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      Both resistance- and endurance-type exercise reduce the prevalence of hyperglycaemia in individuals with impaired glucose tolerance and in insulin-treated and non-insulin-treated type 2 diabetic patients

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          Abstract

          Aims/hypothesis

          The present study compares the impact of endurance- vs resistance-type exercise on subsequent 24 h blood glucose homeostasis in individuals with impaired glucose tolerance (IGT) and type 2 diabetes.

          Methods

          Fifteen individuals with IGT, 15 type 2 diabetic patients treated with exogenous insulin (INS), and 15 type 2 diabetic patients treated with oral glucose-lowering medication (OGLM) participated in a randomised crossover experiment. Participants were studied on three occasions for 3 days under strict dietary standardisation, but otherwise free-living conditions. Blood glucose homeostasis was assessed by ambulatory continuous glucose monitoring over the 24 h period following a 45 min session of resistance-type exercise (75% one repetition maximum), endurance-type exercise (50% maximum workload capacity) or no exercise at all.

          Results

          Average 24 h blood glucose concentrations were reduced from 7.4 ± 0.2, 9.6 ± 0.5 and 9.2 ± 0.7 mmol/l during the control experiment to 6.9 ± 0.2, 8.6 ± 0.4 and 8.1 ± 0.5 mmol/l (resistance-type exercise) and 6.8 ± 0.2, 8.6 ± 0.5 and 8.5 ± 0.5 mmol/l (endurance-type exercise) over the 24 h period following a single bout of exercise in the IGT, OGLM and INS groups, respectively ( p < 0.001 for both treatments). The prevalence of hyperglycaemia (blood glucose >10 mmol/l) was reduced by 35 ± 7 and 33 ± 11% over the 24 h period following a single session of resistance- and endurance-type exercise, respectively ( p < 0.001 for both treatments).

          Conclusions/interpretation

          A single session of resistance- or endurance-type exercise substantially reduces the prevalence of hyperglycaemia during the subsequent 24 h period in individuals with IGT, and in insulin-treated and non-insulin-treated type 2 diabetic patients. Both resistance- and endurance-type exercise can be integrated in exercise intervention programmes designed to improve glycaemic control.

          Trial registration:

          Clinicaltrials.gov NCT00945165

          Funding:

          The Netherlands Organization for Health Research and Development (ZonMw, the Netherlands).

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          Most cited references27

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          Exercise and Type 2 Diabetes

          Although physical activity (PA) is a key element in the prevention and management of type 2 diabetes, many with this chronic disease do not become or remain regularly active. High-quality studies establishing the importance of exercise and fitness in diabetes were lacking until recently, but it is now well established that participation in regular PA improves blood glucose control and can prevent or delay type 2 diabetes, along with positively affecting lipids, blood pressure, cardiovascular events, mortality, and quality of life. Structured interventions combining PA and modest weight loss have been shown to lower type 2 diabetes risk by up to 58% in high-risk populations. Most benefits of PA on diabetes management are realized through acute and chronic improvements in insulin action, accomplished with both aerobic and resistance training. The benefits of physical training are discussed, along with recommendations for varying activities, PA-associated blood glucose management, diabetes prevention, gestational diabetes mellitus, and safe and effective practices for PA with diabetes-related complications.
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            Nutrition recommendations and interventions for diabetes: a position statement of the American Diabetes Association.

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              Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: a meta-analysis of controlled clinical trials.

              Exercise is widely perceived to be beneficial for glycemic control and weight loss in patients with type 2 diabetes. However, clinical trials on the effects of exercise in patients with type 2 diabetes have had small sample sizes and conflicting results. To systematically review and quantify the effect of exercise on glycosylated hemoglobin (HbA(1c)) and body mass in patients with type 2 diabetes. Database searches of MEDLINE, EMBASE, Sport Discuss, Health Star, Dissertation Abstracts, and the Cochrane Controlled Trials Register for the period up to and including December 2000. Additional data sources included bibliographies of textbooks and articles identified by the database searches. We selected studies that evaluated the effects of exercise interventions (duration >/=8 weeks) in adults with type 2 diabetes. Fourteen (11 randomized and 3 nonrandomized) controlled trials were included. Studies that included drug cointerventions were excluded. Two reviewers independently extracted baseline and postintervention means and SDs for the intervention and control groups. The characteristics of the exercise interventions and the methodological quality of the trials were also extracted. Twelve aerobic training studies (mean [SD], 3.4 [0.9] times/week for 18 [15] weeks) and 2 resistance training studies (mean [SD], 10 [0.7] exercises, 2.5 [0.7] sets, 13 [0.7] repetitions, 2.5 [0.4] times/week for 15 [10] weeks) were included in the analyses. The weighted mean postintervention HbA(1c) was lower in the exercise groups compared with the control groups (7.65% vs 8.31%; weighted mean difference, -0.66%; P<.001). The difference in postintervention body mass between exercise groups and control groups was not significant (83.02 kg vs 82.48 kg; weighted mean difference, 0.54; P =.76). Exercise training reduces HbA(1c) by an amount that should decrease the risk of diabetic complications, but no significantly greater change in body mass was found when exercise groups were compared with control groups.
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                Author and article information

                Contributors
                L.vanloon@maastrichtuniversity.nl
                Journal
                Diabetologia
                Diabetologia
                Diabetologia
                Springer-Verlag (Berlin/Heidelberg )
                0012-186X
                1432-0428
                29 November 2011
                29 November 2011
                May 2012
                : 55
                : 5
                : 1273-1282
                Affiliations
                [1 ]Department of Human Movement Sciences, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre+, PO Box 616, 6200 MD Maastricht, the Netherlands
                [2 ]Department of Human Biology, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
                [3 ]Department of Internal Medicine, CARIM Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre+, Maastricht, the Netherlands
                [4 ]Departments of Epidemiology and Surgery, Research School CAPHRI, Maastricht University Medical Centre+, Maastricht, the Netherlands
                Article
                2380
                10.1007/s00125-011-2380-5
                3331783
                22124605
                06df7442-5b5f-4822-800d-9840a1d9c687
                © The Author(s) 2011
                History
                : 15 August 2011
                : 26 October 2011
                Categories
                Article
                Custom metadata
                © Springer-Verlag 2012

                Endocrinology & Diabetes
                continuous glucose monitoring,type 2 diabetes mellitus,metabolic diseases,medicine & public health,glycaemic control,human physiology,internal medicine,postprandial hyperglycaemia,exercise

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