Resistance Exercise on Postprandial Hyperglycemia in Patients With B-thalassemia Exhibiting Resistance to Insulin
Condition: Beta-Thalassemia; Insulin Resistance; PreDiabetes; Diabetes Mellitus, Type 2
MeSH terms: Thalassemia; beta-Thalassemia; Diabetes Mellitus, Type 2; Insulin Resistance; Hyperglycemia; Prediabetic State; Glucose Intolerance
Study type: Interventional

Summary: 
      It is known that postprandial hyperglycemia increases the cardiometabolic risk in both
      diabetic and non-diabetic patients. Moreover, there is insufficient data on the effectiveness
      of exercise on preventing Type II diabetes mellitus in individuals with insulin resistance
      and prediabetes. This study aims to examine the effectiveness of resistance exercise in
      limiting postprandial hyperglycemia and the necessity of prescribing medication particularly
      in patients with beta-thalassemia and insulin resistance.
    

Detailed description: 
      Type II diabetes mellitus is a condition characterized by chronic hyperglycemia due to
      insufficient insulin production and action and tissue resistance to insulin. Pre-diabetes is
      also characterized by elevated levels of blood glucose, but not so high as those in diabetes.

      Existing studies have shown that postprandial hyperglycemia is associated with an increased
      risk for complications of diabetes, both microvascular and macrovascular, as it contributes
      to the deficiency of β-pancreatic cells and endothelial dysfunction to a much greater extent
      than glycosylated hemoglobin (HbA1c) and fasting glucose.

      The main problem in glycemic control is the glucose peak 1-2 hours after the meal. Therefore,
      there is a need to investigate whether postprandial exercise can help solve this problem.

      Βeta-thalassemia is a group of heterogeneous hereditary anemias characterized by decreased or
      no production of beta-chain hemoglobin, resulting in inefficient erythropoiesis. The three
      main phenotypes are: a) major b) intermediate and c) heterozygous beta-thalassemia. Major
      thalassemia occurs in the first 2 years of life with severe anemia and requires systemic
      transfusions. The intermediate appears later and usually does not need transfusions. The
      heterozygote is asymptomatic, but some carriers may experience mild anemia. Beta-thalassemia
      is inherited in an autosomal recessive manner. Patient survival has increased significantly
      in recent years due to systemic transfusions and early treatment of disease complications.
      However, multiple transfusions result in the accumulation of large quantities of iron, which
      is toxic to pancreatic beta cells. Both decreased insulin production and decreased tissue
      sensitivity to insulin occur and result in pre-diabetes or Type II diabetes.

      Regarding the effect of exercise on diabetic patients, it is confirmed that it reduces both
      the blood glucose concentration and hyperglycemia during the day. Resistance exercise
      increases heat production and oxygen consumption by the muscles, thus increasing metabolic
      activity and glucose uptake by these muscles. In addition, resistance exercise improves
      glycemic control without causing hypoglycemia and without affecting fasting glucose. Thus,
      the aim of this study is examine the effectiveness of resistance exercise in limiting
      postprandial hyperglycemia in patients with beta-thalassemia and insulin resistance.
    

Intervention name(s): Resistance exercise
Intervention type(s): Other
Intervention description(s): 2 major muscle groups (lower extremity, chest)
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: None (Open Label)
Primary purpose: Treatment