Comparison of Aerobic and Resistance Training Effects on Glycemic Control in Type 2 Diabetes
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Type 2 Diabetes
- Sponsor
- Universita di Verona
- Enrollment
- 40
- Primary Endpoint
- Change in haemoglobin A1c (HbA1c) levels
- Status
- Completed
- Last Updated
- 14 years ago
Overview
Brief Summary
The purposes of this study are: a) to compare the effects of supervised programs of aerobic training or resistance training on the metabolic control of type 2 diabetes; b) to investigate some potential pathophysiologic and molecular mechanisms underlying these effects; c) to assess whether some changes may persist over time after termination of the supervised programs.
Detailed Description
Meta-analyses of studies which evaluated the effects of interventions based upon structured exercise programs in patients with type 2 diabetes show that regular physical activity may improve glycosylated haemoglobin (HbA1c) by 0.6-0.7%. Most studies assessed the effects of aerobic exercise. However, recent data suggest that resistance training may result in similar effects. It seems likely that these beneficial results are obtained through different molecular mechanisms by aerobic training and resistance training. Consequently, these exercise modalities could be synergistic in improving the metabolic abnormalities in these subjects. On the other hand, comparison data are very limited. Aims of the protocol are to compare the effects of aerobic training or resistance training on the metabolic control of type 2 diabetes and to investigate some potential pathophysiologic and molecular mechanisms underlying these effects. The study will be carried out in 40 sedentary type 2 diabetic patients without diabetic complications, aged 40-70 yr, with body mass index (BMI) between 24-36 kg/m2 and HbA1c between 6.5-9.0%. Admitted diabetes treatments will be diet and oral hypoglycemic agents. Subjects will be assigned, by a randomization schedule weighted by baseline BMI and fitness, to 2 groups of supervised exercise: aerobic training or resistance training. Training programs will have a similar volume and will be scheduled in three 60 min sessions per week for 4 months. During the study subjects will be instructed to follow an isocaloric diet. Before and at the end of the exercise training the following will be assessed: HbA1c (primary outcome), plasma glucose, lipid profile, blood pressure, insulin sensitivity (glucose clamp), body composition (Dual energy X-ray absorptiometry, DEXA), liver and muscle fat content (magnetic resonance imaging), expression in the muscle of some genes involved in ATP production, mitochondrial biogenesis and substrate utilization, markers of inflammation, oxidative stress and early vascular damage, peak oxygen uptake (VO2peak) during a maximal exercise test, other exercise tests, tissue oxygen extraction during exercise (Near-infrared spectroscopy, NIRS), energy expenditure and physical activity in daily life (metabolic Holter and questionnaire). Monitoring of blood glucose will also be carried out over a 48h period, comprising an exercise session (Continuous Glucose Monitoring System). Metabolic features, exercise tests, body composition, daily physical activity and expression of relevant genes in the muscle will also be assessed 1 yr after completion of the training programs, to establish whether some changes may persist over time.
Investigators
Paolo Moghetti
Associate Professor of Endocrinology
Universita di Verona
Eligibility Criteria
Inclusion Criteria
- •BMI between 24-36 kg/m2;
- •HbA1c between 6.5-9.0%;
- •diabetes diagnosis must have been made at least 1 yr previously;
- •admitted diabetes treatments will be diet and oral hypoglycemic agents;
- •baseline physical activity, estimated by the IPAQ questionnaire, lower than 1000 MET min per week;
- •baseline body weight stable (changes lower than 2 kg in the last 2 months).
Exclusion Criteria
- •moderate-severe somatic or autonomic neuropathy;
- •coronary heart disease;
- •peripheral or cerebral vascular disease;
- •preproliferative or proliferative retinopathy or chronic renal failure (serum creatinine \>1.4 mg/dl in females; \>1.5 mg/dl in males);
- •therapy with beta-blocker drugs;
- •acute clinically significant intercurrent diseases;
- •inability to perform the scheduled physical activity programs.
Outcomes
Primary Outcomes
Change in haemoglobin A1c (HbA1c) levels
Time Frame: 4 months
The measurement of HbA1c is carried out with a DCCT (Diabetes Control and Complications Trial)-aligned method.
Secondary Outcomes
- Change in body composition(4 months)
- Change in body weight(4 months)
- Change in total cholesterol levels(4 months)
- Change in LDL-cholesterol levels(4 months)
- Change in triglycerides levels(4 months)
- Change in energy expenditure(4 months)
- Change in peak oxygen uptake(4 months)
- Change in liver and muscle fat content(4 months)
- Changes in expression in the muscle of some genes involved in ATP production, mitochondrial biogenesis and substrate utilization(4 months)
- Change in fasting plasma glucose levels(4 months)
- Change in beta-cell function(4 months)
- Change in tissue oxygen extraction(4 months)
- Change in HDL-cholesterol levels(4 months)
- Change in blood pressure(4 months)
- Change in blood glucose during and after exercise(48 hours)
- Muscle strength(4 months)
- Change in flexibility(4 months)
- Compliance(4 months)
- Change in energy expenditure through voluntary physical activity(4 months)
- Change in insulin sensitivity(4 months)
- Change in antidiabetic medications(4 months)
- Change in 6 minutes walk distance(4 months)