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Hormazábal Aguayo, Ignacio

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https://academica-e.unavarra.es/handle/2454/51380

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Hormazábal Aguayo

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Ignacio

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Ciencias de la Salud

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0009-0002-7221-1731

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812495

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2024 - 20252
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    PublicationOpen Access
    Nonpharmacological interventions on glycated haemoglobin in youth with type 1 diabetes: a Bayesian network meta-analysis
    (BMC, 2024-07-01) Muñoz Pardeza, Jacinto; López Gil, José Francisco; Huerta Uribe, Nidia; Hormazábal Aguayo, Ignacio; Izquierdo Redín, Mikel; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak
    The available evidence on the impact of specific non-pharmacological interventions on glycaemic control is currently limited. Consequently, there is a need to determine which interventions could provide the most significant benefits for the metabolic health of young individuals with type 1 diabetes mellitus. The aim of this study was to identify optimal nonpharmacological interventions on glycaemic control, measured by glycated haemoglobin (HbA1c), in children and adolescents with type 1 diabetes. Systematic searches were conducted in PubMed, Web of Science, Scopus, and SPORTDiscus from inception to July 1, 2023. Randomised clinical trials (RCT) investigating nonpharmacological interventions (e.g., physical activity, nutrition, and behavioural therapies) were included. Primary outcome was change in HbA1c levels. Secondary outcome was change in daily insulin dose requirement. Seventy-four RCT with 6,815 participants (49.43% girls) involving 20 interventions were analysed using a network meta-analysis. Most interventions showed greater efficacy than standard care. However, multicomponent exercise, which includes aerobic and strength training (n = 214, standardised mean difference [SMD] =– 0.63, 95% credible interval [95% CrI] – 1.09 to – 0.16) and nutritional supplements (n = 146, SMD =– 0.49, – 0 .92 to – 0.07) demonstrated the greatest HbA1c reductions. These interventions also led to the larger decreases in daily insulin needs (n = 119, SMD =– 0.79, 95% CrI – 1.19 to – 0.34) and (n = 57, SMD =– 0.62, 95% CrI – 1.18 to – 0.12, respectively). The current study underscores non-pharmacological options such as multicomponent exercise and nutritional supplements, showcasing their potential to significantly improve HbA1c in youth with type 1 diabetes. Although additional research to confirm their efficacy is required, these approaches could be considered as potential adjuvant therapeutic options in the management of type 1 diabetes among children and adolescents.
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    PublicationEmbargo
    Physical fitness and activity levels as predictors of subjective well-being in youths with type 1 diabetes mellitus: a 2-year longitudinal analysis of the diactive-1 cohort study
    (Wiley, 2025-03-05) Muñoz Pardeza, Jacinto; López Gil, José Francisco; Huerta Uribe, Nidia; Hormazábal Aguayo, Ignacio; Yáñez-Sepúlveda, Rodrigo; Ezzatvar, Yasmin; Izquierdo Redín, Mikel; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak
    Subjective well-being (SWB), including cognitive and affective components, may be influenced by the management of type 1diabetes mellitus (T1DM). Physical fitness and adherence to physical activity (PA) are associated with better glycaemic stabilityand diabetes management. However, the relationship with SWB is not yet understood. The aim of the study was to determinethe relationship between physical fitness, PA, and SWB over two years in youths with T1DM. This longitudinal study involved83 participants (aged 6–18 years; 44.6% girls) from the Diactive-1 Cohort. Physical fitness was assessed by spirometry (peak ox-ygen consumption) and dynamometry (handgrip strength). PA domains were measured using triaxial accelerometers, whereasthe number of days participating in muscle-strengthening activities was assessed using a question. The Cuestionario Único deBienestar Escolar was used to determine SWB. Glycaemic stability was determined when glycosylated hemoglobin < 7%, coef-ficient of variability ≤ 36%, and time-in-range target > 70% were met. The linear mixed models used considered three assess-ments and subject variability, showing significant associations between overall physical fitness (unstandardized beta coefficient[B] = 1.778, 95% confidence interval [CI] 0.413–3.158; p = 0.012) and total PA (B = 0.034, 95% CI 0.005–0.063; p = 0.020) withSWB. Although time did not moderate the association with physical fitness (p = 0.116), this was true for PA only in the secondyear (p = 0.020). In contrast, glycaemic stability did not moderate the associations (p > 0.05). In conclusion, physical fitness andPA are associated with greater SWB in young people with T1DM, which may play a role in the psychological aspects of diseasemanagement.