Effects of Aerobic Training on Pancreatic Fat and Cognitive Function in T2DM Patients
Condition: Type 2 Diabetes Mellitus
MeSH terms: Diabetes Mellitus; Diabetes Mellitus, Type 2
Study type: Interventional

Summary: 
      The primary aim of this study was to evaluate the difference in cognitive function and brain
      functional structure between exercise group and control group by performing regular one-year
      moderate-intensity aerobic training in type 2 diabetes mellitus (T2DM) with normal cognitive
      function. The secondary aim of this study was to explore the effects of six-month regular
      moderate-intensity aerobic training on pancreatic fat content, metabolic index of glucose and
      lipid, as well as cardiovascular risks in patients type 2 diabetes mellitus.
    

Detailed description: 
      In recent years, more attention has been paid to the role of aerobic exercise in improving
      cognitive ability, but there is still a lack of prospective studies on the T2DM population
      with normal cognitive function. Therefore, the purpose of this study is to compare the
      differences of cognitive function and hippocampal volume between exercise group and
      non-exercise group by regular moderate-intensity aerobic exercise intervention for one year
      in T2DM patients with normal cognitive function to evaluate the impact of aerobic exercise on
      cognitive function and hippocampal volume for these patients and provide scientific evidence
      for early prevention and delaying the occurrence of cognitive dysfunction in patients with
      T2DM. Pancreatic fat deposition in patients with type 2 diabetes is not only a simple fat
      accumulation but also an early marker of insulin resistance. In this study, The effectiveness
      of six months of an aerobic exercise intervention on pancreas fat reduction for type 2
      diabetes patients was examed.

      In this study, 106 T2DM patients who met the inclusion criteria were enrolled and randomized
      into two groups. All patients received diabetes education(once a month, the course will be
      focused on basic knowledge of diabetes, diet management, and blood glucose monitoring). The
      control group followed their regular lifestyle without exercise intervention and recorded
      24-hour dietary intake. The aerobic training group was supervised by the trainers who had
      received professional training and given 60min moderate aerobic rhythmic exercise (including
      5min warm-up, 50min aerobic exercise, and 5min stretching exercise).

      Baseline assessment included demographic data, duration of diabetes, body mass index（BMI）,
      waist circumference（WC）, hip circumference（HC）, systolic blood press（SBP）, diastolic blood
      press（DBP）, smoking and drinking, drug use, acute and chronic complications of diabetes,
      other chronic complications, 24-hour diet review, international physical activity
      questionnaire (IPAQ).

      Evaluation after 6 months of intervention included pancreatic fat content(PFC), liver fat
      content (LFC), visceral adipose tissue (VAT), subcutaneous adipose tissue(SAT), fasting
      plasma glucose (FPG), 2-hour postprandial blood glucose(2hPG), hemoglobin A1c(HbA1c), fasting
      insulin (FINS), homeostasis model assessment of insulin resistance(HOMA2-IR), homeostasis
      model assessment of Beta-cell function (HOMA2-β), early insulin secretion index(Δ I30 / Δ
      G30), total cholesterol(TC),
      triglycerides(TG),high-density-lipoprotein-cholesterol(HDL-C),low-density lipoprotein
      cholesterol(LDL-C). The Framingham cardiovascular risk scale (Framingham) and 10-year
      ischemic cardiovascular disease risk assessment (ICVD) scores were calculated.

      Evaluation after 12 months of intervention included fasting plasma glucose(FPG),30 minutes
      postprandial glucose(30minPG), 2-hour postprandial glucose(2hPG)，hemoglobin A1c(HbA1c),
      fasting insulin(FINS),30 minutes Insulin(30minINS), homeostasis model assessment of insulin
      resistance(HOMA2-IR),homeostasis model assessment of Beta cell function(HOMA2-β),early
      insulin secretion index(Δ I30 / Δ
      G30),totalcholesterol(TC),triglycerides(TG),high-density-lipoprotein cholesterol(
      HDL-c），low-density-lipoprotein cholesterol(LDL-c),muscle mass, right, left hippocampal volume
      of hippocampal volume, the hippocampal volume, and total physical activity energy
      expenditure, total moderate physical activity energy expenditure. In addition to this,
      cognitive function (MMSE, MoCA) were also evaluated.
    

Intervention name(s): Aerobic training
Intervention type(s): Behavioral
Intervention description(s): The intervention was aerobic rhythmic training under the guidance and supervision of a professional. The aerobic training program required participants to exercise 3 days/week for 60 minutes/session (including 5-10 minutes of warm-up and 50 minutes aerobic training and 5-10 minutes to relax). All patients received an open class, relate to diabetes health education．
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: aerobic training; type 2 diabetes mellitus; pancreatic fat content; cognitive function; hippocampal volume