Aiming to Improve the Quality of Life and Health of Patients With Type 2 Diabetes Mellitus. Project "Healthy Walk" Completed

Statistics shows that 1 in 11 people worldwide has developed type 2 diabetes mellitus. There are about 91 000 patients in Latvia, moreover, the number of patients with diabetes increases by about 2 000 new cases per year. So far, no studies in Latvia had addressed the impact of physical activities on physiological and biological factors, leading to reduction in diabetic complication events in these patients. In collaboration with multi-disciplinary professionals, a virtual trainer has been developed within the framework of project “Healthy Walk” in order to improve patient health and quality of life in the long term. The project was implemented with support of the patron Mikrotīkls, and it was administered by the University of Latvia Foundation.

The main objective: to improve quality of life and health

A program of physical activities for patients with type 2 diabetes was developed in collaboration with the UL Faculty of Computing (FC), UL Faculty of Medicine (FM), P. Stradiņš Clinical University Hospital (PSCUH) and Latvian Academy of Sport Education (LASE). Its goal is to improve the health condition and quality of life of patients by applying the interval shifting exercise (interval) training. The main project implementers are Prof. Leo Seļāvo (UL FC), Prof. Aija Kļaviņa (LASE), and Dr. med. Jeļizaveta Sokolovska (UL FM, PSCUH). Successful implementation of the project was further ensured by support of Latvijas Mobilais Telefons and Foracare (Switzerland), who donated smartphones, glucometers and other devices required for study.

“Modern medical science has accumulated a lot of data on diabetes and related mechanisms. At the moment, a notion is becoming increasingly urgent – enough knowledge is obtained, and now the action is needed. With the project “Healthy Walk”, we show patients, doctors and society that real action is necessary to reduce the incidence of type 2 diabetes and improve the health of patients. It seems very simple – we should encourage patients to move, to spend time and effort on physical activities and on their own health, rather than hope for a "miracle pill". The project provides an experience for the entire team, facing various challenges. One of the most unpleasant observations was that in Latvia diabetes patients are poorly motivated to change their lifestyle. However, our project is one of the few examples in Latvia where professionals from four different fields (computer science specialists, physicians, physiotherapists and molecular biologists) successfully cooperate to implement the recommendations for patients with diabetes. We are finally doing it,” say project implementers.

Lack of motivation – the cause of the dropout

By treating diabetes, it is possible to maintain normal blood glucose levels, prevent the development of complications of the disease and improve well-being, including quality of life. Within the framework of the project “Healthy Walk”, the team aimed to understand and evaluate whether it is possible to improve the health of patients without any medicamentous therapy. An interval method for monitoring and controlling physical activity programs was developed in a mobile phone, project participants had to exercise 3 to 4 times a week in order to obtain a long-term therapeutic effect. In case of a positive result, it should become a part of patient’s lifestyle.

Within the framework of the project, new application for a specific task of this study was developed. It was a software with high quality criteria. More than 10 strict exclusion criteria were implemented in order to avoid any risks: patients had to perform long-term trainings and intensive walks. At the beginning, 81 patients aged 35 to 75 years participated in the study. However, at the end of the project, only 17 people remained in the control group, and 39 stayed in the remote virtual training group, in which each participant had a mobile app and sensors. Observations obtained in the study show that only 13 people met the requirements, corresponding to about one third of the virtual workout group. The main cause of such a “dropout” is lack of motivation. As the project implementers admit, many participants initially underestimated their physical abilities in both respects: too low and too high physical condition in comparison with to reality. A tool is needed to reflect the real situation and help to improve their physical condition.

Interval training has a lasting effect on health

Key findings: active lifestyle and interval training improve your health, including measures of glycohemoglobin (HbA1c, blood glucose levels 2–3 months) and albuminuria. However, motivation to exercise regularly is one of the major challenges.

In the future, project implementers are determined to create more efficient and user-friendly solution. In addition, a way must be found to optimize and increase patient motivation and adherence, so that at least 50% of the participants would be completely involved in the project. The possible solution for this is cooperation with professionals of cognitive sciences.

So far, several scientific publications have already been prepared, creating great interest among both doctors and patients. Furthermore, diabetes is not the only disease that may be treated by the application of interval training, it may also be suitable to improve the condition of patients with cardiovascular disease.