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

ObjectiveTo 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.DesignShort-term, single-arm intervention trial.MethodsEleven male T2D patients (age: 59.1±7.5 years; body mass index: 32.2±4.0 kg/m2) performed progressive resistance and interval exercise training thrice a week for 10 weeks. Besides primary diabetes outcome measures, muscle strength (MUST), maximal workload capacity (Wmax), whole-body peak oxygen uptake (VO2peak) 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.ResultsMUST and Wmax increased with 17% (90% confidence intervals 9–24%) and 14% (6–21) respectively. Furthermore, mean arterial blood pressure declined with 5.5 mmHg (−9.7 to −1.4). EIR dropped with 5.0 IU/d (−11.5 to 1.5) compared with baseline. A decline of respectively −0.7 mmol/l (−2.9 to 1.5) and −147 μmol/l (−296 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 VO2peak, MUOX, IMCL or IMCG, and blood glycolysated haemoglobin, adiponectin, tumor necrosis factor-α and/or cholesterol concentrations.ConclusionShort-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.

Download Full-text

Short-Term Aerobic Exercise Training in Obese Humans with Type 2 Diabetes Mellitus Improves Whole-Body Insulin Sensitivity through Gains in Peripheral, not Hepatic Insulin Sensitivity

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2007-1524 ◽

2008 ◽

Vol 93 (3) ◽

pp. 771-778 ◽

Cited By ~ 62

Author(s):

Jason J. Winnick ◽

W. Michael Sherman ◽

Diane L. Habash ◽

Michael B. Stout ◽

Mark L. Failla ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Insulin Sensitivity ◽

Exercise Training ◽

Aerobic Exercise Training ◽

Whole Body ◽

Short Term ◽

Hepatic Insulin Sensitivity

Download Full-text

Exercise Training as an Intervention to Improve Muscle Function and Recovery Following Bed Rest in Older Adults With Type 2 Diabetes

Case Medical Research ◽

10.31525/ct1-nct04057677 ◽

2019 ◽

Author(s):

Keyword(s):

Type 2 Diabetes ◽

Older Adults ◽

Exercise Training ◽

Muscle Function ◽

Bed Rest

Download Full-text

Determinants of changes in blood glucose response to short-term exercise training in patients with Type 2 diabetes

Clinical Science ◽

10.1042/cs20070422 ◽

2008 ◽

Vol 115 (9) ◽

pp. 273-281 ◽

Cited By ~ 23

Author(s):

Matthew D. Hordern ◽

Louise M. Cooney ◽

Elaine M. Beller ◽

Johannes B. Prins ◽

Thomas H. Marwick ◽

...

Keyword(s):

Type 2 Diabetes ◽

Blood Glucose ◽

Insulin Sensitivity ◽

Exercise Training ◽

Cardiorespiratory Fitness ◽

Training Group ◽

Moderate Intensity ◽

Model Assessment ◽

Short Term

The aim of the present study was to determine the effects of a 4-week exercise training intervention on blood glucose, insulin sensitivity, BMI (body mass index) and cardiorespiratory fitness in patients with Type 2 diabetes, and to identify and establish criteria for patients who are more likely to improve their blood glucose from short-term exercise training. A randomized, controlled trial of exercise training, comprising two supervised and one non-supervised sessions of individualized cardiorespiratory and resistance exercise per week, was performed in 132 healthy patients with Type 2 diabetes (exercise training group, n=68), with the aim of accumulating a minimum of 150 min of moderate-intensity exercise for 4 weeks. BMI, waist circumference, blood pressure, blood lipid profile, blood glucose, insulin, insulin sensitivity [calculated by HOMAIR (homoeostasis model assessment of insulin resistance) and QUICKI (quantitative insulin check index)], β-cell function (calculated by HOMAβ-Cell), HbA1c (glycated haemoglobin) and V̇O2max (maximal oxygen consumption) were measured at baseline and at 4 weeks. The exercise training group had significant improvements in V̇O2max, BMI and triacylglycerols (triglycerides). There were no significant changes in blood glucose, HOMAIR, QUICKI or HOMAβ-Cell. Decreases in blood glucose were significantly predicted by baseline blood glucose and HbA1c, with these variables accounting for 15.9% of the change in blood glucose (P<0.001). ROC (receiver operator characteristic) curve analysis revealed that patients with a blood glucose >8.85 mmol/l (sensitivity=73%, specificity=78%) and HbA1c >7.15% (sensitivity=79%, specificity=60%) were more likely to achieve a clinically significant decrease in blood glucose. In conclusion, in apparently healthy patients with Type 2 diabetes, a 4-week exercise intervention improved cardiorespiratory fitness, BMI and triacylglycerols. Elevated blood glucose and HbA1c predicted improvements in blood glucose.

