Effects of different doses of exercise and diet-induced weight loss on beta-cell function in type 2 diabetes (DOSE-EX): a randomized clinical trial

Abstract

Diet-induced weight loss is associated with improved beta-cell function in people with type 2 diabetes (T2D) with remaining secretory capacity. It is unknown if adding exercise to diet-induced weight loss improves beta-cell function and if exercise volume is important for improving beta-cell function in this context. Here, we carried out a four-armed randomized trial with a total of 82 persons (35% females, mean age (s.d.) of 58.2 years (9.8)) with newly diagnosed T2D (<7 years). Participants were randomly allocated to standard care (n = 20), calorie restriction (25% energy reduction; n = 21), calorie restriction and exercise three times per week (n = 20), or calorie restriction and exercise six times per week (n = 21) for 16 weeks. The primary outcome was beta-cell function as indicated by the late-phase disposition index (insulin secretion multiplied by insulin sensitivity) at steady-state hyperglycemia during a hyperglycemic clamp. Secondary outcomes included glucose-stimulated insulin secretion and sensitivity as well as the disposition, insulin sensitivity, and secretion indices derived from a liquid mixed meal tolerance test. We show that the late-phase disposition index during the clamp increases more in all three intervention groups than in standard care (diet control group, 58%; 95% confidence interval (CI), 16 to 116; moderate exercise dose group, 105%; 95% CI, 49 to 182; high exercise dose group, 137%; 95% CI, 73 to 225) and follows a linear dose–response relationship (P > 0.001 for trend). We report three serious adverse events (two in the control group and one in the diet control group), as well as adverse events in two participants in the diet control group, and five participants each in the moderate and high exercise dose groups. Overall, adding an exercise intervention to diet-induced weight loss improves glucose-stimulated beta-cell function in people with newly diagnosed T2D in an exercise dose-dependent manner (NCT03769883).

A Combination of Exercise and Yogurt Intake Protects Mice against Obesity by Synergistic Promotion of Adipose Browning

“…Although exercise alone is helpful, dietary guidelines around the world suggest that the dual intervention of diet and lifestyle is the most efficacious therapy in alleviating obesity. − Yogurt is rich in lactate, owing to probiotic fermentation. In addition, prospective cohort researches have elucidated an inverse correlation between yogurt consumption and obesity prevalence. , According to our study, the combination of yogurt and exercise could provide a new strategy for personalized diet and lifestyle interventions for obese individuals.…”

Metabolic impairments associated with type 2 diabetes mellitus and the potential effects of exercise therapy: An exploratory randomized trial based on untargeted metabolomics

“…For a pilot omics study, the application of 10-case samples in similar omics studies [73][74][75] during that timeframe underline the relative adequacy of our sample size given the specific conditions. Additionally, we noted that recent high-quality omics studies on exercise intervention in diabetes, where sample sizes have expanded to 15-21 cases per group [76,77]. A sample size of 15-21 per group as reference to facilitate the scientific rigor and reliability of similar study in the future.…”

Unveiling the pathogenesis and therapeutic approaches for diabetic nephropathy: insights from panvascular diseases

“…Mounting evidence suggests that stringent control of hyperglycemia effectively mitigates renal complications ( 63 ). Clinical studies ( 64 , 65 ) have validated that achieving near-normal glycemia through a combinatorial pharmacotherapy approach, dietary modification and exercise substantially delays DN progression and lowers risks of renal adverse outcomes. Hypertension is also a key driver of DN pathogenesis ( 66 , 67 ).…”