Exercise as it relates to Disease/The Effect of High Intensity Resistance Training on Glycemic Control in Older Type 2 Diabetics
Title - The Effect of High Intensity Resistance Training on Glycemic Control in Older Type 2 Diabetics
(Dunstan DW, Daly RM, Owen N, Damien J, Courten M, Shaw J, Zimmet P. High-Intensity Resistance Training Improves Glycemic Control in Older Patients with Type 2 Diabetes. DiabCare. 2002 October; 25 (10): 1729-1736) [1]
Research Background
[edit | edit source]- Type II Diabetes - Type II Diabetes is a lifestyle disease[2] in which the pancrease gradually loses the ability to produce enough insulin.[3] According to Diabetes Australia and Better Health Victoria, type II diabetes can be caused by lifestyle and genetic factors including: older age, being overweight/obesity, high blood pressure, cardiovascular disease, little or no physical activity and smoking.[2]
- Glycemic Control - Glycemic control is maintaining blood glucose levels[4] within a range of 6-8 mmol/L[5] (for type 2 diabetics) to help treat and regulate diabetics mellitus. Glycemic control can be controlled through a variety of methods, some include: continuous home monitoring of glucose,[6] Exenatide (Exendin-4),[7] and resistance training.[8]
- High Intensity Resistance Training - According to Better Health Victoria, resistance training (also known as strength or weight training) uses resistance to build strength throughout muscular contraction. High Intensity resistance training involves more weight and a higher intensity of sets of reps.[9]
Research Information
[edit | edit source]- Where is the research from? - This study was held in Victoria, Australia and conducted by researches from the International Diabetes Institute, School of Health Sciences - Deakin University and School of Population Health - University of Queensland. This study was published in Diabetes Care Journal in 2002.
- What kind of research was this? - This study was a clinical controlled trial to assess whether high-intensity resistance training has an effect in improving glycemic control in older type II diabetics.
- What did the research involve? - This study investigated the effects of high-intensity resistance training (HIRT) on glycemic control in older type II diabetes. 29 overweight men and women aged 60–80yrs were randomly split into two groups:
- High-Intensity Progressive Resistance Training + Moderate Weight-Loss [RT & WL]
- Moderate Weight-Loss + Control Program [WL]
Each participant attended 3 exercise sessions per week for 6 months in a laboratory setting under supervision.
RT & WL group goal was to achieve 75-80% of their 1RM with a program consisting of 5min warm-up, 45min HIRT and 5min cool-down. Various exercises were used including: bench press, leg extension, dumbbell seated shoulder press, bicep curl and abdominal curls. The workload for each exercise was regularly increased to achieve 3 sets of 10 reps. 1RM was tested every 12 weeks to set a new baseline measure.
The WL group goal was the achieve weight loss. There program consisted of 5min stationary cycling and 30min static stretching.
Both groups also undertook a healthy eating plan for the first 4 weeks designed to cause 0.25 kg weight loss per week. After 4 weeks, participants met with a dietitian to complete a weekly food checklist. 3 day food records were taken at 3 and 6 months to compare nutrients changes across the trial.
- Pre & Post Testing Procedures - Pre and Post testing procedures included: anthropometry, muscle strength (using 1RM), habitual physical activity, resting blood pressures and a blood sample to measure different blood markers.
Results
[edit | edit source]Resistance Training & Weight Loss | Weight Loss & Control | |
---|---|---|
Subject Characteristics | No differences from baseline | No differences from baseline |
Adherence to Interventions | 88% attendance to sessions | 85% attendance to sessions |
Metabolic Variable Changes | 0.5% reduction of HBLA1c at 3 months
0.8% reduction of HBLA1c at 6 months |
No detectable changes in HBLA1c |
Fasting Insulin | 1.4 mmol/L reduction after 6 months | No change |
Anthropometric Measurements | Reduction in body weight and waist circumference at 3 and 6 months
Reduction in fat mass at 6 months Increase in Lean Body Mass |
Reduction in body weight and waist circumference at 3 and 6 months
Reduction in fat mass at 6 months Decrease of lean body mass |
Muscular Strength | Upper Body – 22.9% increase at 3 months and 41.7% increase at 12 months
Lower Body – 5.8% increase at 3 months and 28% increase at 6 months. |
No change |
Blood Pressure | Reduction in Diastolic and Systolic at 6 months | No change |
Energy intake & Habitual Physical Activity | Decreased total energy intake at 3 & 6 months
No change in habitual activity. |
Decreased total energy intake at 3 & 6 months
No change in habitual activity. |
- Interpreting Results - The researchers concluded that a high-intensity resistance training program has a positive effect in improving glycemic control in older type II diabetics. Participants also achieved a reduction in fat mass making the training program a valid source of research therefore opening more areas for further investigation/research.
