Diabetes Resistance Training Adaptations in Elderly

Study Overview
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Brief Summary
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This study aims to verify the effects of resistance training on neuromuscular, vascular and functional adaptations of elderly diabetics type 2. Half of participants will be the intervention group that will perform resistance training, while the other half will be the control group that will perform stretching sessions.

Detailed Description
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Resistance training may be an interesting strategy to fight diabetes deleterious conditions, as it is known to increase muscle mass and quality, strength, functional capacity, vascular health, and decrease inflammation status and blood lipids, besides leading to improves in glycemic control. To test this hypothesis, 42 diabetic patients will be recruited and randomized to two groups that will be evaluated before and after 12 weeks of both intervention or control period. The resistance training group will perform all body resistance exercises three times per week, while the control group will perform a stretching session one time per week.

Official Title
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Muscle and Vascular Adaptations Induced by Resistance Training in Elderly Diabetic Type 2

Conditions
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Diabetes Mellitus, Type 2

Intervention / Treatment
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* Other: Resistance training
* Other: Stretching control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Type 2 diabetes 60 yers and older HbA1c > 6,5% BMI from 18,5 kg/m2 - 34,9 kg/m2 Exclusion Criteria: Current smoking Insulin users Hypertension uncontrolled Diabetic neuropathy Diabetic retinopathy Diabetic nephropathy Peripheral amputations Clinical depression Myocardial infarction (within past 6 months) Any unstable chronic condition Muscle-skeletal complications that limit the practice of the exercises

Ages Eligible for Study
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Minimum Age: 60 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: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Resistance training<br>Resistance training will be performed three times a week, for 12 weeks, composed by 12 resistance exercises for all body muscles with 2-3 series and 12-8 repetitions in each exercise. | Other: Resistance training<br>* The resistance training will be compound by 12 exercises for all body muscles, performed three times per week. The intensity of training will be measure by maximum repetitions from 12 until 8 repetitions with 2-3 series. The loads will increase for keep the maximum strength as the capacity of patients. The blood pressure and the casual glycemic will be measure before and after the training in each session. Before to start the exercises, patients will perform a warming on treadmill for 10 minutes and after the training will perform some stretching exercises for muscles groups trained.<br>|
| Active Comparator: Stretching control<br>The control group will perform one stretching session a week. | Other: Stretching control<br>* The stretching session will be composed by stretching and joint mobilization exercises for all body muscles and will happen only one time per week.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quadriceps Muscle Quality measure by echo intensity | Echo intensity is a grey scale for analyse the image that ranging from 0 (black) to 255 (white). | 12 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Functional capacity measure by stair climb test. | Total time, as fast as possible, to climb 10 steps. | 12 weeks | 
| Quadriceps muscle strength measured by one repetition maximum (1RM) test. | 1RM is a maximum load lifted, reported in kg, during the knee extension. | 12 weeks | 
| Visceral adipose tissue measured by ultrasonography | Visceral adipose tissue (VAT) thickness measured by ultrasonography. The VAT thickness is considered from the back of the subcutaneous tissue until the anterior part of the aorta. It is reported in mm. | 12 weks | 
| Muscle thickness measured by ultrasonography | Muscle thickness measured by ultrasonography takes into account the superior fascia of the muscle and the distance until the inferior fascia. It is reported in mm. | 12 weeks | 
| Inflammation status estimated by tumor necrosis factor alpha (TNF-α ) and C reactive protein (CRP) | TNF-α will be evaluated by specific commercial kit and CRP will be measured in a regular laboratorial equipment (COBAS C111). | 12 weeks | 
| Lipid profile | HDL, LDL, total cholesterol and triglycerides will be measured in a regular laboratorial equipment (COBAS C111) | 12 weeks | 
| Glycemic profile | Blood glycated hemoglobin and glucose will be measured in a regular laboratorial equipment (COBAS C111) | 12 weeks | 
| Endothelial function measured by ultrasonography | Endothelial function estimated by the response of endothelial cells for hyperemia. | 12 weeks | 
| Quadriceps Muscle Quality measure by specific tension | Specific tension is the ratio between muscle strength and muscle mass. | 12 weeks | 
| Functional capacity measure by time up and go test | Time to get up from the chair walk around the marker (3 m) and return to the sitting position, as fast as possible. | 12 weeks | 
| Functional capacity measure by sit-to-stand-up test | The time, as fast as possible, to stand and sit on the chair 10 times. | 12 weeks | 
| Quadriceps muscle power capacity measure by rate of torque development. | The rate torque development is a slope of torque/time curve. | 12 weeks |