Health Benefits of Aerobic and Resistance Training in Individuals With Type 2 Diabetes
Condition: Type 2 Diabetes
MeSH terms: Diabetes Mellitus; Diabetes Mellitus, Type 2
Study type: Interventional

Summary: 
      The goal of the proposed study, Health Benefits of Aerobic and Resistance Training in
      individuals with type 2 diabetes (HART-D), is to compare the effect of resistance training
      alone (RT), resistance in combination with aerobic training (AT+RT), and aerobic training
      alone (AT) to standard care (SC) on hemoglobin A1C (HbA1C), in initially sedentary women and
      men with type 2 diabetes (T2D).
    

Detailed description: 
      Although it is generally accepted that regular exercise provides substantial health benefits
      to individuals with T2D, the exact exercise prescription in terms of type (AT versus RT
      versus AT+RT) still remains an important research issue, particularly in regard to
      week-to-week glucose control as assessed by HbA1C.

      There is a need for more adequately powered and well-controlled studies to examine the
      effects of RT, AT and AT+RT on HbA1C in individuals with T2D. With the incidence of T2D
      expected to increase dramatically in the coming years, it is essential to have a better
      understanding of the relative benefits of various exercise interventions. This information
      can help better formulate exercise recommendations for patients with T2D as well as
      potentially provide more exercise options, which is important given the small percentage of
      individuals with TD2 who regularly exercise. The study group was sedentary women and men with
      T2D, aged 30 to 75 years. We randomly assigned 262 individuals to an aerobic exercise
      training only group (AT; n=72), a resistance training only group (RT; n=73), a combination of
      aerobic plus resistance training (AT+RT; n=76), or a standard care group (SC; n=41). The AT
      individuals participated in 3 or 4 training sessions each week for 9 months progressing to a
      total energy expenditure of 12 kcal/kg/week (KKW), which is an exercise dose consistent with
      the current public health recommendations for physical activity for individuals with T2D. The
      target exercise intensity was 50%-80% of baseline VO2 max. The RT group participated in 3
      sessions per week (9 exercises, 2-3 sets each), which focuses on large muscle groups. This RT
      regimen is based on the studies that most successfully improved HbA1C in individuals with
      T2D. Individuals in the AT+RT group completed 10 KKW of aerobic training and a reduced
      resistance-training regimen of 2 sessions per week (9 exercises, 1 set of each). The AT+RT
      regimen represents the exercise recommendations of the American College of Sports Medicine
      (ACSM) and the American Diabetes Association (ADA).

      Simply stated, we compared the effect of resistance training alone, resistance in combination
      with aerobic training, and aerobic training alone to standard care on HbA1C, in initially
      sedentary women and men with T2D. The primary outcome measure was HbA1C, an integrated
      measure of blood glucose control over the past 8-12 weeks. Other outcomes of interest
      included resting blood pressure, C-reactive protein (CRP), total body fat, and lean muscle
      mass as measured by DEXA, cardiorespiratory fitness, muscular strength, and metabolic
      measures including serum cholesterol and triglycerides.
    

Intervention name(s): exercise
Intervention type(s): Behavioral
Intervention description(s): compared effects on HbA1C on aerobic only, resistance only, combination of aerobic and resistance, and a stretching & relaxing groups.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: aerobic exercise; resistance exercise; type 2 diabetes; hemoglobin A1C; exercise