Effect of arobic training, resistance training or both on gylcemic control in Type 2 diabetes

Sigal, R.J., Kenny, G.P., Boule, N.G., Wells, G.A., Prud’homme, D., Fortier, M., Reid, R., Tulloch, H., Coyle, D., Phillips, P., Jennings, A. & Jeffrey, J. 2007. Ann. of Int. Medicine.147(6): 357-w71.

Structured aerobic exercise or resistance exercise are able to reduce HbA1c about 0.6% where 1% reduction in HbA1c resulted 15% - 20% decrease in major cardiovascular events and 37% reduction in micrvovascualr complication.

This group if researchers carried out a ramdomized clinical trial to measure the effect of aerobic or resistanace training alone or the combination of both on glycemic control and other risk factor for CVD.

Primary outcome was the change in HbA1c whereby the secondary outcome are plasma lipid levels, BP, and body composition.

Study lasted for 26 weeks and started by 4 weeks run-in phase. Subejct were previous;y inactive diabetes type 2 patience randmizationed done after the run-in trial phase and divided into 4 group
1 - aerobic exercise
2 - resistance exercie
3 - combination
4 - control (no exercise)

Aerobic group performed on either treadmills or cycle ergometer, 3 times weekly, difficulty increased gradually for both duration and intensity. Satrted at 15 - 20 mins at 60% of max HR to 45 mins at 75% of maxHR per session
Resistabce group performed 7 diffrents exercise on weight training machines, gradually increased from 2 - 3 sets at maximum weight 7 - 9 reps.
Combine group did both of aerobic and resistance exercise regimens - hence resulted in longer exercise duration in total. All subjects got clearance from cardiologist. Those only completed 70% or more of teh exercise sessions included for the data analysis.

Rsult shown each exercise groupscontributed to improvement of glycemic control with the combination group shown a better result. Researchers mentioned about the effect or longer exercise duration which might contributre to the effect, but they did not design the study to really see the effect this factor. However they gave the argunentation that earobic and resistance gave different physiological effects.

The effect of arobic and resistance exercise are complimentary cardiorespiratory and muscle endurance and strength are the main effect respectively.

This study also argued that older person may benifit more from resistance training as older persons have lost more muscle mass. No significant result on BP and a modest differences on lipid parameters. HInger intensity might be needed in rder to get more significant result on these parameters.

Thi sstudy cant be genralized to those who can not or do not want to eangage in exercise and also cant be applied on those patients who are under insulin therapy as they excluded these group of patients.