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Development of exercise intervention program for improving blood glucose variability in patients with coronary heart disease

Research Project

Project/Area Number 21K17511
Research Category

Grant-in-Aid for Early-Career Scientists

Allocation TypeMulti-year Fund
Review Section Basic Section 59010:Rehabilitation science-related
Research InstitutionNagoya University

Principal Investigator

Takuji Adachi  名古屋大学, 医学系研究科(保健), 助教 (10849946)

Project Period (FY) 2021-04-01 – 2024-03-31
Project Status Completed (Fiscal Year 2023)
Budget Amount *help
¥4,550,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥1,050,000)
Fiscal Year 2022: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
Fiscal Year 2021: ¥2,860,000 (Direct Cost: ¥2,200,000、Indirect Cost: ¥660,000)
Keywords心臓リハビリテーション / 冠動脈疾患 / 重症化予防 / 血糖変動 / 遠隔モニタリング / 運動療法 / 身体活動量 / 生活習慣 / 持続血糖測定 / インスリン抵抗性 / 生活習慣改善 / 血糖管理 / ライフスタイル
Outline of Research at the Start

糖尿病は冠動脈疾患の再発と関連するため、一般的に、過去1~2ヵ月の平均血糖を反映するHbA1cを下げることを目標に薬物治療や生活習慣指導を行う。しかし、治療を強化してHbA1cを下げても再発率や死亡率が下がらないことが報告されている。
そこで注目されているのが、高血糖の持続、または血糖の変動幅が大きいといった過剰な血糖変動の是正である。Continuous glucose monitoringは血糖値を持続的に測定できる機器であり、血糖変動に応じた個別治療への活用が期待されている。
本研究課題では、冠動脈疾患治療後の血糖変動パターンの正常化に効果的な運動プログラムを開発することを目的とする。

Outline of Final Research Achievements

This study aimed to develop exercise intervention program for improving glucose variability in patients with coronary heart disease. Patients participated in the program for lifestyle modification using wearable devices and tablet. Glucose variability was assessed using continuous glucose monitoring system pre- and post intervention. Since sufficient data for analyzing the intervention effects on glucose variability was not obtained, we conducted detailed analysis for the association between accelerometer-measured physical activity and glucose variability. As a result, higher physical activity was associated with smaller standard deviation or coefficient of variation, which reflect the glucose variability. Additionally, higher physical activity was associated with longer time of range, which reflects time that blood glucose levels are within target range.

Academic Significance and Societal Importance of the Research Achievements

糖尿病を保有していると冠動脈疾患は重症化しやすく、生活習慣改善と薬物治療による血糖管理が重要である。血糖管理の指標として、一定期間の平均血糖を反映するHbA1cが広く用いられており、例えばガイドラインでは冠動脈疾患治療後の目標値は7.0%未満としている。しかし、HbA1cに基づく厳格な血糖管理を行っても、糖尿病の予後は改善しないことが報告された。そこで、近年は、過剰な血糖変動を抑制することの重要性が注目されている。本研究では、明確な運動介入の効果を示すには至らなかったものの、身体活動量の増加、食後の運動の実施などにより食後血糖の上昇を抑制する方策を検討する基礎的なデータを収集することができた。

Report

(3 results)
  • 2023 Final Research Report ( PDF )
  • 2022 Research-status Report
  • 2021 Research-status Report
  • Research Products

    (25 results)

All 2023 2022 2021

All Journal Article (22 results) (of which Int'l Joint Research: 2 results,  Peer Reviewed: 22 results,  Open Access: 12 results) Presentation (3 results) (of which Int'l Joint Research: 1 results,  Invited: 1 results)

  • [Journal Article] Physical Frailty May Predict 2-Year Prognosis in Elderly Patients With Acute Myocardial Infarction ― A Report From the FLAGSHIP Study ―2023

    • Author(s)
      Ashikawa H, Adachi T, Iwatsu K, Kamisaka K, Kamiya K, Uchiyama Y, Yamada S
    • Journal Title

