This study aimed to identify the specific reactance frequency that most significantly predicts the likelihood of achieving an HbA1c level below 6.5% after 6 months among T2DM patients participating in a lifestyle modification program. The study also sought to establish the threshold for Walk Score that differentiates patient groups.
A prospective observational cohort study was conducted with T2DM patients attending a diabetes outpatient clinic in a suburban hospital in Japan, with an annual patient volume of 1,200. Eligible participants were those who presented within 3 months of diagnosis and consented to participate in the program in addition to receiving standard care. The study period was from April 1, 2022, to March 31, 2023. Participants were divided into two groups based on their Walk Score threshold. Body composition measurements, including muscle mass, fat mass, impedance, and reactance in the limbs and trunk, were performed using Inbody (USA) every two months. Right arm and trunk impedance and reactance at 5kHz, 50kHz, and 250kHz were assessed, and logistic regression was used to estimate the odds ratios. ROC analysis was performed for each indicator using IBM-SPSSv26 (IBM, USA) .
Out of 221 initial patients, 65 participated, with a mean age of 65 years and 66% male. The mean BMI was 24.4, and the initial mean HbA1c was 7.7±1.4. No dropouts were recorded. A WS threshold of 74 was identified, separating the participants into two groups: high WS (BG, n=21) and low WS (LG, n=44). Among the BG group, the right arm reactance at 50kHz was significantly associated with blood glucose normalization (beta: -0.585, 95% CI: -0.376 to -0.075), with an estimated cut-off point around 29.4Ω. No significant reactance frequencies were identified in the LG group.
For T2DM patients aiming to normalize HbA1c, higher WS scores correlated significantly with right arm 50kHz reactance resistance. This suggests that utilizing body composition information, particularly reactance data, could enhance the management of diabetes and prevent the onset of complications. Physiotherapists could contribute to promoting physical activity by incorporating such monitoring techniques into patient care.
This project highlights the importance of integrating environmental and physiological assessments into diabetes care. For physiotherapy practice, this means designing personalized physical activity programs and utilizing non-invasive health monitoring techniques. In management, these insights support the enhancement of patient care strategies. Educationally, it emphasizes the need to incorporate these concepts into training programs, while in policy, it suggests the promotion of diabetes prevention programs that include body composition analysis.
Walk Score
Type 2 Diabetes Mellitus
