| Summary: | 碩士 === 長庚大學 === 物理治療學系 === 101 === Background and purpose: Many studies have shown that type 2 diabetes mellitus (T2DM)and functional disability incidence increase is closely related to physical function performance tests. Physical function performance tests can predict further functional decline, co-morbidity rates, health care use and mortality. The study is to explore the association of functional performance between subjects with and without T2DM as well as T2DM with good and poor glycemic control.
Methods: The study was a retrospective cross-sectional design. The eligible subjects was recruited from our previous collected database of the patients from the internal & geriatric OPD clinic, Linkou, CGMH. Subjects must be aged 65 years or more. T2DM cases were identified by self-report and the disease status will be confirmed by either doctor diagnosis, taking medicine for glycemic control, plasma glucose, or HbA1C level according to the definition of the American Diabetes Association by chart review. Sixty-nine T2DM with good and 69 with poor glycemic control were identified. And 138 age- and sex-matched cases without the diagnosis of T2DM were chosen from the same dataset. All subjects had received the questionnaires(age, height, weight, smoking, exercise habits, and years of education) and physical performance tests(hand grip strength, knee extensor strength, 30 seconds sit to stand, one leg standing test, functional reach, chair sit and reach test, 6-minute walk test, timed up and go test)before. One way ANOVA and chi-square test were used to compare differences of basic data in the three groups, and ANCOVA was used to test the differences of the physical functional performance tests in the three groups.
Results：The results showed that between non-diabetic group and poor glycemic control group, there were significantly different in body mass index(BMI)(F=6.250,p<0.01), waist circumference(F=9.11,p<0.001), waist-to-hip ratio(WHR)(F=8.892,p<0.001), co-morbidity rates(F=17.657,p<0.001), hypertension(F=13.307,p<0.01),hyperlipidemin(F=23.307,p<0.001), arthritis(F=17.52,p<0.001), hand grip strength(F=4.819,p<0.01), knee extensor strength (F=3.336,p<0.05), functional reach(F=2.818,p<0.05). There were significantly diferent between good and poor glycemic control group with non-diabetic group in years of education(F=19.916,p<0.001), depression status(χ 2=26.81,p<0.001), 30 seconds sit to stand(F=6.875,p<0.01),6-minute walk test(F=8.735,p<0.001), timed up and go test(F=6.014,p<0.01). In addition, there were significantly different between non-diabetic and good glycemic control group with poor glycemic control group in mental status(F=13.496,p<0.01).
Conclusion：Compared with non-diabetic, older T2DM had significantly poorer education level, depression status, lower extremity muscular endurance, cardiorespiratory endurance, and functional mobility, in addition, diabetic with poor glycemic control showed significantly higher BMI, WHR, co-morbidity rates, poorer muscle strength and balance. Poor health related conditions and declined physical performance were associated with diabetes itself and the status of glycemic control.
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