Abstract MP76: The Effect of Exercise Training Modality on 30-Year Cardiovascular Mortality Risk in Individuals with Type 2 Diabetes

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Damon Swift ◽  
Neil M Johannsen ◽  
Carl J Lavie ◽  
Jarett D Berry ◽  
Conrad P Earnest ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Exercise Training ◽  
Aerobic Exercise ◽  
Mortality Risk ◽  
Smoking Status ◽  
Analysis Of Covariance ◽  
Aerobic Exercise Training ◽  
Control Group

Introduction: Current calculators to estimate risk of cardiovascular (CV) disease mortality do not include cardiorespiratory fitness (CRF) or physical activity (PA) measures. This is problematic as CRF is an independent risk factor for CV mortality. To address this issue, Wickramasinghe et al. developed a calculator which includes CRF along with other traditional CV risk factors. The purpose of the present study is to determine the effect of aerobic (AER), resistance (RES) or combination (COMB) exercise training on 30-year CV mortality risk in individuals with type 2 diabetes (T2D). Methods: The present study is an ancillary analysis of the Health Benefits of Aerobic and Resistance Training Study (HART-D). Adults with type 2 diabetes (T2D) (n=196) were randomized to 9 months of AER, RES, COMB exercise training or a control group (CON). Thirty-year CV mortality risk was evaluated by entering each participant’s sex, age, blood pressure, smoking status, T2D status, cholesterol, and BMI into a risk calculator developed by Wickramasinghe et al. at baseline and follow-up. CRF was quantified as the highest metabolic equivalent level (estimated from the final speed and grade using American College of Sports Medicine equations) achieved during a maximal treadmill test at baseline and follow-up. Analysis of covariance was used to evaluate change in CV risk with adjustments for age, sex and baseline CV risk. Results: Participants in the present analysis had a mean (SD) 30-year CV risk of 30.4% (17.8). A significant reduction in 30-year CV risk was observed in the AERO (-2.9%, CI: -4.7 to -1.0) and COMB groups (-2.8%, CI: -4.5 to -1.0), but not in the RES group (0.0%, CI: -1.8 to 1.7) compared to CON (2.1%, CI: -0.1 to 4.3). In the AERO and COMB groups, change in CV risk was associated with change in fat mass (r= -0.19, p=0.04), but not change in lean mass or hemoglobin A1c (all ps>0.05). Conclusions: The present study suggests that 9 months of aerobic exercise training or combination of resistance with aerobic exercise training resulted in a ~3% reduction in absolute 30-year CV risk (~11% relative risk), and further validates the importance of aerobic exercise in the treatment of individuals with T2D.

Abstract P137: Aerobic, Resistance or Combination Exercise Training does not Reduce C-Reactive Protein Levels in Individuals with Type 2 Diabetes

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Damon L Swift ◽  
Neil M Johannsen ◽  
Conrad P Earnest ◽  
Steven N Blair ◽  
Timothy S Church
Keyword(s):  
Type 2 Diabetes ◽  
Exercise Training ◽  
Aerobic Exercise ◽  
Fat Mass ◽  
Fasting Glucose ◽  
Aerobic Exercise Training ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein

Introduction: Type 2 diabetes is associated with elevated C-reactive protein levels (CRP), which is an independent risk factor for cardiovascular disease. Aerobic exercise training especially with weight/adiposity reduction has been shown to improve CRP, however few studies have evaluated the effect of other exercise training modalities (aerobic, resistance or combination training) on CRP in individuals with type 2 diabetes. Hypothesis: We hypothesize that combination training will improve CRP to a greater extent than other modalities of exercise training, and change in CRP levels will be associated with changes in weight and adiposity. Methods: The present study is a secondary analysis of the Health Benefits of Aerobic and Resistance Training in Individuals with Type 2 Diabetes (HART-D) study. Participants (n=204) were randomized to aerobic exercise (aerobic), resistance exercise (resistance) or a combination of both (combination) for nine months. Results: Baseline CRP was correlated with fat mass, waist circumference, BMI, and inversely correlated with VO2 peak (p<0.05). CRP was not reduced in the aerobic (0.16 mg•L-1, 95% CI: -1.0, 1.3), resistance (-0.03 mg•L-1, 95% CI: -1.1, 1.0) or combination (-0.49 mg•L-1, 95% CI: -1.5 to 0.6) groups compared to control (0.35 mg•L-1, 95% CI: -1.0, 1.7). Change in CRP was associated with change in fasting glucose (r=0.20, p= 0.009), glycated hemoglobin (HbA1C) (r=0.21 p=0.005), and fat mass (r=0.19, p=0.016), but not change in fitness or weight (p > 0.05). Conclusions: In conclusion, aerobic, resistance or a combination of both did not reduce CRP levels in individuals with type 2 diabetes. However, exercise related improvements in HbA1C, fasting glucose, and fat mass were associated with reductions in CRP.

