Metabolic Effects of Aerobic Training and Resistance Training in Type 2 Diabetic Subjects: A randomized controlled trial (the RAED2 study)

• Published in: Diabetes care Vol. 35; no. 4; pp. 676 - 682
• Main Authors: Bacchi, Elisabetta, Negri, Carlo, Zanolin, Maria Elisabetta, Milanese, Chiara, Faccioli, Niccolò, Trombetta, Maddalena, Zoppini, Giacomo, Cevese, Antonio, Bonadonna, Riccardo C, Schena, Federico, Bonora, Enzo, Lanza, Massimo, Moghetti, Paolo
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.04.2012
• Subjects: abdominal fat; adipose tissue; Adult; adverse effects; Aged; analysis; Biological and medical sciences; blood; Blood Glucose; Blood Glucose - analysis; Blood Glucose - metabolism; Cholesterol; Combined Modality Therapy; Dextrose; Diabetes; Diabetes Mellitus, Type 2; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - metabolism; Diabetes Mellitus, Type 2 - therapy; Diabetes. Impaired glucose tolerance; dual-energy X-ray absorptiometry; Eating; Eating - physiology; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Exercise; Exercise - physiology; Exercise Therapy; Exercise Therapy - adverse effects; Exercise Therapy - methods; Female; Glucose; glucose tolerance; glycohemoglobin; Humans; Insulin; Insulin resistance; Insulin Resistance - physiology; islets of Langerhans; magnetic resonance imaging; Male; Medical research; Medical sciences; Medicine, Experimental; Metabolic diseases; metabolism; methods; Middle Aged; Miscellaneous; multivariate analysis; noninsulin-dependent diabetes mellitus; Original Research; oxygen consumption; patients; phenotype; Physical Fitness; Physical Fitness - physiology; Physiological aspects; physiology; Public health. Hygiene; Public health. Hygiene-occupational medicine; randomized clinical trials; Resistance Training; Resistance Training - adverse effects; Resistance Training - methods; risk factors; strength training; Studies; therapy; Type 2 diabetes; Weight training; Endocrinopathy; Type 2 diabetes; Human; Resistance; Randomization; Nutrition; Randomised controlled trial; Clinical trial; Metabolic diseases; Metabolism; Endocrinology
• ISSN: 0149-5992; 1935-5548; 1935-5548
• DOI: 10.2337/dc11-1655

OBJECTIVE: To assess differences between the effects of aerobic and resistance training on HbA1c (primary outcome) and several metabolic risk factors in subjects with type 2 diabetes, and to identify predictors of exercise-induced metabolic improvement. RESEARCH DESIGN AND METHODS: Type 2 diabetic patients (n = 40) were randomly assigned to aerobic training or resistance training. Before and after 4 months of intervention, metabolic phenotypes (including HbA1c, glucose clamp–measured insulin sensitivity, and oral glucose tolerance test–assessed β-cell function), body composition by dual-energy X-ray absorptiometry, visceral (VAT) and subcutaneous (SAT) adipose tissue by magnetic resonance imaging, cardiorespiratory fitness, and muscular strength were measured. RESULTS: After training, increase in peak oxygen consumption (VO2peak) was greater in the aerobic group (time-by-group interaction P = 0.045), whereas increase in strength was greater in the resistance group (time-by-group interaction P < 0.0001). HbA1c was similarly reduced in both groups (–0.40% [95% CI –0.61 to –0.18] vs. –0.35% [–0.59 to –0.10], respectively). Total and truncal fat, VAT, and SAT were also similarly reduced in both groups, whereas insulin sensitivity and lean limb mass were similarly increased. β-Cell function showed no significant changes. In multivariate analyses, improvement in HbA1c after training was independently predicted by baseline HbA1c and by changes in VO2peak and truncal fat. CONCLUSIONS: Resistance training, similarly to aerobic training, improves metabolic features and insulin sensitivity and reduces abdominal fat in type 2 diabetic patients. Changes after training in VO2peak and truncal fat may be primary determinants of exercise-induced metabolic improvement.