Long-standing, insulin-treated type 2 diabetes patients with complications respond well to short-term resistance and interval exercise training

Abstract

Objective: To determine the feasibility and the benefits of combined resistance and interval exercise training on phenotype characteristics and skeletal muscle function in deconditioned, type 2 diabetes (T2D) patients with polyneuropathy. Design: Short-term, single-arm intervention trial. Methods: Eleven male T2D patients (age: 59.1G7.5 years; body mass index: 32.2G4.0 kg/m 2 ) performed progressive resistance and interval exercise training thrice a week for 10 weeks. Besides primary diabetes outcome measures, muscle strength (MUST), maximal workload capacity (W max ), whole-body peak oxygen uptake (VO 2peak ) and muscle oxidative capacity (MUOX), intramyocellular lipid (IMCL) and glycogen (IMCG) storage, and systemic inflammation markers were determined before and after training. Daily exogenous insulin requirements (EIR) and historic individualized EIR were gathered and analysed. Results: MUST and W max increased with 17% (90% confidence intervals 9-24%) and 14% (6-21) respectively. Furthermore, mean arterial blood pressure declined with 5.5 mmHg (K9.7 to K1.4). EIR dropped with 5.0 IU/d (K11.5 to 1.5) compared with baseline. A decline of respectively K0.7 mmol/l (K2.9 to 1.5) and K147 mmol/l (K296 to 2) in fasting plasma glucose and non-esterified fatty acids concentrations were observed following the intervention, but these were not accompanied by changes in VO 2peak , MUOX, IMCL or IMCG, and blood glycolysated haemoglobin, adiponectin, tumor necrosis factor-a and/or cholesterol concentrations. Conclusion: Short-term resistance and interval exercise training is feasible in deconditioned T2D patients with polyneuropathy and accompanied by moderate improvements in muscle function and blood pressure. Such a specific exercise regimen may provide a better framework for future exercise intervention programmes in the treatment of deconditioned T2D patients.

Adaptations to exercise training within skeletal muscle in adults with type 2 diabetes or impaired glucose tolerance: a systematic review

“…ES for each of the controlled trials was interpreted according to the method of Cohen [16]. from 18 studies including 3 randomized controlled trials reported in 9 publications [17][18][19][20][21][22][23][24][25] (2 trials reported in 8 publications with resistance training [17][18][19][20][21][22][23][24] and 1 with aerobic training [25]), 2 non-randomized controlled trials [26,27] (with aerobic training [26,27]) and 13 uncontrolled trials reported in 15 publications [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] (11 trials reported in 13 publications with aerobic training [28,[30][31][32][33][34][35][36][37][38]…”

“…In the randomized controlled trials and non-randomized controlled trials, all studies consisted of mixed gender cohorts [17][18][19][20][21][22][23][24][25][26][27]; in the uncontrolled trials, five studies published in six papers were in male cohorts [31,32,34,37,38,42], seven studies published in eight papers were in mixed cohorts [28][29][30]33,35,36,39,41] and one study did not report gender [40].…”

“…Except for one uncontrolled trial [33], all other studies of type 2 diabetes [17-24,27-29,31,32,34-36, 38-40,42] reported the subjects' diabetic medications. Among these studies, two trials reported in five papers included some or all subjects with insulin treatment [17][18][19][20]42]; subjects in the other 10 studies reported in 15 publications [21][22][23][24][27][28][29]31,32,[34][35][36][38][39][40] were treated only with oral agents or did not take diabetic medications. In studies including type 2 diabetes, 18% of subjects took insulin, 81% took oral agents, and 16% did not take diabetic medications.…”

“…Two randomized controlled trials reported in eight papers [17][18][19][20][21][22][23][24] and one uncontrolled trial [42] used resistance training, and one uncontrolled trial [29] used combined aerobic and resistance training.…”

“…In the three resistance training studies reported in 9 publications, the intensity increased progressively from 50 to 80% of the one-repetition maximum (1RM) [17][18][19][20][21][22][23][24]42], thus concluding training with high intensity progressive resistance training at the time of biopsy. In the aerobic training studies, the intensity was low in one study, moderate in six studies, and high in six studies.…”