High-intensity interval training for 12 weeks improves cardiovascular autonomic function but not somatosensory nerve function and structure in overweight men with type 2 diabetes

Abstract

Aims/hypothesis It remains unclear whether and which modality of exercise training as a component of lifestyle intervention may exert favourable effects on somatosensory and autonomic nerve tests in people with type 2 diabetes. Methods Cardiovascular autonomic and somatosensory nerve function as well as intraepidermal nerve fibre density (IENFD) were assessed in overweight men with type 2 diabetes (type 2 diabetes, n = 20) and male glucose-tolerant individuals (normal glucose tolerance [NGT], n = 23), comparable in age and BMI and serving as a control group, before and after a supervised high-intensity interval training (HIIT) intervention programme over 12 weeks. Study endpoints included clinical scores, nerve conduction studies, quantitative sensory testing, IENFD, heart rate variability, postural change in systolic blood pressure and spontaneous baroreflex sensitivity (BRS). Results After 12 weeks of HIIT, resting heart rate decreased in both groups ([mean ± SD] baseline/12 weeks: NGT: 65.1 ± 8.2/60.2 ± 9.0 beats per min; type 2 diabetes: 68.8 ± 10.1/63.4 ± 7.8 beats per min), while three BRS indices increased (sequence analysis BRS: 8.82 ± 4.89/14.6 ± 11.7 ms2/mmHg; positive sequences BRS: 7.19 ± 5.43/15.4 ± 15.9 ms2/mmHg; negative sequences BRS: 12.8 ± 5.4/14.6 ± 8.7 ms2/mmHg) and postural change in systolic blood pressure decreased (−13.9 ± 11.6/−9.35 ± 9.76 mmHg) in participants with type 2 diabetes, and two heart rate variability indices increased in the NGT group (standard deviation of R–R intervals: 36.1 ± 11.8/55.3 ± 41.3 ms; coefficient of R–R interval variation: 3.84 ± 1.21/5.17 ± 3.28) (all p<0.05). In contrast, BMI, clinical scores, nerve conduction studies, quantitative sensory testing, IENFD and the prevalence rates of diabetic sensorimotor polyneuropathy and cardiovascular autonomic neuropathy remained unchanged in both groups. In the entire cohort, correlations between the changes in two BRS indices and changes in $$ \dot{V}{\mathrm{O}}_{2\max } $$ V ̇ O 2 max over 12 weeks of HIIT (e.g. sequence analysis BRS: r = 0.528, p=0.017) were observed. Conclusions/interpretation In male overweight individuals with type 2 diabetes, BRS, resting heart rate and orthostatic blood pressure regulation improved in the absence of weight loss after 12 weeks of supervised HIIT. Since no favourable effects on somatic nerve function and structure were observed, cardiovascular autonomic function appears to be more amenable to this short-term intervention, possibly due to improved cardiorespiratory fitness. Graphical abstract

Spectrum of Diabetic Neuropathy: New Insights in Diagnosis and Treatment

“…For example, in the Steno-2 cohort, a multifactorial intervention combining glycemic control with optimal pharmacological and lifestyle management of cardiovascular disease risk factors was associated with a 63% reduction in the risk of CAN (47). More recently, a study in Germany found that a 12-week period of high-intensity interval training improved CAN indices in a small group of overweight men with T2D (58). Larger, longitudinal studies are needed to characterize the ideal exercise type and duration as well as to establish the long-term sustainability of the effect (2).…”

Low to High Intensity Exercise dalam Menurunkan Kadar Gula Darah pada Pasien DM Tipe 2

“…Perbedaan penurunan tersebut adalah signifikan secara statistik (p <0.05) (Kanaley et al, 2022). Demikian terjadi peningkatan yang signifikan dalam jumlah insulin setelah latihan dengan p <0.01, low intensity exercise walaupun memakan waktu yang lebih lama ketika latihan, namun memiliki keunggulan bagi lansia memiliki kekuatan otot menurun untuk meminimalisir terkurasnya energi secara tiba-tiba sehingga seseorang yang belum memiliki kebiasaan atau malas olahraga bisa melakukannya tanpa mengejar target yang membebani (Bönhof et al, 2022).…”

“…Berbeda dengan penelitian lain yang membandingkan efektivitas latihan interval tingkat intensitas tinggi (HIIT) dengan latihan kontinu intensitas sedang (MICT) pada subjek dengan diabetes tipe 2 dengan usia 59 ± 8 sebanyak 50 responden. didapatkan hasil adanya perbedaan signifikan dalam indeks gula darah puasa (FBG) sebelum dan setelah intervensi pada kelompok MICT dan HIIT (Ax et al, 2022;Bönhof et al, 2022;Ogando et al, 2023). Penelitian lain didapatkan hasil bahwa darah pra-latihan, pasca latihan, dan 1 jam pasca latihan pada kelompok moderat dan tinggi (Clifford et al, 2021).…”

“…Jenis diabetes ini sebagian besar diakibatkan dari kelebihan berat badan dan kurangnya aktivitas fisik. Untuk itu intervensi yang dapat dilakukan pasien diabetes tipe 2 antara lain edukasi, terapi nutrisi medis, terapi farmakologi, dan aktivitas fisik (exercise) (Bönhof et al, 2022).…”

Kardiale autonome diabetische Neuropathie

“…Eine Studie, durchgeführt bei übergewichtigen Personen mit Typ-2-Diabetes mellitus, konnte zeigen, dass eine Lifestyle-Intervention im Sinne eines hochintensiven Intervalltrainings zu einer signifikanten Verbesserung von Parametern der autonomen Nervenfunktion führt [23], während keine signifikanten Veränderungen im Bereich der sensomotorischen diabetischen Polyneuropathie festzustellen waren.…”