25
                : 3-4
                : 113-117
                Affiliations
                Department of Human Kinetics and Health Education, Adekunle Ajasin University, Akungba Akoko, Nigeria
                Author notes
                *Olasunkanmi R. Adeleke, Department of Human Kinetics and Health Education, Adekunle Ajasin University, P.M.B. 001, Akungba Akoko, Ondo State 342111 (Nigeria), E-Mail rowylandy@gmail.com
                Article
                502006 Int J Diabetes Metab 2019;25:113–117
                10.1159/000502006
                54fabcbe-1f92-4e2b-8873-c770f39118b3
                © 2019 The Author(s) Published by S. Karger AG, Basel

                This article is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND). Usage and distribution for commercial purposes as well as any distribution of modified material requires written permission. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                : 20 March 2019
                : 08 July 2019
                Page count
                Pages: 5
                Categories
                Case Challenge and Education – Review Article

                Endocrinology & Diabetes,Neurology,Nutrition & Dietetics,Sexual medicine,Internal medicine,Pharmacology & Pharmaceutical medicine
                Diabetes mellitus,Physical exercise,Obesity,Diet,Carbohydrates,Type 2 diabetes,Soft drinks,Lifestyle modification,Sedentary life

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