Best practice diabetes cycle of care. A Diabetes program letöltése

Abstract Study Objectives Many adolescents are exposed to sleep restriction on school nights. We assessed how different apportionment of restricted sleep continuous vs.

A Diabetes program letöltése Tudok enni a hajdina 2-es típusú cukorbetegséggel this paper describes a clinic and community-based diabetes intervention program designed to improve dietary, physical activity, and self-care behaviors of older African American women with type 2 diabetes. It also describes the study to evaluate this program and baseline characteristics of participants. The New Leaf. Process and outcome measures in 89 diabetic patients referred to a Diabetes Management Program in which diabetes care was delivered by pharmacists following detailed algorithms experimental group were compared with measures in 92 diabetic patients who received diabetes care in the general clinic setting control group.

Methods Adolescents, aged 15—19 years, were evaluated in a dormitory setting using a parallel-group design. Following two baseline nights of 9-hour time-in-bed TIBparticipants underwent either 5 nights of continuous 6.

After two recovery nights of 9-hour TIB, participants were sleep restricted for another three nights. Sleep was assessed using polysomnography PSG. Cognitive performance and mood were evaluated three times per day.

Oral glucose tolerance tests OGTT were conducted on mornings after baseline sleep, recovery sleep, and the third day of each sleep restriction cycle. Results The split sleep group had fewer vigilance lapses, better working memory and executive function, faster processing speed, lower level of subjective sleepiness, and more positive mood, even though PSG-verified total sleep time was less than the continuous sleep group.

However, vigilance in both sleep-restricted groups was inferior to adolescents in a prior sample given 9-hour nocturnal TIB. During both cycles of sleep restriction, blood glucose during the OGTT increased by a greater amount in the split sleep schedule compared with persons receiving 6.

Conclusions In adolescents, modest multinight best practice diabetes cycle of care restriction had divergent negative effects on cognitive performance and glucose levels depending on how the restricted sleep was apportioned. They are best advised to obtain the recommended amount of nocturnal sleep.

Trial registration Keywords: adolescents, cognition, continuous sleep, glucose tolerance, partial sleep deprivation, sleep restriction, split sleep, vigilance Statement of Significance Many adolescents do not get adequate sleep, but the outcomes of how that restricted sleep is apportioned have not been studied.

During a simulated school week with time-in-bed restricted to 6. However, they exhibited a greater increase in blood glucose during a glucose tolerance test. Under conditions of suboptimal sleep, effects on neurobehavioral outcomes and morning glucose levels diverge depending on how sleep is apportioned. Introduction Many adolescent students sleep less than the recommended duration of 8—10 hours [ 12 ] a night [ 34 ].

Diabetes Program 2000

Even those who take compensatory naps may fall short of their daily sleep need for optimal cognitive performance, mood and physical health. Existing sleep restriction studies have mainly examined adults and have evaluated cognition and metabolism separately with protocols that mostly manipulate only nocturnal sleep [ 5—8 ]. The handful of studies that examined split sleep schedules in working-age adults found that such schedules yield comparable cognitive performance when compared to an equivalent amount of continuous sleep [ 12—15 ].

However, no insight has been provided about their metabolic impact, a significant gap given that short sleep is associated with increased risk of diabetes mellitus [ 1617 ].

A Diabetes 2000 program letöltése

Expert opinion suggests that optimal sleep duration for maintenance of neurobehavioral function and metabolic health may differ [ 18 ], but there is a dearth of supportive empirical data. The aim of the present study was to determine whether neurobehavioral function and glucose levels differ in sleep-restricted adolescents when best practice diabetes cycle of care is either split primary night sleep opportunity with a daytime nap or taken in a single nocturnal sleep episode.

The two cycles of sleep restriction provided an opportunity to evaluate the degree of recovery following the intervening recovery sleep 9-hour TIB as well as the added alterations in neurobehavioral function [ 9 ], and the consistency of glucose tolerance measurements. Neurobehavioral function in these two wanta cukorbetegség kezelésében was also compared to a reference historical control group that received an age-appropriate amount of sleep 9-hour TIB every night over 2 weeks [ 19 ].

A total of adolescents were assessed for eligibility for this day parallel-group study. Two participants dropped out, and analyses were based on 58 participants Supplementary Figure S1. Although the primary goal of the current work was to compare two sleep restriction schedules, the data generated were also appraised in light of the recommended sleep duration for adolescents 8—10 hours per night.

To this end, we compared the present findings to previously published data on students sleeping 9-hour TIB at night [ 19 ], recruited using the recruitment criteria used in the present study. Although the split and the continuous sleep groups did not differ in sleep behavior based on both self-report [ 24 ] and actigraphy Table 1some slight differences were found with the control group from our previous protocol 3 years ago. Specifically, the control group seemed to sleep less on weekdays, but extended their sleep more on weekends.

Overall, based on actigraphy data, the three groups spent about 6.

This was far less than the recommended sleep duration of 8—10 hours for adolescents [ 12 ]. Table 1. Characteristics of all manipulation and control groups Split sleep group.