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The Effect of Blood Flow Restriction Training on Glycemic Control Among Type 2 Diabetes Patients

Not Applicable
Completed
Conditions
Type 2 Diabetes
Interventions
Behavioral: Low intensity exercise (LI)
Behavioral: Low-intensity training combined with blood flow restriction (LI-BFR)
Behavioral: High-intensity aerobic exercise (HI)
Registration Number
NCT04946799
Lead Sponsor
Uppsala University
Brief Summary

Blood flow restriction training (BFRT) combined with resistance or aerobic exercise has been shown to improve the glucose uptake in humans. In addition, BFRT represents a low-load, alternative exercise program for type 2 diabetes patients who often have reduced physical fitness. However, it is not clear to what extent could BFRT improve glycemic control among patients with type 2 diabetes. This pilot randomized-controlled trial aims to investigate the effect of a 12-week, low-intensity BFRT on glycemic control among patients with type 2 diabetes, compared to medium-high intensity aerobic exercise or low-intensity exercise without BFRT.

Detailed Description

Objectives:

The pilot randomized study aims to explore the effects of blood flow restriction combined with aerobic training (BFRT) on the glucose and lipid metabolism indexes and vascular endothelial factors of type 2 diabetes, by comparing it with traditional low-intensity and high-intensity aerobic training. It aims to evaluate the effectiveness of BFRT in glycemic control of type 2 diabetes patients.

Study Population:

A total of 60 patients with type 2 diabetes who are 50-65 years old at the Maigaoqiao Community Health Service Center, Qixia District, Nanjing, China, with a course of type 2 diabetes of 2-10 years will be included as the participants.

Randomization:

Participants will be stratified by baseline hemoglobin A1c (HbA1c) and age, they will be randomly assigned into three groups with a block size of six. The study groups are: 1) low-intensity training combined with blood flow restriction group (LI-BFR group, 40% heart rate reserve combined with 50% arterial occlusion pressure, n=20) 2)high-intensity aerobic exercise group (HI group, 70% heart rate reserve, n=20) 3) Low-intensity group (LI group, 40% heart rate reserve, n=20).

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
54
Inclusion Criteria
  • type 2 diabetes patients diagnosed by at least one of these criteria: 1) random blood glucose >= 11.1mmol/L; 2) fasting blood glucose >= 7.0 mmol/L; 3) 2-hr post oral glucose tolerance test blood glucose >= 11.1mmol/L; 4) hemoglobin A1c >= 6.5%.
  • aged between 50-65 years at baseline
  • disease course of type 2 diabetes between at least 1 year
Exclusion Criteria
  • type 1 diabetes
  • fasting blood glucose > 16.7 mmol/L, or suffers frequent hypoglycemia, or have significant glucose fluctuations considered by the physician
  • body mass index > 33 kg/m2
  • severe diabetes complications, including cardiovascular diseases, cerebrovascular diseases, diabetic retinopathy, kidney diseases, diabetic ketoacidosis, and diabetic foot ulcers
  • neuromuscular disorders, sarcopenia, severe osteoporosis, dementia
  • have regular moderate-intensive exercise habit
  • resting systolic blood pressure >= 160 mmHg or resting diastolic blood pressure >= 100 mmHg
  • abnormal electrocardiogram
  • other comorbidities or medications irrelevant to diabetes treatment that may influence glycemia during the past 6 months

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Low intensity group (LI)Low intensity exercise (LI)-
Low-intensity training combined with blood flow restriction group (LI-BFR)Low-intensity training combined with blood flow restriction (LI-BFR)-
High-intensity aerobic exercise group (HI)High-intensity aerobic exercise (HI)-
Primary Outcome Measures
NameTimeMethod
Hemoglobin A1c (HbA1c) at follow-upAt week 13, within 7 days after the completion of the 12-week intervention (observation)

