Effects of Aerobic Training, Resistance Training, or Both on Glycemic Control in Type 2 Diabetes

Sigal, Ronald J.; Kenny, Glen P.; Boulé, Normand G.; Wells, George A.; Prud’homme, Denis; Fortier, Michelle; Reid, Robert D.; Tulloch, Heather; Coyle, Doug; Phillips, Penny; Jennings, Alison; Jaffey, James

doi:10.7326/0003-4819-147-6-200709180-00005

Cited by 1,049 publications

(1,039 citation statements)

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“…The key finding in the present randomized controlled trial was no reductions in resting SBP or DBP were achieved among exercisers at 6 months despite a training effect as evidenced by increased fitness, improved glycemic control and improved body composition. Thus, our study provides a higher level of evidence, and corroborates the finding of a recent trial, 14 supporting the conclusion of ACSM/ADA Abbreviations: SE standard error *Test for difference on change from baseline **Test for between-group difference on the change from baseline regarding lack of efficacy of exercise for reducing BP in this population. Several factors might explain the lack of change in BP.…”

Section: Discussionsupporting

confidence: 89%

Effect of Exercise on Blood Pressure in Type 2 Diabetes: A Randomized Controlled Trial

et al. 2012

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BACKGROUND: Increased blood pressure (BP) in type 2 diabetes (T2DM) markedly increases cardiovascular disease morbidity and mortality risk compared to having increased BP alone. OBJECTIVE: To investigate whether exercise reduces suboptimal levels of untreated suboptimal BP or treated hypertension. DESIGN: Prospective, randomized controlled trial for 6 months. SETTING: Single center in Baltimore, MD, USA. PATIENTS: 140 participants with T2DM not requiring insulin and untreated SBP of 120-159 or DBP of 85-99 mmHg, or, if being treated for hypertension, any SBP <159 mmHg or DBP<99 mmHg; 114 completed the study. INTERVENTION: Supervised exercise, 3 times per week for 6 months compared with general advice about physical activity. MEASUREMENTS: Resting SBP and DBP (primary outcome); diabetes status, arterial stiffness assessed as carotid-femoral pulse-wave velocity (PWV), body composition and fitness (secondary outcomes). RESULTS: Overall baseline BP was 126.8±13.5 / 71.7 ± 9.0 mmHg, with no group differences. At 6 months, BP was unchanged from baseline in either group, BP 125.8±13.2 / 70.7±8.8 mmHg in controls; and 126.0 ± 14.2 / 70.3 ± 9.0 mmHg in exercisers, despite attaining a training effects as evidenced by increased aerobic and strength fitness and lean mass and reduced fat mass (all p<0.05), Overall baseline PWV was 959.9±333.1 cm/s, with no group difference. At 6-months, PWV did not change and was not different between group; exercisers, 923.7±319.8 cm/s, 905.5± 344.7, controls. LIMITATIONS: A completion rate of 81 %. CONCLUSIONS: Though exercisers improve fitness and body composition, there were no reductions in BP. The lack of change in arterial stiffness suggests a resistance to exercise-induced BP reduction in persons with T2DM.KEY WORDS: exercise training; diabetes; high blood pressure; randomized trial.

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Section: Discussionsupporting

confidence: 89%

Effect of Exercise on Blood Pressure in Type 2 Diabetes: A Randomized Controlled Trial

et al. 2012

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“…Overall, 59/218 (27%) of participants included in this analysis sustained an adverse event during the course of the study, including 16 participants in the combined exercise group, 19 participants in the resistance exercise group, 16 participants in the aerobic exercise group, and eight participants in the control group. The main outcomes of the trial have been reported previously [8]. Briefly, the absolute change in the HbA 1c value in combined compared with control groups was −0.96 percentage points (95% CI −1.32, −0.61).…”

Section: Resultsmentioning

confidence: 99%

“…Resistance exercise training caused some clinically important improvements in physical health status; however, none of the exercise training programmes enhanced the mental component of health status relative to non-exercise control. While aerobic and resistance exercise training and a combination of both unmistakably improve glycaemic control [2,8], effects on patient-reported quality of life outcomes during a 6-month exercise intervention are less clear. Duality of interest The authors declare that there is no duality of interest associated with this manuscript.…”

Section: Discussionmentioning

confidence: 99%

“…Design A complete description of the DARE study design and methods has been published [8]. This was a singlecentre, randomised controlled trial with a parallel group design.…”

Section: Methodsmentioning

confidence: 99%

“…Its primary results concerning effects on HbA 1c have been reported [8]. Both aerobic and resistance exercise training improved glycaemic control, while a combination of both was superior to either type of exercise training alone [8].…”

Section: Introductionmentioning

confidence: 99%

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Effects of aerobic exercise, resistance exercise or both, on patient-reported health status and well-being in type 2 diabetes mellitus: a randomised trial

et al. 2009

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Aims/hypothesis The Diabetes Aerobic and Resistance Exercise (DARE) study showed that aerobic and resistance exercise training each improved glycaemic control and that a combination of both was superior to either type alone in patients with type 2 diabetes mellitus. Here we report effects on patient-reported health status and well-being in the DARE Trial. Methods We randomised 218 inactive participants with type 2 diabetes mellitus in parallel to 22 weeks of aerobic exercise (n=51), resistance exercise (n=58), combined aerobic and resistance exercise (n=57) or no exercise (control; n=52). Intervention allocation was managed by a central office. Outcomes included health status as assessed by the physical and mental component scores of the Medical Outcomes Trust Short-Form 36-item version (SF-36) and well-being as measured by the Well-Being Questionnaire 12-item version (WBQ-12); these were measured at the Ottawa Hospital. Results Using a p value of 0.0125 for statistical significance due to multiple comparisons, mixed model analyses indicated that resistance exercise led to clinically but not statistically significant improvements in the SF-36 physical component score compared with aerobic exercise (Δ=2.7 points; p=0.048) and control (i.e. no exercise; Δ=3.3 points; p=0.015). For mental component scores, there were clinically important improvements favouring no (control) compared with resistance (Δ=7.6 points; p<0.001) and combined (Δ=7.2 points; p<0.001) exercise. No effects on WBQ-12 scores were noted. Overall, 59/218 (27%) of participants included in this analysis sustained an adverse event during the course of the study, including 16 participants in the combined exercise group, 19 participants in the resistance exercise group, 16 participants in the Electronic supplementary material The online version of this article

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Effects of Exercise Modality on Insulin Resistance and Functional Limitation in Older Adults

Davidson¹,

Hudson²,

Kilpatrick³

et al. 2009

Arch Intern Med

254

266

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Effects of Aerobic Training, Resistance Training, or Both on Glycemic Control in Type 2 Diabetes

Abstract: Either aerobic or resistance training alone improves glycemic control in type 2 diabetes, but the improvements are greatest with combined aerobic and resistance training. ClinicalTrials.gov registration number: NCT00195884.

Cited by 1,049 publications

References 20 publications

Effect of Exercise on Blood Pressure in Type 2 Diabetes: A Randomized Controlled Trial

Effect of Exercise on Blood Pressure in Type 2 Diabetes: A Randomized Controlled Trial

Effects of aerobic exercise, resistance exercise or both, on patient-reported health status and well-being in type 2 diabetes mellitus: a randomised trial

Effects of Exercise Modality on Insulin Resistance and Functional Limitation in Older Adults

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