- Implications of Research- The implications of this research along with previous studies[10][11][12] suggest that high intensity resistance training has a positive effect in improving glycemic control in older type II diabetics and moderate weight loss.
- Further Research - Type II diabetes is currently responsible for 85% of diabetes in Australia,[13] therefore this study suggests further research options for improving glycemic control in older type II diabetics utilizing high intensity resistance training: training periods longer than 6 months, sessions held outside a lab-based setting and identifying the optimal intensity of resistance training to safety train and gain maximal effects.[11]
Conclusions
[edit | edit source]This study investigated the effects on glycemic control in older type II diabetics throughout a high-intensity resistance training program. Results demonstrated that the program was effective. The RT & WL group showed a 0.8% decrease in HBLA1c therefore improving glycemic control. Both groups experienced a reduction in body weight and fat mass. Alongside supporting evidence,[14] this study shows glycemic control in older type II diabetics can be controlled with a high-intensity resistance training program and a moderate weight loss.
Further reading
[edit | edit source]- Exercise and Sports Science Australia - Diabetes Position Statement
- Resistance Exercise in Type Ii Diabetics (Pages 309-310)
References
[edit | edit source]- ↑ Dunstan DW, Daly RM, Owen N, Damien J, Courten M, Shaw J, Zimmet P. High-Intensity Resistance Training Improves Glycemic Control in Older Patients with Type 2 Diabetes. DiabCare. 2002 October; 25 (10): 1729-1736
- ↑ a b Better Health Channel. Diabetes type 2 - Better Health Channel [Internet]. 2015 [cited 24 September 2015]. Available from: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/diabetes_type_2
- ↑ Diabetesaustralia.com.au. Type 2 diabetes [Internet]. 2015 [cited 24 September 2015]. Available from: https://www.diabetesaustralia.com.au/type-2-diabetes
- ↑ TheFreeDictionary.com. glycaemic control [Internet]. 2015 [cited 24 September 2015]. Available from: http://medical-dictionary.thefreedictionary.com/glycaemic+control
- ↑ Diabetesaustralia.com.au. Blood glucose monitoring [Internet]. 2015 [cited 24 September 2015]. Available from: https://www.diabetesaustralia.com.au/blood-glucose-monitoring
- ↑ Garg SK, Kelly WC, Voelmle MK, Ritchie PJ, Gottlieb PA, McFann KK, Ellis SL. Continuous Home Monitoring of Glucose. DiabCare. 2007 December; 30 (12) 3023-3025
- ↑ Buse JB, Henry RR, Han J, Kim DD, Fineman MS, Baron AD. Effects pf Exenatide (Exendin-4) on Glycemic Control over 30 Weeks in Sulfonylurea-Treated Patients with Patients with Type 2 Diabetes. DiabCare. 2004 November; 27 (11) 2628-2633
- ↑ Castaneda C, Layne JE, Munoz-Orians L, Gordon PL, Walsmith J, Foldvari M, Roubenoff R, Tucker KL, Nelson ME. A Randomized Controlled Trial of Resistance Exercise Training to Improve Glycemic Control in Older Adults with Type 2 Diabetes. DiabCare. 2002 December; 25 (12) 2355-2341
- ↑ Better Health Channel. Resistance Training – Health Benefits – Better Health Channel [Internet]. 2015 [cited 24 September 2015]. Available from: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Resistance_training_the_health_benefits?open
- ↑ Warburton DER, Nicol CW, Bredin SSD. Health Benefits of Physical Activity: the evidence. CMAJ. 2006 March 14; 174 (6) 801-809
- ↑ a b Eves ND, Plotnikoff RC. Resistance Training and Type 2 Diabetes.DiabCare. 2006 August; 29 (8) 1933-1946.
- ↑ Honkola A, Forsen T, Eriksson J. Resistance Training improves the metabolic profile in individuals with type 2 diabetes. Acta Diabet. 1997 December; 34 (4) 245-248
- ↑ Diabetes Australia. Diabetes in Australia – Diabetes Australia [Internet]. 2015 [cited 24 September 2015] Available from: https://www.diabetesaustralia.com.au/diabetes-in-australia
- ↑ Boule NG, Haddad E, Kenny GP, Wells GA, Sigal RJ. Effects of Exercise on Glycemic Control and Body Mass in Type 2 Diabetes Mellitus. JAMA. 2001 September 12; 286 (10) 1218-1227