HbA1c level in blood

Fasting glucose at baselineAt baseline, within 7 days before the intervention (observation) starts

blood glucose level following overnight (12-h) fasting

Fasting glucose at follow-upAt week 13, within 7 days after the completion of the 12-week intervention (observation)

blood glucose level following overnight (12-h) fasting

Fasting insulin at baselineAt baseline, within 7 days before the intervention (observation) starts

blood insulin level following overnight (12-h) fasting

Hemoglobin A1c (HbA1c) at baselineAt baseline, within 7 days before the intervention (observation) starts

HbA1c level in blood

Fasting insulin at follow-upAt week 13, within 7 days after the completion of the 12-week intervention (observation)

blood insulin level following overnight (12-h) fasting

Secondary Outcome Measures
NameTimeMethod
Continuous glucose monitoringAt baseline, within 14 days before the intervention (observation) starts, measurement lasts for 14 days

14-day continuous glucose monitoring with portable device

Weight at follow-upAt week 13, within 7 days after the completion of the 12-week intervention (observation)

weight in kilograms

non-esterified fatty acid (NEFA) at baselineAt baseline, within 7 days before the intervention (observation) starts

morning NEFA level in blood following overnight (12-h) fasting

Pittsburg sleep quality index (PSQI) at follow-upAt week 13, within 7 days after the completion of the 12-week intervention (observation)

Pittsburg sleep quality index global (0-21) and sub-scores (0-3), higher score means poorer quality

Total sleep duration and total awakening duration at baselineAt baseline, within 14 days before the intervention (observation) starts, measurement lasts for at least 7 days

total sleep duration (in minutes) and total awakening duration after sleep onset (in minutes) assessed by wrist actigraphy (GT3x, Actigraph LLC, Pensacola, FL, USA)

Height at baselineAt baseline, within 7 days before the intervention (observation) starts

height in meters

Height at follow-upAt week 13, within 7 days after the completion of the 12-week intervention (observation)

height in meters

Weight at baselineAt baseline, within 7 days before the intervention (observation) starts

weight in kilograms

Total sleep duration and total awakening duration at follow-upAt week 13, within 14 days after the completion of the 12-week intervention (observation), measurement lasts for at least 7 days

total sleep duration (in minutes) and total awakening duration after sleep onset (in minutes) assessed by wrist actigraphy (GT3x, Actigraph LLC, Pensacola, FL, USA)

Pittsburg sleep quality index (PSQI) at baselineAt baseline, within 7 days before the intervention (observation) starts

Pittsburg sleep quality index global (0-21) and sub-scores (0-3), higher score means poorer quality

total cholesterol at baselineAt baseline, within 7 days before the intervention (observation) starts

total cholesterol level in blood following overnight (12-h) fasting

total cholesterol at follow-upAt week 13, within 7 days after the completion of the 12-week intervention (observation)

total cholesterol level in blood following overnight (12-h) fasting

triglyceride at baselineAt baseline, within 7 days before the intervention (observation) starts

triglyceride level in blood following overnight (12-h) fasting

triglyceride at follow-upAt week 13, within 7 days after the completion of the 12-week intervention (observation)

triglyceride level in blood following overnight (12-h) fasting

non-esterified fatty acid (NEFA) at follow-upAt week 13, within 7 days after the completion of the 12-week intervention (observation)

morning NEFA level in blood following overnight (12-h) fasting

IL-6 at follow-upAt week 13, within 7 days after the completion of the 12-week intervention (observation)

morning interleukin-6 level in blood following overnight (12-h) fasting

International Physical Activity Questionnaire - Short Form at baselineAt week 13, within 7 days after the completion of the 12-week intervention (observation)

International Physical Activity Questionnaire (IPAQ) - Short Form for assessing level of physical activity. Level of physical activity are calculated into metabolic equivalent minutes per week (MET mins/wk) according to the answers of the questionnaire. Higher MET mins/wk refers to higher level of physical activity.

IL-6 at baselineAt baseline, within 7 days before the intervention (observation) starts

morning interleukin-6 level in blood following overnight (12-h) fasting

Trial Locations

Locations (1)

Nanjing Maigaoqiao Community Healthcare Center

🇨🇳

Nanjing, Jiangsu, China

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