      Circulation Journal

      Volume: 87 Issue: 4 Pages: 490-497

    • DOI

      10.1253/circj.CJ-22-0515

    • ISSN
      1346-9843, 1347-4820
    • Year and Date
      2023-03-24
    • Related Report
      2022 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Factors associated with changes in objectively measured moderate-to-vigorous physical activity in patients after percutaneous coronary intervention: A prospective cohort study2023

    • Author(s)
      Funaki K, Adachi T, Kameshima M, Fujiyama H, Iritani N, Tanaka C, Sakui D, Hara Y, Sugiura H, Yamada S
    • Journal Title

      Journal of Physical Activity and Health

      Volume: 20 Issue: 4 Pages: 279-291

    • DOI

      10.1123/jpah.2022-0396

    • Related Report
      2022 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Prognostic effects of cardiac rehabilitation in heart failure patients classified according to physical frailty: A propensity score-matched analysis of a nationwide prospective cohort study2023

    • Author(s)
      Adachi T, Iritani N, Kamiya K, Iwatsu K, Kamisaka K, Iida Y, Yamada S
    • Journal Title

      International Journal of Cardiology Cardiovascular Risk and Prevention

      Volume: 17 Pages: 200177-200177

    • DOI

      10.1016/j.ijcrp.2023.200177

    • Related Report
      2022 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Reasons for non-participation in outpatient cardiac rehabilitation among older patients with heart failure: a report of the FLAGSHIP study2023

    • Author(s)
      Iritani N, Adachi T, Iwatsu K, Kamiya K, Kamisaka K, Yamada S
    • Journal Title

      Journal of Cardiopulmonary Rehabilitation and Prevention

      Volume: - Issue: 4 Pages: 303-305

    • DOI

      10.1097/hcr.0000000000000788

    • Related Report
      2022 Research-status Report
    • Peer Reviewed
  • [Journal Article] Association Between the Redox State of Human Serum Albumin and Exercise Capacity in Patients With Cardiac Disease2023

    • Author(s)
      Ishimaru Y, Adachi T, Ashikawa H, Hori M, Shimozato T, Ohtake H, Shimizu S, Ueyama J, Yamada S
    • Journal Title

      American Journal of Cardiology

      Volume: 189 Pages: 56-60

    • DOI

      10.1016/j.amjcard.2022.11.034

    • Related Report
      2022 Research-status Report
    • Peer Reviewed
  • [Journal Article] Physical frailty and use of guideline-recommended drugs in patients with heart failure and reduced ejection fraction2023

    • Author(s)
      Kondo T, Adachi T, Kobayashi K, Okumura T, Izawa H, Murohara T, McMurray JVV, Yamada S
    • Journal Title

      Journal of American Heart Association

      Volume: -

    • Related Report
      2022 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] National survey on the secondary preventive measures for coronary artery disease among interventional cardiologists: a report from the Japanese Association of Cardiovascular Intervention and Therapeutics2023

    • Author(s)
      Yamada S, Adachi T, Ashikawa H, Funaki K, Kohsaka S, Ikari Y, Amano T
    • Journal Title

      Cardiovascular Intervention and Therapeutics

      Volume: 38 Issue: 1 Pages: 49-54

    • DOI

      10.1007/s12928-022-00874-y

    • Related Report
      2022 Research-status Report
    • Peer Reviewed
  • [Journal Article] Reply to the comments on “Association among mild cognitive impairment, social frailty, and clinical events in elderly patients with cardiovascular disease”2022

    • Author(s)
      Adachi T, Tsunekawa Y, Tanimura D
    • Journal Title

      Heart & Lung

      Volume: 56 Pages: 191-192

    • DOI

      10.1016/j.hrtlng.2022.06.004

    • Related Report
      2022 Research-status Report
    • Peer Reviewed
  • [Journal Article] Association among mild cognitive impairment, social frailty, and clinical events in elderly patients with cardiovascular disease2022

