# Exercise as it relates to Disease/How High Intensity Resistance training effects Type 2 Diabetes

The is an analysis of the journal article "High-Intensity Resistance Training Improves Glycemic Control in Older Patients With Type 2 Diabetes" by Dunstan et al (2002)

## What is the background to this research?

The disease Diabetes comes in two forms type 1 and type 2 (which is what we will be researching) Type 2 diabetes is progressive disease, the body will slowly start to lose its ability to produce an adequate amount of insulin and/ or the insulin produced in the body is not working effectively. (3). Its known that by lifestyle, and genetics all make up some strong risk factors for type 2 diabetes. (3) (4)

### Prevalence

Data from the recorded in Australia shows that 1 million people have type 2 diabetes in the years 2014-2015. (1) It is also shown that is it more prevalent in males than woman. With ageing the more likely you are to develop the condition. “for people ages 75 and over almost one in five people had diabetes.” This area of study and research is very important as it is a matter that is growing remarkably not only In Australian but around the world.

## Where is the research from?

This research conducted was based in Australia. The article was published in the Diabetes Care journal in 2002 and it can also be found online on the American Diabetes Association website. Authors Dunstan, Daly, Owen, Jolley, Courten, Shaw, and Zimmet are all health professionals who completed their studies in Australia.(6) Recruitment of participants was from the International Diabetes Institute and a media campaign. Unfortunately location of the subjects who took part in the study and where they came from is not identified but it is known that they are Australian residents. As stated by (Tilburg J, Haeften T, Pearson P and Wijmenga C) (5) that “type 2 diabetes is a multifactorial genetic syndrome… and also determined by ones environment”. Providing the subjects background, ethnicity and location would of been an important part of the research, to predict if they may be able to

## What kind of research was this?

The Australian Glycemic Control study is a controlled trial and closed cohort that was designed to study if high intensity resistance training can help improve the health of type 2 diabetics in the older population. This kind of research analyses is used to study that is conducted over a period of time that involved a specialised population group. For the healthy eating plan dietitian used an Australian software called “ Foodworks” to analyse nutrient intake. The eating plan was assed every fortnight, Then at 3 and 6 months a 3-day food record was attained and data was inputted into the software. When compared to other articles about the implication of exercise to help control the condition this article does not differ, and results are very similar. (4)
The main objective was to examine what effects does moderate weight loss and a combination of high intensity resistance training have on controlling the levels of glucose in the blood ( glycemic ), for the patients aged 60-80 years with type 2 diabetes
The participants compiled who completed this research were randomly separated into groups to take part In exercise. The group labeled “RT& WL group ” were taking part in the progressive resistance training at high intensity with moderate weight loss. The second group only labeled “WL group” had a controlled programmed with moderate weight loss . Whilst this research was being conducted the researched took laboratory and Clinical measurements that were assed three time at 0,3, and the 6th month.

## What did the research involve?

The participants in this research has to complete 24 weeks of high intensity resistance training comprising of 3 sessions a week. Resistance Training : 5 min warm up and Cool down on a stationary bike. 45 min High intensity resistance training In the first two weeks of training the exercise was set at 50-60% of the individuals 1-RM (The maximum amount of force that an individual can exert in one movement)
Nine Exercises Used:
* Bench Press
* Leg extension
* Upright row
* Lateral Pull Down
* Standing leg Curl (with ankle weights)
* Seated Shoulder press (dumbbell)
* Biceps Curl (seated dumbbell )
* Triceps Kickback (dumbbell)
* Abdominal curls
All exercise were performed supervision at a slow and controlled technique. Individuals workloads were adjusted or increased after completing 3 sets of 10 reps with correct technique.
* REST: 90- 120 seconds between sets.
A healthy eating plan was also put in for the days that participants had training.
Special Requirements to take part in this study
* BMI of more than 27
* Sedentary life style
* less than 150 minutes of moderate exercise per week
* less than 60 minutes Vigorous exercise a per week
* non smokers
* No Insulin intake
LIMITATIONS
* only a 3 day healthy food eating program was put in place.
* Healthy eating plan was also for the first 4 weeks.
* Selection on nonsmokers only to study; therefore it only provides data for people living with diabetes and are not smokers.

## What were the basic results?

some of the key finding that came out of this study were changes in blood pressure and serum some of lipids, change in metabolic variables, changes in body composition and anthropometry, and lastly participants increased they lower and upper body muscle strength through out the 24 intervention.

## What conclusions can we take from this research?

In conclusion this research's findings aligns with what I was expecting. That High intensity resistance exercise does help with controlling type 2 diabetes, I think an endurance based programme would produce more of an effect on controlling diabetics insulin levels. A research done in 2012 by Roden testing which form of exercise is more beneficial concluded that both resistance and endurance had equally the same effect, meaning that for diabetics any exercise is beneficial compared to being sedentary.

## Practical advice

Management of Type 2 Diabetes
* life style modifications
* Pharmaceutical Medications
* healthy body weight.

## Further information/resources

The Diabetes Australia website provides information about the disease: Help Line: 1300 136 588 Website: https://www.diabetesaustralia.com.au/type-2-diabetes
Study also related to Physical Activity as a prevention of Type 2 Diabetes http://diabetes.diabetesjournals.org/content/54/1/158.long

## References

National Health Survey: First Results, 2014-15, Diabetes Mellitus ,Abs.gov.au. 2017 [cited 9 September 2017]. Available from: 1. 1.
1. http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4364.0.55.001~2014-15~Main%20Features~Diabetes%20mellitus~12
3. Type 2 diabetes [Internet]. Diabetesaustralia.com.au. 2015 [cited 9 September 2017]. Available from: https://www.diabetesaustralia.com.au/type-2-diabetes
4. Laaksonen D, Lindstrom J, Lakka T, Eriksson J, Niskanen L, Wikstrom K et al. Physical Activity in the Prevention of Type 2 Diabetes: The Finnish Diabetes Prevention Study. Diabetes [Internet]. 2004 [cited 13 September 2017];54(1):158-165. Available from: http://diabetes.diabetesjournals.org/content/54/1/158
5. van Tilburg J. Defining the genetic contribution of type 2 diabetes mellitus. Journal of Medical Genetics [Internet]. 2001 [cited 15 September 2017];38(9):569-578. Available from: http://jmg.bmj.com/content/jmedgenet/38/9/569.full.pdf
6. Dunstan D, Daly R, Owen N, Jolley D, de Courten M, Shaw J et al. High-Intensity Resistance Training Improves Glycemic Control in Older Patients With Type 2 Diabetes. Diabetes Care [Internet]. 2002 [cited 31 August 2017];25(10):1729-1736. Available from: http://care.diabetesjournals.org/content/diacare/25/10/1729.full.pdf