The effects of a combined strength and aerobic exercise program on glucose control and insulin action in women with type 2 diabetes

Aristotle University of Thessaloniki, Saloníki, Central Macedonia, Greece
Arbeitsphysiologie (Impact Factor: 2.19). 08/2004; 92(4-5):437-42. DOI: 10.1007/s00421-004-1174-6
Source: PubMed


The purpose of the present study was to investigate the short- and long-term effects of a combined strength and aerobic training program on glycemic control, insulin action, exercise capacity and muscular strength in postmenopausal women with type 2 diabetes. Nine postmenopausal women, aged 55.2 (6.7) years, with type 2 diabetes participated in a supervised training program for 4 months consisting of two strength training sessions (3 sets of 12 repetitions at 60% one-repetition maximum strength) and two aerobic training sessions (60-70% of maximum heart rate at the beginning, and 70-80% of maximum heart rate after 2 months). Anthropometrical measurements, percentage glycated hemoglobin, a 2-h oral glucose tolerance test, exercise stress testing and maximum strength were measured at the beginning, and after 4 and 16 weeks of the exercise program. Significant reductions were observed in both the glucose (8.1% P<0.01) and insulin areas under the curve (20.7%, P<0.05) after 4 weeks of training. These adaptations were further improved after 16 weeks (glucose 12.5%, insulin 38%, P<0.001). Glycated hemoglobin was significantly decreased after 4 weeks [7.7 (1.7) vs 7.1 (1.3)%, P<0.05] and after 16 weeks [7.7 (1.7) vs 6.9 (1.0)%, P<0.01] of exercise training. Furthermore, exercise time and muscular strength were significantly improved after 4 weeks (P<0.01) as well as after 16 weeks (P<0.001) of training. Body mass and body-mass index, however, were not significantly altered throughout the study. The results indicated that a combined training program of strength and aerobic exercise could induce positive adaptations on glucose control, insulin action, muscular strength and exercise tolerance in women with type 2 diabetes.

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Available from: Konstantinos A Volaklis, May 20, 2014
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    • "Previous studies have found that reductions in fat mass (10) and central adiposity (9,11) and increases in fitness (11,12) and muscle strength (12,13) are associated with reductions in HbA1c after exercise training. In a large (n = 251) randomized trial, Larose et al. (12) found that change in cardiorespiratory fitness was the strongest predictor of change in HbA1c after aerobic and aerobic combined with resistance training. "
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    ABSTRACT: OBJECTIVE To investigate the associations between changes in body composition and fitness after exercise training and changes in hemoglobin A1c (HbA1c) in individuals with type 2 diabetes.RESEARCH DESIGN AND METHODS Participants (n = 201) were randomized to aerobic, resistance, or combined training for 9 months. HbA1c, waist circumference, total and trunk fat mass, appendicular fat mass, lean body mass, isokinetic leg muscle strength, peak O2 uptake, and estimated METs were assessed at baseline and follow-up. Change in HbA1c was evaluated across quartiles of change in body composition and fitness.RESULTSChange in HbA1c was associated with changes in body weight (r = 0.13, P = 0.052), waist circumference (r = 0.17, P = 0.013), trunk fat mass (r = 0.19, P = 0.005), and estimated METs (r = -0.16, P = 0.023). There was a trend in change in HbA1c across quartiles of waist circumference (P = 0.011), trunk fat mass (P = 0.020), and estimated METs (P = 0.011). Participants with increased estimated METs and reduced trunk fat mass had greater odds of having reduced HbA1c after training (3.48, 1.46-8.31). Finally, participants with increased estimated METs and reduced waist circumference were 2.81 (1.13-6.98) times more likely to have reduced HbA1c and type 2 diabetes medication use than those who without improved fitness and central adiposity.CONCLUSIONS In patients with type 2 diabetes, a reduction in central adiposity and increase in fitness were the most prominent predictors of the change in HbA1c in response to exercise training.
    Diabetes care 05/2013; 36(9). DOI:10.2337/dc12-2428 · 8.42 Impact Factor
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    • "However, other markers of metabolic control did not change. It was not the scope of this study to investigate insulin resistance, and others have shown signs of decreased insulin resistance after exercise in 2DM [34] however, the effect of training is unclear in CHF [35]. We could not confirm that immersion in warm water solely could enhance metabolic function in patients with 2DM, as shown by Hooper [36]. "
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    ABSTRACT: Background. Peak oxygen uptake (VO2peak) and muscle function are more decreased in patients with a combination of chronic heart failure (CHF) and type 2 diabetes mellitus (2DM) compared to patients with only one of the conditions. Further, patients with 2DM have peripheral complications that hamper many types of conventional exercises. Aim. To evaluate the efficacy and applicability of eight-week aquatic exercise in patients with the combination of CHF and 2DM. Methods. Twenty patients (four women) with both CHF and 2DM (age 67.4 ± 7.1, NYHA II-III) were randomly assigned to either aquatic exercise or a control group. The patients exercised for 45 minutes 3 times/week in 33–34°C, swimming pool. Results. The training programme was well tolerated. Work rate (+11.7 ± 6.6 versus −6.4 ± 8.1 watt, P < 0.001) and VO2peak (+2.1 ± 0.8 versus −0.9 ± 1.4 mL·kg−1·min−1, P < 0.001) and walking capacity (P = 0.01) increased significantly in the training group. Muscle function was also significantly improved and Hba1c decreased significantly (P < 0.01) during training, while fasting glucose, insulin, c-peptide, and lipids were unchanged . Training also increased vitality measured by SF-36 significantly (P = 0.05). Conclusion. Aquatic exercise could be used to improve exercise capacity and muscle function in patients with the combination of CHF and 2DM.
    Evidence-based Complementary and Alternative Medicine 04/2012; 2012:349209. DOI:10.1155/2012/349209 · 1.88 Impact Factor
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    • "Two studies reported reductions in the HbA1c values of 0.6 with combined aerobic and resistance exercises of 8 weeks or more [35,38]. Tokmakidis showed a reduction of 0.8 percentage points and Sigal et al had a reduction of 0.9 percentage points in HbA1c with combined aerobic and resistance exercises [30,36]. We report a decrease of 1.6 percentage points over the course of a 10 week resistance training program. "
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    ABSTRACT: The aim of this study was to compare the effects of 10 weeks of resistance or treadmill exercises on glycemic indices levels prior to and immediately following exercise in adults with type 2 diabetes. Twenty inactive subjects (mean age 53.5 years) with type 2 diabetes enrolled in the study. Baseline HbA1c, blood glucose levels, heart rate, and blood pressure were measured for each subject prior to the initiation of the exercise program. Subsequently, subjects were matched to age, waist circumference and sex and assigned to either isocaloric resistance or treadmill exercise groups, which met 3 times per week for 10 weeks. Both groups showed a reduction in pre and post-exercise blood glucose and HbA1c values. There was no change in resting blood pressure or heart rate in either group during the course of the 10 week intervention. The group receiving resistance exercises showed significant differences in the daily pre-exercise plasma glucose readings between the beginning and end of the exercise protocol (p < 0.001). There were significant improvements in the mean HbA1c reading pre and post training in both groups (p < 0.001). However, the greater reduction was noted in the resistance exercise group, and at 10 weeks their HbA1c levels were significantly lower than the group that received treadmill exercises (p < 0.006). Ten weeks of resistance exercises were associated with a significantly better glycemic control in adults with type 2 diabetes compared to treadmill exercise.
    Diabetology and Metabolic Syndrome 12/2009; 1(1):27. DOI:10.1186/1758-5996-1-27 · 2.17 Impact Factor
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