    • Author(s)
      Adachi T, Tsunekawa Y, Tanimura D
    • Journal Title

      Heart & Lung

      Volume: 55 Pages: 82-88

    • DOI

      10.1016/j.hrtlng.2022.04.011

    • Related Report
      2022 Research-status Report
    • Peer Reviewed
  • [Journal Article] Association between the Big Five personality traits and medication adherence in patients with cardiovascular disease: a cross-sectional study2022

    • Author(s)
      Adachi T, Tsunekawa Y, Tanimura D
    • Journal Title

      PLoS One

      Volume: 17 Issue: 12 Pages: e0278534-e0278534

    • DOI

      10.1371/journal.pone.0278534

    • Related Report
      2022 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Factors associated with postsurgical muscle weakness in patients who undergo thoracic aortic surgery: a retrospective cohort study2022

    • Author(s)
      Shimizu M, Adachi T, Kobayashi K, Mutsuga M, Oshima H, Usui A, Yamada S
    • Journal Title

      Physiotherapy Theory and Practice

      Volume: 23 Issue: 10 Pages: 1-9

    • DOI

      10.1080/09593985.2022.2068168

    • Related Report
      2022 Research-status Report
    • Peer Reviewed
  • [Journal Article] Clinical benefit of combined assessment of physical and psychological frailty in patients with heart failure2022

    • Author(s)
      Iwatsu K, Adachi T, Kamisaka K, Kuniyasu K, Iida Y, Yamada S
    • Journal Title

      Journal of American Geriatrics Society

      Volume: 70 Issue: 7 Pages: 2070-2079

    • DOI

      10.1111/jgs.17769

    • Related Report
      2022 Research-status Report 2021 Research-status Report
    • Peer Reviewed
  • [Journal Article] Relationship between spleen size and exercise tolerance in advanced heart failure patients with a left ventricular assist device.2022

    • Author(s)
      Hiroaki Hiraiwa, Takahiro Okumura, Akinori Sawamura, Takashi Araki, Takashi Mizutani, Shingo Kazama, Yuki Kimura, Naoki Shibata, Hideo Oishi, Tasuku Kuwayama, Toru Kondo, Kenji Furusawa, Ryota Morimoto, Takuji Adachi, Sumio Yamada, Masato Mutsuga, Akihiko Usui, Toyoaki Murohara
    • Journal Title

      BMC Res Notes.

      Volume: 15 Issue: 1 Pages: 40-40

    • DOI

      10.1186/s13104-022-05939-y

    • Related Report
      2022 Research-status Report 2021 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Prognostic Effects of Cardiac Rehabilitation in Patients with Heart Failure (From a Multicenter Prospective Cohort Study)2022

    • Author(s)
      Takuji Adachi, Naoki Iritani, Kuniyasu Kamiya, Kotaro Iwatsu, Kenta Kamisaka, Yuki Iida, Sumio Yamada
    • Journal Title

      American Journal of Cardiology

      Volume: 164 Pages: 79-85

    • DOI

      10.1016/j.amjcard.2021.10.038

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Association between Rapid Dementia Screening Test score and clinical events in elderly patients with cardiovascular disease: a retrospective cohort study2022

    • Author(s)
      Takuji Adachi, Yuki Tsunekawa, Akihito Matsuoka, Daisuke Tanimura
    • Journal Title

      European Journal of Cardiovascular Nursing

      Volume: -

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Association among mild cognitive impairment, social frailty, and clinical events in elderly patients with cardiovascular disease2022

    • Author(s)
      Takuji Adachi, Yuki Tsunekawa, Daisuke Tanimura
    • Journal Title

      Heart and Lung

      Volume: -

    • Related Report
      2021 Research-status Report
    • Peer Reviewed
  • [Journal Article] 高齢心不全患者における入院中の介護保険サービス調整と退院後のイベント発生との関連2022

