Determinants of changes in blood glucose response to short-term exercise training in patients with Type 2 diabetes

Abstract

The aim of the present study was to determine the effects of a 4-week exercise training intervention on blood glucose, insulin sensitivity, BMI (body mass index) and cardiorespiratory fitness in patients with Type 2 diabetes, and to identify and establish criteria for patients who are more likely to improve their blood glucose from short-term exercise training. A randomized, controlled trial of exercise training, comprising two supervised and one non-supervised sessions of individualized cardiorespiratory and resistance exercise per week, was performed in 132 healthy patients with Type 2 diabetes (exercise training group, n=68), with the aim of accumulating a minimum of 150 min of moderate-intensity exercise for 4 weeks. BMI, waist circumference, blood pressure, blood lipid profile, blood glucose, insulin, insulin sensitivity [calculated by HOMA(IR) (homoeostasis model assessment of insulin resistance) and QUICKI (quantitative insulin check index)], beta-cell function (calculated by HOMA(beta-Cell)), HbA(1c) (glycated haemoglobin) and VO(2max) (maximal oxygen consumption) were measured at baseline and at 4 weeks. The exercise training group had significant improvements in VO(2max), BMI and triacylglycerols (triglycerides). There were no significant changes in blood glucose, HOMA(IR), QUICKI or HOMA(beta-Cell). Decreases in blood glucose were significantly predicted by baseline blood glucose and HbA(1c), with these variables accounting for 15.9% of the change in blood glucose (P<0.001). ROC (receiver operator characteristic) curve analysis revealed that patients with a blood glucose >8.85 mmol/l (sensitivity=73%, specificity=78%) and HbA(1c) >7.15% (sensitivity=79%, specificity=60%) were more likely to achieve a clinically significant decrease in blood glucose. In conclusion, in apparently healthy patients with Type 2 diabetes, a 4-week exercise intervention improved cardiorespiratory fitness, BMI and triacylglycerols. Elevated blood glucose and HbA(1c) predicted improvements in blood glucose.

Exercise Training for Type 2 Diabetes Mellitus

“…51 Moreover, patients with greater metabolic disturbances have shown the greatest improvement in glycemic control. 57 Other potential mechanisms for better glucose control include improvement in insulin sensitivity 58,59 and effects on glucose transporters (eg, GLUT4). 60 -64 Muscle contractions can elicit movement of glucose transporters (GLUT4) to the plasma membrane independently of insulin, [65][66][67] and it is further speculated that muscle hypertrophy 30,40,51,68 and blood flow 69 are also contributing mechanisms.…”

Virtual Reality Exercise Improves Balance of Elderly Persons with Type 2 Diabetes: a Randomized Controlled Trial

“…Most previous researches of the elderly with diabetes has focused on improving glycemic control and lowering the risk of cardiovascular diseases through exercise intervention [11][12][13][14][15][16] , and only a few studies have dealt with enhancing balance. Therefore a systematic study of the effects of exercise on the balance of old adults with diabetes is needed 17) .…”

Underwater Treadmill Training, Glycemic Control, and Health-Related Fitness in Adults with Type 2 Diabetes

“…The post-UTT increase in estimated VO 2 max (∼8% or 2.2 ml•kg -1 •min -1 ) is consistent with relative gains in aerobic fitness in middle-aged and older adults with type 2 diabetes after 4 weeks of supervised land-based resistance and aerobic exercise (6.3%; Hordern et al, 2008) and 6 months of combined aerobic and resistance training (7.5%; Tan et al, 2012). The degree of improvement in cardiorespiratory fitness noted in our study was also similar to the 8.6% increase in VO 2 max following a 16-week circuit resistance training program which employed gradual increments in intensity and duration and met current exercise guidelines for adults with type 2 diabetes (Kang et al, 2009).…”