Type 2-diabetes - Sundhedsstyrelsen

H Physical activity reduces the blood level of triglycerides (1b), while the
total cholesterol remains unchanged (1b).
H There is no evidence that physical activity per se changes the blood pressure
(1b).
H Physical activity results in either unchanged (1b) or lower weight (1b).
H Physical activity is of importance for maintenance of a weight loss (1a).
Smoking
Smoking is a well-known risk factor for the development of atherosclerosis, as
is Type 2 diabetes. It is therefore natural to investigate the evidence that smoking
and Type 2 diabetes are unfortunate, concomitant risk factors, and that
cessation of smoking can improve the prognosis for the Type 2 diabetes patient.
A review of the literature revealed very few studies concerning diabetes and
smoking, however. Moreover, in several of these studies it was difficult to differentiate
between Type 1 and Type 2 diabetes. Based on the studies the Project
Group nevertheless concludes that:
H Smoking increases the risk of developing diabetes (2b).
H Smoking exacerbates both the macroangiopathy (1b) and the microangiopathy
(2b).
H Efforts to attain smoking cessation in patients with diabetes seem to be
very modest (2c).
H Smoking cessation counselling must be expected to be cost-effective (1b).
H Prioritisation of smoking cessation seems low in diabetes patients, partly
because of the risk of weight gain (2b) and the development of depression
(3a).
Education
Education of the Type 2 diabetes patient is considered to be one of the cornerstones
of diabetes treatment. The aim is to strengthen the patient’s diabetesrelated
knowledge and skills, e.g. blood glucose measurement, foot care, shopping
and cooking, in order to achieve permanent lifestyle changes and improve
the patient’s quality of life. This information-based partnership between the
patient and the diabetes team can thus help ensure that the patient understands
his disease and can take responsibility for it and participate to a greater degree
in its treatment (self care). From a review of the literature it is concluded that:
H The effect of education on the diabetic regulation expressed as HbA1c,
lipid status and BMI is limited (1b).
H Education has effects on knowledge about diabetes and practical skills
(1b).
H The effect diminishes with time following cessation of education (1b).
H Education does not have any demonstrable effect on the late complications
of diabetes (1a).
H It is not possible to identify which forms and methods of education yield
Type 2-diabetes. Medicinsk teknologivurdering af screening, diagnostik og behandling 71