Download Full-text

The Short-Term Effect of a Switch from Glybenclamide to Metformin on Blood Pressure and Microalbuminuria in Patients with Type 2 Diabetes Mellitus

Archives of Medical Research ◽

10.1016/s0188-4409(00)00241-1 ◽

2000 ◽

Vol 31 (6) ◽

pp. 571-575 ◽

Cited By ~ 45

Author(s):

Norma Amador-Licona ◽

Juan-Manuel Guı́zar-Mendoza ◽

Enrique Vargas ◽

Guillermo Sánchez-Camargo ◽

Lilia Zamora-Mata

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Term Effect ◽

Short Term ◽

Short Term Effect

Download Full-text

Strength training reduces arterial blood pressure but not sympathetic neural activity in young normotensive subjects

Journal of Applied Physiology ◽

10.1152/japplphysiol.01109.2002 ◽

2003 ◽

Vol 94 (6) ◽

pp. 2212-2216 ◽

Cited By ~ 40

Author(s):

Jason R. Carter ◽

Chester A. Ray ◽

Emily M. Downs ◽

William H. Cooke

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Resistance Training ◽

Exercise Training ◽

Resistance Exercise ◽

Arterial Blood Pressure ◽

Whole Body ◽

Arterial Blood ◽

Blood Pressures ◽

Body Resistance

The effects of resistance training on arterial blood pressure and muscle sympathetic nerve activity (MSNA) at rest have not been established. Although endurance training is commonly recommended to lower arterial blood pressure, it is not known whether similar adaptations occur with resistance training. Therefore, we tested the hypothesis that whole body resistance training reduces arterial blood pressure at rest, with concomitant reductions in MSNA. Twelve young [21 ± 0.3 (SE) yr] subjects underwent a program of whole body resistance training 3 days/wk for 8 wk. Resting arterial blood pressure ( n = 12; automated sphygmomanometer) and MSNA ( n = 8; peroneal nerve microneurography) were measured during a 5-min period of supine rest before and after exercise training. Thirteen additional young (21 ± 0.8 yr) subjects served as controls. Resistance training significantly increased one-repetition maximum values in all trained muscle groups ( P < 0.001), and it significantly decreased systolic (130 ± 3 to 121 ± 2 mmHg; P = 0.01), diastolic (69 ± 3 to 61 ± 2 mmHg; P = 0.04), and mean (89 ± 2 to 81 ± 2 mmHg; P = 0.01) arterial blood pressures at rest. Resistance training did not affect MSNA or heart rate. Arterial blood pressures and MSNA were unchanged, but heart rate increased after 8 wk of relative inactivity for subjects in the control group (61 ± 2 to 67 ± 3 beats/min; P = 0.01). These results indicate that whole body resistance exercise training might decrease the risk for development of cardiovascular disease by lowering arterial blood pressure but that reductions of pressure are not coupled to resistance exercise-induced decreases of sympathetic tone.

Download Full-text

Dapagliflozin does not affect short-term blood pressure variability in patients with type-2 diabetes mellitus

American Journal of Hypertension ◽

10.1093/ajh/hpaa207 ◽

2020 ◽

Author(s):

Eirini Papadopoulou ◽

Marieta P Theodorakopoulou ◽

Charalampos Loutradis ◽

Georgios Tzanis ◽

Glykeria Tzatzagou ◽

...