    • Author(s)
      恒川裕気, 足立拓史, 松岡昭仁, 谷村大輔
    • Journal Title

      心臓

      Volume: 54 Pages: 367-376

    • Related Report
      2021 Research-status Report
    • Peer Reviewed
  • [Journal Article] Usefulness of the Japanese version of Rapid Dementia Screening Test for mild cognitive impairment in older patients with cardiovascular disease: a cross-sectional study2021

    • Author(s)
      Takuji Adachi, Yuki Tsunekawa, Akihito Matsuoka, Daisuke Tanimura
    • Journal Title

      Journal of Geriatric Cardiology

      Volume: 18 Pages: 245-251

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Association between Big Five Personality Traits and Participation in Cardiac Rehabilitation in Japanese Patients with Cardiovascular Disease: A Retrospective Cohort Study2021

    • Author(s)
      Takuji Adachi, Yuki Tsunekawa, Akihito Matsuoka, Daisuke Tanimura
    • Journal Title

      International Journal of Environmental Research and Public Health

      Volume: 18 Issue: 16 Pages: 8589-8589

    • DOI

      10.3390/ijerph18168589

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Prognostic score based on physical frailty in patients with heart failure: a multicenter prospective cohort study (FLAGSHIP)2021

    • Author(s)
      Yamada Sumio、Adachi Takuji、Izawa Hideo、Murohara Toyoaki、Kondo Takaaki、FLAGSHIP collaborators
    • Journal Title

      Journal of Cachexia, Sarcopenia and Muscle

      Volume: 12 Issue: 6 Pages: 1995-2006

    • DOI

      10.1002/jcsm.12803

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Association between a pre-admission limitation in walking ability and post-discharge adverse outcomes among hospitalized patients with heart failure: Report from a multicenter prospective cohort study2021

    • Author(s)
      Kuniyasu Kamiya, Takuji Adachi, Kotaro Iwatsu, Kenta Kamisaka, Yuki Iida, Naoki Iritani, Sumio Yamada
    • Journal Title

      International Journal of Cardiology

      Volume: 337 Pages: 105-112

    • DOI

      10.1016/j.ijcard.2021.05.020

    • Related Report
      2021 Research-status Report
    • Peer Reviewed
  • [Journal Article] Impact of weight loss in patients with heart failure with preserved ejection fraction: results from the FLAGSHIP study2021

    • Author(s)
      Kamisaka Kenta、Kamiya Kuniyasu、Iwatsu Kotaro、Iritani Naoki、Imoto Shota、Adachi Takuji、Iida Yuki、Yamada Sumio、FLAGSHIP collaborators
    • Journal Title

      ESC Heart Failure

      Volume: 8 Issue: 6 Pages: 5293-5303

    • DOI

      10.1002/ehf2.13619

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access
  • [Presentation] Effects of cardiac rehabilitation on the two-year prognosis of patients with heart failure: a multicentre prospective cohort study2021

    • Author(s)
      Takuji Adachi, Naoki Iritani, Kuniyasu Kamiya, Kotaro Iwatsu, Kenta Kamisaka, Yuki Iida, Sumio Yamada
    • Organizer
      ESC Congress 2022
    • Related Report
      2021 Research-status Report
    • Int'l Joint Research
  • [Presentation] 就業年層におけるbody mass indexと高血圧症重症化リスクとの関連:8年間の縦断的調査2021

    • Author(s)
      足立拓史、芦川博信、平松愛望、根岸真也、舟木空也、近藤諒、小野哲也、井出光昭、今井俊博、永田博巳、荻上隆、近藤高明、山田純生
    • Organizer
      第57回日本循環器病予防学会
    • Related Report
      2021 Research-status Report
  • [Presentation] 心臓リハビリテーションの予後改善効果2021

    • Author(s)
      足立拓史、入谷直樹、神谷訓康、岩津弘太郎、上坂建太、飯田有輝、山田純生
    • Organizer
      第58回日本臨床生理学会
    • Related Report
      2021 Research-status Report
    • Invited

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Published: 2021-04-28   Modified: 2025-01-30  

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