scholarly journals Metabolic Adaptations to Aerobic Exercise in Aged Mice

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 533-533
Author(s):  
Tyler Marx ◽  
Anastasiia Vasileva ◽  
Stephen Hutchison ◽  
Jennifer Stern
Keyword(s):  
Type 2 Diabetes ◽  
Exercise Training ◽  
Aerobic Exercise ◽  
Aerobic Exercise Training ◽  
Metabolic Function ◽  
Glucagon Receptor ◽  
Age Related ◽  
Exercise Induced

Abstract Aerobic exercise training is a potent intervention for the treatment and prevention of age-related disease, such as heart disease, obesity, and Type 2 Diabetes. Insulin resistance, a hallmark of Type 2 Diabetes, is reversed in response to aerobic exercise training. However, the effect of aerobic exercise training on glucagon sensitivity is unclear. Glucagon signaling at the liver promotes fatty acid oxidation, inhibits De novo lipogenesis, and activates AMP Kinase, a key mediator of healthy aging. Like humans, aging in mice age leads to a decline in physical and metabolic function. To understand the role of glucagon signaling in exercise-induced improvements in physical and metabolic function in the mouse, we implemented a 16-week aerobic exercise training protocol in young and aged mice. 16 weeks of exercise training initiated at 6 months of age increased markers of physical function (P&lt;0.01) and attenuated age-related weight gain (P&lt;0.05) and fat mass (P&lt;0.0001). Additionally, exercise training improved glucose clearance (P&lt;0.01), enhanced glucose-stimulated insulin secretion (P&lt;0.01) and decreased hepatic lipid accumulation (P&lt;0.05). Importantly, exercise training decreased hypoglycemia stimulated glucagon secretion (P&lt;0.01), with no effect on hepatic glucagon receptor mRNA expression or serum glucagon. Thus, we propose that aerobic exercise training enhances glucagon sensitivity at the liver, implicating glucagon as a potential mediator of exercise-induced improvements in aging. Studies initiating the same aerobic exercise training intervention at 18 months of age in the mouse are currently underway to establish the role of glucagon receptor signaling in exercise-induced improvements in aging.

scholarly journals Peripheral Arterial Adaptations to All‐Extremity Aerobic Exercise Training in Type 2 Diabetes

2019 ◽  
Vol 33 (S1) ◽  
Author(s):  
Yasemin Sakarya ◽  
Chueh‐Lung Hwang ◽  
Jisok Lim ◽  
Han‐Kyul Kim ◽  
Jeung‐Ki Yoo ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Exercise Training ◽  
Aerobic Exercise ◽  
Aerobic Exercise Training ◽  
Peripheral Arterial

HDL Atheroprotection by Aerobic Exercise Training in Type 2 Diabetes Mellitus

2008 ◽  
Vol 40 (5) ◽  
pp. 779-786 ◽  
Author(s):  
ISABEL C. D. RIBEIRO ◽  
RODRIGO T. IBORRA ◽  
MÔNICA Q. T. S. NEVES ◽  
SIMÃO A. LOTTENBERG ◽  
ANA M. CHARF ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Exercise Training ◽  
Aerobic Exercise ◽  
Aerobic Exercise Training

scholarly journals The impact of aerobic exercise training on novel adipokines, apelin and ghrelin, in patients with type 2 diabetes

2012 ◽  
Vol 18 (5) ◽  
pp. CR290-CR295 ◽  
Author(s):  
Nikolaos P.E. Kadoglou ◽  
Ioannis S. Vrabas ◽  
Alkistis Kapelouzou ◽  
Stilianos Lampropoulos ◽  
Nikolaos Sailer ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Exercise Training ◽  
Aerobic Exercise ◽  
Aerobic Exercise Training ◽  
The Impact

scholarly journals Combining metformin and aerobic exercise training in the treatment of type 2 diabetes and NAFLD in OLETF rats

