Impact of lifestyle modification on glycemic control in patients with type 2 diabetes mellitus

Abstract

Background:Current treatment guidelines support the role of lifestyle modification, in terms of increasing the quantity and quality of physical activity to achieve target glycemia in patients with type 2 diabetes mellitus.Objective:To assess the effect of structured exercise training and unstructured physical activity interventions on glycemic control.Materials and Methods:This was a randomized six-month exercise intervention study conducted with previously inactive 279 patients of type 2 diabetes mellitus. Before randomization, all enrolled T2DM participants (n: 300; 30 to 60 year old, having diabetes for more than a year with HbA1c levels of 6.5% or higher) entered a one-month run-in phase to reduce dropout and maintain adherence.Results:A recommendation to increase physical activity was beneficial (0.14% HbA1c reduction; P = 0.12), but was not bringing significantly declines in HbA1c, whereas, structured exercise training is associated with a significant HbA1c decline of 0.59%. (P = 0.030). In a subgroup analysis limited to participants with a baseline HbA1c value > 7%, both the unstructured (0. 48%; P = 0.04) and structured exercise training (0.77%; P < 0.01) groups experienced significant decline in HbA1c Vs the control, whereas among participants with baseline hemoglobin A1c values less than 7%, significant reduction occurred only in the structured exercise training group. Changes in blood pressure; total cholesterol, HDL-cholesterol (high-density lipoprotein), LDL-cholesterol (low-density lipoprotein) and the atherogenic index factors did not statistically significantly differ within (baseline to follow-up) and among groups.Conclusion:Supervised structured training was more efficacious than unstructured activity in achieving declines in HbA1c. Although both structured and unstructured training provide benefits, only the former was associated with significant reductions in HbA1c levels. Therefore, T2DM patients should be stimulated to participate in specifically designed exercise intervention programs.

The association of dyslipidemia and obesity with glycated hemoglobin

“…There are several mechanisms to elicit the effects of increased physical activity to improve dyslipidemia as it increases glucose removal and decreases muscle and hepatic IR through a number of mechanisms that would not necessarily be associated with changes in body weight [33]. This is in accordance with our results where we could not find correlation of HbA1c with BMI (which is an indicator of overall weight gain).…”

Effect of Aerobic Exercise Training on Blood Pressure in Indians: Systematic Review

“…Out of 24 included articles (23 for meta-analysis), 10 studies used control group (5 healthy subjects and 5 subjects with clinical condition) [ 10 , 12 , 14 , 17 , 23 , 24 , 26 , 30 , 32 , 33 ]. Subgroup analysis of control versus experimental group in healthy Indian subjects showed mean reduction of 2.92 mmHg in SBP and 2.25 mmHg in DBP in favor of experimental group.…”

<p>Association between glycated hemoglobin (HbA1c) and the lipid profile in patients with type 2 diabetes mellitus at a tertiary care hospital: a retrospective study</p>

“…Importantly, a 1% drop in the HbA1c level decreases the 40% risk of microvascular complications 23. However, the literature indicates the positive effects of enhanced physical activity and lifestyle modifications in improving glycemic control and dyslipidemia 24…”