Normalization of diastolic dysfunction in type 2 diabetics after exercise training.

Laval Hospital Research Center, Quebec Heart and Lung Institute, Quebec, Canada.
Medicine &amp Science in Sports &amp Exercise (Impact Factor: 4.46). 11/2007; 39(11):1896-901. DOI: 10.1249/mss.0b013e318145b642
Source: PubMed

ABSTRACT The purpose of this study was to evaluate the impact of aerobic exercise training on left ventricular diastolic dysfunction (LVDD) and exercise capacity in subjects with type 2 diabetes.
Twenty-three sedentary subjects with well-controlled type 2 diabetes, free of coronary disease and having different degrees of LVDD, participated in the study. Subjects were treated with oral hypoglycemic agents and/or diet. Eleven subjects (EX) (age: 58 +/- 5 yr; mean +/- SD) underwent a 3-month aerobic exercise training program using a cycle ergometer, whereas a control group (CONT) of 12 subjects (57 +/- 6 yr) maintained their activities of daily living. Exercise capacity and LVDD, using echocardiography, were evaluated before and after the 3-month exercise program.
At baseline, anthropometric data were similar between the groups, except for body mass index (BMI), which was higher in CONT (31 +/- 3 vs 28+/- 3 kg x m(-2); P < 0.05). There were no significant differences in glycemic control (HbA1c: 6.4 +/- 1.2 vs 5.8 +/- 1.3%; P = 0.2) or maximal oxygen uptake (26.7 +/- 5.9 vs 28.6 +/- 3.9 mL x kg(-1) x min(-1); P = 0.4) between groups. Normalization of LVDD was observed in 5 of 11 EX subjects, (P < 0.0001) of whom four had grade 1 LVDD before exercise training. No change in diastolic function was observed in the CONT group. After exercise training, maximal oxygen uptake increased in the EX group (28.6 +/- 3.9 vs 32.7 +/- 5.7 mL x kg(-1) x min(-1); P < 0.05), whereas there was no change in the CONT group (26.7 +/- 5.9 vs 27.3 +/- 6.2 mL x kg(-1) x min(-1); P = 0.58). In both groups, there was no significant change in BMI.
Along with an improvement in exercise capacity, aerobic exercise training has the potential to reverse LVDD in patients with well-controlled, uncomplicated type 2 diabetes.

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    ABSTRACT: Background The role of structured exercise in improving cardio-metabolic profile and quality of life in patients with type 2 diabetes mellitus (2DM) has been widely demonstrated. Little is known about the effects of an aquatic-based exercise program in patients with 2DM. Objective to evaluate the effects of a supervised aquatic-based exercise program on cardio-metabolic profile, quality of life and physical activity levels in 2DM patients. Design and Setting: Observational study, community pre-post aquatic-based exercise program, primary care intervention Patients Eighteen men diagnosed with 2DM (52.2±9.3 years) Methods and Main Outcome Measurements: Cardio-metabolic profile, quality of life and physical activity levels were assessed before and after 12-weeks of an aquatic-based exercise program Results The results show a significant improvement of cardio-metabolic assessments (VO₂Max:24.1 vs 21.1 ml/kg/min, p<.05; blood pressure:125.4/77 vs 130.7/82.5 mmHg, p<.05; fasting blood glucose:119.6 vs 132.5 mg/dl, p<.05; body mass index:29.9 vs 31.1 Kg/m², p<.005; LDL-Chol:95.2 vs 104.9 mg/dl, p<.05 and diastolic function:E/E’ 9.1 vs 10.1, <.005) and an increase in quality of life and physical activity levels (Sf-36 - Mental component summary:72.3 vs 67, p<.05; PAID:20.1 vs 33.2, p<.005 and energy expenditure in general physical activity (PA:3888.7 vs 1239.5 Kcal/week, p<.05). Conclusions These findings demonstrate that an aquatic-based exercise program produces benefits on the cardiovascular system, metabolic profile and appears to be safe and effective improving quality of life and increasing physical activity levels in 2DM patients.
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