2014 ◽  
Vol 306 (3) ◽  
pp. E300-E310 ◽  
Author(s):  
Melissa A. Linden ◽  
Justin A. Fletcher ◽  
E. Matthew Morris ◽  
Grace M. Meers ◽  
Monica L. Kearney ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Fatty Acid ◽  
Exercise Training ◽  
Aerobic Exercise ◽  
Aerobic Exercise Training ◽  
Palmitate Oxidation ◽  
Oletf Rats ◽  
Long Evans ◽  
Exercise Induced

Here, we sought to compare the efficacy of combining exercise and metformin for the treatment of type 2 diabetes and nonalcoholic fatty liver disease (NAFLD) in hyperphagic, obese, type 2 diabetic Otsuka Long-Evans Tokushima Fatty (OLETF) rats. OLETF rats (age: 20 wk, hyperglycemic and hyperinsulinemic; n = 10/group) were randomly assigned to sedentary (O-SED), SED plus metformin (O-SED + M; 300 mg·kg−1·day−1), moderate-intensity exercise training (O-EndEx; 20 m/min, 60 min/day, 5 days/wk treadmill running), or O-EndEx + M groups for 12 wk. Long-Evans Tokushima Otsuka (L-SED) rats served as nonhyperphagic controls. O-SED + M, O-EndEx, and O-EndEx + M were effective in the management of type 2 diabetes, and all three treatments lowered hepatic steatosis and serum markers of liver injury; however, O-EndEx lowered liver triglyceride content and fasting hyperglycemia more than O-SED + M. In addition, exercise elicited greater improvements compared with metformin alone on postchallenge glycemic control, liver diacylglycerol content, hepatic mitochondrial palmitate oxidation, citrate synthase, and β-HAD activities and in the attenuation of markers of hepatic fatty acid uptake and de novo fatty acid synthesis. Surprisingly, combining metformin and aerobic exercise training offered little added benefit to these outcomes, and in fact, metformin actually blunted exercise-induced increases in complete mitochondrial palmitate oxidation and β-HAD activity. In conclusion, aerobic exercise training was more effective than metformin administration in the management of type 2 diabetes and NAFLD outcomes in obese hyperphagic OLETF rats. Combining therapies offered little additional benefit beyond exercise alone, and findings suggest that metformin potentially impairs exercise-induced hepatic mitochondrial adaptations.

scholarly journals Can non-responders be ‘rescued’ by increasing exercise intensity? A quasi-experimental trial of individual responses among humans living with pre-diabetes or type 2 diabetes mellitus in Canada

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e044478
Author(s):  
Travis J Hrubeniuk ◽  
Danielle R Bouchard ◽  
Brendon J Gurd ◽  
Martin Sénéchal
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycaemic Control ◽  
Aerobic Exercise ◽  
Intervention Group ◽  
Aerobic Exercise Training ◽  
Control Group ◽  
Metabolic Equivalents

IntroductionExercise is recommended to improve glycaemic control. Yet, individual changes in glycaemic control following exercise can vary greatly, meaning while some significantly improve others, coined ‘non-responders’, do not. Increasing the intensity of exercise may ‘rescue’ non-responders and help generate a response to training. This trial will identify non-responders to changes in glycated haemoglobin (HbA1c) across inactive individuals living with pre-diabetes or type 2 diabetes mellitus following an aerobic exercise programme and evaluate if increasing training intensity will elicit beneficial changes to ‘rescue’ previously categorised non-responders.Methods and analysisThis study will recruit 60 participants for a two-phase aerobic exercise training programme. Participants will be allocated to a control group or assigned to an intervention group. Control participants will maintain their current lifestyle habits. During phase 1, intervention participants will complete 16 weeks of aerobic exercise at an intensity of 4.5 metabolic equivalents (METs) for 150 min per week. Participants will then be categorised as responders or non-responders based on the change in HbA1c. For phase 2, participants will be blocked based on responder status and randomly allocated to a maintained intensity, or increased intensity group for 12 weeks. The maintained group will continue to train at 4.5 METs, while the increased intensity group will train at 6.0 METs for 150 min per week.Ethics and disseminationResults will be presented at scientific meetings and submitted to peer-reviewed journals. Publications and presentations related to the study will be authorised and reviewed by all investigators. Findings from this study will be used to provide support for future randomised control trials. All experimental procedures have been approved by the Research Ethics Board at the University of New Brunswick (REB: 2018–168).Trial registration numberNCT03787836.

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