Effects of Different Mode of Exercise Training on Type 2 Diabetes

Study Overview
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Brief Summary
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Randomized study on the comparison between aerobic training versus progressive resistance training over a 2 months period for older adults with type 2 diabetes. The hypothesis is that progressive resistance training is just as effective as aerobic training on Hba1c and could be an alternative training for those older diabetic patients who cannot participate in aerobic exercise.

Detailed Description
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Many studies have shown the importance of aerobic training with respect to management of diabetes. However adoption of aerobic activities may be challenging for some individuals with diabetes, especially the elderly and the obese. There is increasing interest in resistance training and no study have looked at direct comparison between the two. Subjects with diabetes but is generally sedentary (determined by means of a questionnaire) were recruited and randomized in one of the two groups. Subjects are supervised in a group and a completer is defined as one who completed 18 sessions within 8 weeks.

Official Title
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Differential Effects of Aerobic Versus Progressive Resistance Training on Metabolic Profile and Fitness in Older Adults With Diabetes Mellitus - a Randomized Controlled Trial

Conditions
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Diabetes Mellitus, Type 2

Intervention / Treatment
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* Other: Aerobic Training
* Other: Progressive resistance training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: aged 50 years and above, Hba1c between 8 to 10 % in the past one month, sedentary, able to continuously walk for at least 20 minutes and climbed one flight of stairs unaided without stopping were eligible for participation. Exclusion Criteria: uncontrolled diabetes mellitus with Hba1c more than 10% or if escalation of treatment of glycemic control or dyslipidemia was likely to be necessary over the 2 months training period period, congestive cardiac failure, unstable angina or acute myocardial infarction within the last one year, proliferative diabetic retinopathy, uncontrolled hypertension, advanced arthritis likely to limit mobility or participation in prescribed exercises, respiratory conditions such as asthma and chronic obstructive lung disease, significant proteinuria or chronic renal insufficiency, received drugs for the treatment of obesity or very low caloric diet (VLCD, less than 1000 kcal/ day), renal disease and inability to monitor glucose level or comply with exercise program.

Ages Eligible for Study
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Minimum Age: 50 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Aerobic Training<br>50 minutes of aerobic training, 18 sessions within 2 months period | Other: Aerobic Training<br>* 18 sessions over 2 months period. Each session consist of 50 minutes of aerobic training at 65-70 % of maximum predicted heart rate<br>* Other names: Cycling;|
| Experimental: Progressive Resistance Training<br>50 minutes of progressive resistance training consisting of nine resistance exercises, each conducted 3 sets of 10 repetitions. 18 sessions over 2 months period. | Other: Progressive resistance training<br>* 18 sessions completed in 2 months. each session consists of 50 minutes of resistance training which is made up of 3 sets of 10 repetitions of nine resistive exercises using machines and free weights at 65-70% of 1-repetitive maximum.<br>* Other names: Circuit training;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hemoglobin A, Glycosylated (Hba1c). Measuring unit: percentage | Blood was drawn from each subject who fasted at least 10 hours overnight. Hba1c (%) was measured using high performance liquid chromatography (HPLC Variant II Bio Rad Laboratories, Munich, Germany). Change in Hba1c before and after intervention were looked at. | 2 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Peak volume of oxygen consumed (VO2peak) or fitness level. Measuring unit: ml/kg/min | Modified Bruce protocol on a treadmill using Cosmed K4B2 machine to measure | 2 months | 
| Anthropometric measurements | weight (kilogram), height (metres), body mass index (BMI), waist circumference (centimeters) and body fat (percentage). Measurements to be taken before and after intervention. | 2 months | 
| Cholesterol | Blood was drawn from each subject who fasted at least 10 hours overnight. Total cholesterol and triglycerides (TG) were measured using enzymatic colorimetric methods with cholesterol oxidase-peroxidase amino phenazone phenol and glycerol-3-phospahte oxidase-peroxidase amino phenazone phenol. High-density lipoprotein cholesterol (HDL-C) was measured using homogenous enzymatic colorimetric assay. Low-density lipoprotein cholesterol (LDL-C) was calculated using the Friedewald formula. | 2 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Diabetes mellitus, Randomized control trial, Exercise, Hemoglobin A, Glycosylated