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Blood Pressure Variability ◽

Controlled Trial ◽

Secondary Analysis ◽

Short Term ◽

Double Blind

Abstract Background Increased blood-pressure-variability (BPV) is associated with increased cardiovascular and all-cause mortality in patients with type 2 diabetes mellitus (T2DM). Sodium-glucose-co-transporter-2 (SGLT-2) inhibitors decrease the incidence of cardiovascular events, renal events, and death in this population. This study aimed to evaluate the effect of dapagliflozin on short-term BPV in patients with T2DM. Methods This is a secondary analysis of a double-blind, randomized, placebo-controlled trial in 85 patients with T2DM (NCT02887677). Subjects were randomized to oral dapagliflozin 10mg once daily or placebo for 12 weeks. All participants underwent 24-h ambulatory blood pressure (BP) monitoring with the Mobil-O-Graph NG device at baseline and study-end. Standard-deviation (SD), weighted-SD (wSD), coefficient-of-variation (CV), average-real-variability (ARV) and variation-independent-of-mean (VIM) were calculated with validated formulae for the 24-h and the daytime and nighttime periods. Results Dapagliflozin reduced 24-h brachial BP compared to placebo. From baseline to study-end 24-h brachial BPV indexes did not change with dapagliflozin (SBP-ARV: 11.51±3.45 vs 11.05±3.35; p=0.326, SBP-wSD: 13.59±3.60 vs 13.48±3.33; p=0.811) or placebo (SBP-ARV: 11.47±3.63 vs 11.05±3.00; p=0.388, SBP-wSD: 13.85±4.38 vs 13.97±3.87 ; p=0.308). Similarly, no significant changes in BPV indexes for daytime and nighttime were observed in any group. At study-end, no differences between the groups were observed for any BPV index. Deltas(Δ) of all indexes during follow-up were minimal and not different between-groups (SBP-wSD: dapagliflozin: -0.11±3.05 vs placebo: 0.12±4.20; p=0.227). Conclusions This study is the first to evaluate the effects of an SGLT-2 inhibitor on short-term BPV in patients with T2DM, showing no effect on dapagliflozin on all BPV indexes studied.

Download Full-text

Abstract 13697: Glucagon-like Peptide-1 Analogue Liraglutide Does Not Improve Microvascular Myocardial Function in Patients With Type 2 Diabetes - a Randomized, Single-blinded Cross Over Trial

Circulation ◽

10.1161/circ.130.suppl_2.13697 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Rebekka Faber ◽

Mette Zander ◽

Adam A Pena ◽

Marie M Michelsen ◽

Naja D Mygind ◽

...

Keyword(s):

Blood Pressure ◽

Type 2 Diabetes ◽

Systolic Blood Pressure ◽

Coronary Microcirculation ◽

Short Term ◽

Short Term Treatment ◽

Flow Reserve ◽

Glucagon Like Peptide ◽

Glucagon Like Peptide 1

Background: Impaired coronary microcirculation is associated with a poor prognosis in patients with type 2 diabetes. In the absence of stenosis of major coronary arteries, coronary flow reserve (CFR) reflects coronary microcirculation. Studies have shown beneficial effects of glucagon-like peptide-1 (GLP-1) on the cardiovascular system. The aim of the study was to explore the short-term effect of GLP-1 treatment on coronary microcirculation estimated by CFR in patients with type 2 diabetes. Methods: Twenty patients with type 2 diabetes and no history of coronary artery disease were treated with the GLP-1 analogue Liraglutide for 10 weeks, in a randomized single-blinded crossover setup. The effect of GLP-1 on coronary microcirculation was evaluated using non-invasive trans-thoracic Doppler-flow echocardiography during dipyridamole induced stress. Data were analysed as two-sample t-test after ensuring no carry over effect. Results: A total of 20 patients (15 male; mean age 57 ± 9; mean BMI 33.1 ± 4.4, mean baseline CFR 2.35 ± 0.45) completed full protocol. There was a small increase in CFR following GLP-1 treatment (change 0.18, CI95% [-0.01; 0.36], p=0.06) but with no difference in effect compared with the no treatment group (0.16, CI95% [-0.08; 0.40], p=0.18). GLP-1 significantly reduced glycated haemoglobin (-10.1 mmol/mol CI95% [-13.9; -6.4], p=<0.001) systolic blood pressure (-10 mmHg CI95% [-17; -3], p=0.01) and weight (-1.9 kg CI95% [-3.6; -0.2], p=0.03). Conclusion: Despite a significant weight-loss, reduction in HbA1c and systolic blood pressure, we did not find a significant improvement in coronary microcirculation after 10 weeks treatment with GLP-1. In our short-term treatment study, we therefore conclude that the GLP-1 analogue Liraglutide does not improve coronary microcirculation in patients with type 2 diabetes. Further long-term studies are needed to explore mechanisms to improve coronary microcirculation in patients with type 2 diabetes.

Download Full-text