β‐Cell function and body mass index are predictors of exercise response in elderly patients with prediabetes

Abstract

Aims/Introduction To explore the predicting factors of exercise response (whether the participants converted to diabetes) in elderly patients with prediabetes. Materials and Methods This is a retrospective subgroup analysis of the registered clinical trial with previous publication of the same cohort. A total of 248 participants with prediabetes were randomized to the aerobic training ( n = 83) group, resistance training ( n = 82) group and control group ( n = 83). The patients who finished the 2‐year exercise intervention were included in this analysis to explore the factors impacting exercise response. Results A total of 113 patients with prediabetes completed 2 years of exercise, with 56 participants in the aerobic exercise group and 57 in the resistance exercise group. Patients who reversed to normal glucose tolerance, remained in prediabetes and developed diabetes were 18 (15.90%), 70 (62.00%) and 25 (22.10%), respectively. Logistic regression showed that baseline, homeostatic model 2 assessment of β‐cell function (β = −0.143, P = 0.039), hemoglobin A1c (β = 3.301, P = 0.007) and body mass index (β = 0.402, P = 0.012) were related to exercise response, whereas the waist‐to‐hip ratio (β = −3.277, P = 0.693) and types of exercise (β = 1.192, P = 0.093) were not significantly related to exercise response. Conclusions Baseline homeostatic model 2 assessment of β‐cell function, hemoglobin A1c and body mass index were the predictors for the response to exercise in elderly patients with prediabetes.

Effects of aerobic exercises in prediabetes patients: a systematic review and meta-analysis

“…Among these, 3117 were excluded based on their titles and abstracts, leaving 105 papers for full-text examination. Finally, 10 RCTs were included in the review and meta-analysis ( 14 , 15 , 19 – 26 ) ( Figure 1 ).…”

“…All aerobic training was performed under supervised conditions. Modes of training include aerobic dance ( 14 , 19 – 21 , 24 , 25 ), treadmill running ( 15 , 26 ), walking ( 15 , 22 ), and mixed aerobic exercise ( 23 ). In nine studies, exercise intensity was reported as maximum heart rate (HRmax), maximum heart rate reserve (HRRmax), or heart rate reserve (HRR) with a median intensity and range of 65% (50%-75%).…”

“…Seven out of the ten included studies reported BMI indicators ( 14 , 15 , 20 – 23 , 25 ). The combined analysis revealed a significant difference in BMI between the aerobic exercise group and the control group (WMD=-1.44 kg/m 2 , 95%CI -1.89, -0.98, I 2 = 44%, P <0.001).…”

“…( 13 ) found that appropriate physical activity can reduce the risk of progression to diabetes in patients with prediabetes. Aerobic exercise is widely recognized for its capacity to reduce insulin resistance and mitigate the risk of developing diabetes through aerobic training ( 14 ). Kargarfard et al.…”

Diet and exercise are a fundamental part of comprehensive care for type 2 diabetes

“…A study conducted on elderly pre‐diabetic patients found that the type of exercise did not significantly affect the glucose response to exercise 23 . However, it was observed that initial poor HbA1c levels and a high body mass index were associated with a poor response to exercise in terms of blood glucose tolerance and HbA1c reduction.…”