People with diabetes who attended classes to help them increase their exercise had more significant improvements than people who focused on trying to change exercise, diet modification and medication at the same time.

"In studies that focused on exercise only, blood glucose improved twice as much as in studies that focused on exercise, diet and medication adherence," said Vicki Conn, professor and associate dean of research in the MU Sinclair School of Nursing.

The meta-analysis considered data from 10,455 subjects in 103 research reports. No previous meta-analysis has compared exercise-only interventions with interventions including multiple diabetes self-management behaviors. Complications from diabetes are serious and can include: heart attacks, kidney disease or limb amputation.

"One thing we found was that it doesn't matter how overweight you are or how poor your current blood glucose is at the start of the studies, the improvements from exercise were equal across the board," Conn said.

The study also found that women did not improve as much as men. However, both young and older adults had similar benefits from the physical activity intervention.

"The censuses among these studies could mean that it is easier for people to focus on one thing at a time. It is easy for people to get overwhelmed when asked to make too many changes," Conn said.

missouri

Heavy-metal toxic effects, and environmental and occupational exposures, have also been proposed as causes of MND. But the authors say: Despite extensive research, the disorder remains poorly understood in terms of a unifying causal hypothesis, and, indeed, might turn out to be a common end-stage phenotype of diverse causes.

Many treatments have been tried for MND, but few have had success. Riluzole is the only drug licensed to treat MND, and has been shown to extend the lives of MND patients by an average of three months.

The authors are sceptical about the use of stem cell treatment, saying much work needs to be done before stem-cell treatment can ever be regarded as even an experimental therapeutic treatment. An earlier trial of injecting stem-cells into the spinal cord proved ineffective in relieving MND symptoms.

Use of viral vectors for drug delivery could be a pioneering MND treatment, since it extended the life expectancy of mice it was tested in by 30%. The need to deliver disease-modifying treatments direct to the site of disease process “ i.e. the motor neurone “ is a recurring theme of treatment discussions.

The authors conclude: Because of the shortage of satisfactory disease-modifying treatments, early diagnosis of amyotrophic lateral sclerosis has traditionally not been imperative. It will, however, be increasingly important for any attempts to develop more effective treatments.

the lancet/