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Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial.

Abstract

BACKGROUND

Previous trials have evaluated the effects of aerobic training alone and of resistance training alone on glycemic control in type 2 diabetes, as assessed by hemoglobin A1c values. However, none could assess incremental effects of combined aerobic and resistance training compared with either type of exercise alone.

OBJECTIVE

To determine the effects of aerobic training alone, resistance training alone, and combined exercise training on hemoglobin A1c values in patients with type 2 diabetes.

DESIGN

Randomized, controlled trial.

SETTING

8 community-based facilities.

PATIENTS

251 adults age 39 to 70 years with type 2 diabetes. A negative result on a stress test or clearance by a cardiologist, and adherence to exercise during a 4-week run-in period, were required before randomization.

INTERVENTIONS

Aerobic training, resistance training, or both types of exercise (combined exercise training). A sedentary control group was included. Exercise training was performed 3 times weekly for 22 weeks (weeks 5 to 26 of the study).

MEASUREMENTS

The primary outcome was the change in hemoglobin A1c value at 6 months. Secondary outcomes were changes in body composition, plasma lipid values, and blood pressure.

RESULTS

The absolute change in the hemoglobin A1c value in the combined exercise training group compared with the control group was -0.51 percentage point (95% CI, -0.87 to -0.14) in the aerobic training group and -0.38 percentage point (CI, -0.72 to -0.22) in the resistance training group. Combined exercise training resulted in an additional change in the hemoglobin A1c value of -0.46 percentage point (CI, -0.83 to -0.09) compared with aerobic training alone and -0.59 percentage point (CI, -0.95 to -0.23) compared with resistance training alone. Changes in blood pressure and lipid values did not statistically significantly differ among groups. Adverse events were more common in the exercise groups.

LIMITATIONS

The generalizability of the results to patients who are less adherent to exercise programs is uncertain. The participants were not blinded, and the total duration of exercise was greater in the combined exercise training group than in the aerobic and resistance training groups.

CONCLUSION

Either aerobic or resistance training alone improves glycemic control in type 2 diabetes, but the improvements are greatest with combined aerobic and resistance training. ClinicalTrials.gov registration number: NCT00195884.

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  • Authors+Show Affiliations

    ,

    University of Ottawa, Clinical Epidemiology Program, Ottawa Health Research Institute, and Prevention and Rehabilitation Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. rsigal@ucalgary.ca

    , , , , , , , , , ,

    Source

    Annals of internal medicine 147:6 2007 Sep 18 pg 357-69

    MeSH

    Adult
    Aged
    Blood Glucose
    Blood Pressure
    Body Composition
    Diabetes Mellitus, Type 2
    Exercise Therapy
    Female
    Glycated Hemoglobin A
    Humans
    Lipids
    Male
    Middle Aged
    Patient Compliance
    Physical Education and Training

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    17876019

    Citation

    Sigal, Ronald J., et al. "Effects of Aerobic Training, Resistance Training, or Both On Glycemic Control in Type 2 Diabetes: a Randomized Trial." Annals of Internal Medicine, vol. 147, no. 6, 2007, pp. 357-69.
    Sigal RJ, Kenny GP, Boulé NG, et al. Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial. Ann Intern Med. 2007;147(6):357-69.
    Sigal, R. J., Kenny, G. P., Boulé, N. G., Wells, G. A., Prud'homme, D., Fortier, M., ... Jaffey, J. (2007). Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial. Annals of Internal Medicine, 147(6), pp. 357-69.
    Sigal RJ, et al. Effects of Aerobic Training, Resistance Training, or Both On Glycemic Control in Type 2 Diabetes: a Randomized Trial. Ann Intern Med. 2007 Sep 18;147(6):357-69. PubMed PMID: 17876019.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial. AU - Sigal,Ronald J, AU - Kenny,Glen P, AU - Boulé,Normand G, AU - Wells,George A, AU - Prud'homme,Denis, AU - Fortier,Michelle, AU - Reid,Robert D, AU - Tulloch,Heather, AU - Coyle,Douglas, AU - Phillips,Penny, AU - Jennings,Alison, AU - Jaffey,James, PY - 2007/9/19/pubmed PY - 2007/9/22/medline PY - 2007/9/19/entrez SP - 357 EP - 69 JF - Annals of internal medicine JO - Ann. Intern. Med. VL - 147 IS - 6 N2 - BACKGROUND: Previous trials have evaluated the effects of aerobic training alone and of resistance training alone on glycemic control in type 2 diabetes, as assessed by hemoglobin A1c values. However, none could assess incremental effects of combined aerobic and resistance training compared with either type of exercise alone. OBJECTIVE: To determine the effects of aerobic training alone, resistance training alone, and combined exercise training on hemoglobin A1c values in patients with type 2 diabetes. DESIGN: Randomized, controlled trial. SETTING: 8 community-based facilities. PATIENTS: 251 adults age 39 to 70 years with type 2 diabetes. A negative result on a stress test or clearance by a cardiologist, and adherence to exercise during a 4-week run-in period, were required before randomization. INTERVENTIONS: Aerobic training, resistance training, or both types of exercise (combined exercise training). A sedentary control group was included. Exercise training was performed 3 times weekly for 22 weeks (weeks 5 to 26 of the study). MEASUREMENTS: The primary outcome was the change in hemoglobin A1c value at 6 months. Secondary outcomes were changes in body composition, plasma lipid values, and blood pressure. RESULTS: The absolute change in the hemoglobin A1c value in the combined exercise training group compared with the control group was -0.51 percentage point (95% CI, -0.87 to -0.14) in the aerobic training group and -0.38 percentage point (CI, -0.72 to -0.22) in the resistance training group. Combined exercise training resulted in an additional change in the hemoglobin A1c value of -0.46 percentage point (CI, -0.83 to -0.09) compared with aerobic training alone and -0.59 percentage point (CI, -0.95 to -0.23) compared with resistance training alone. Changes in blood pressure and lipid values did not statistically significantly differ among groups. Adverse events were more common in the exercise groups. LIMITATIONS: The generalizability of the results to patients who are less adherent to exercise programs is uncertain. The participants were not blinded, and the total duration of exercise was greater in the combined exercise training group than in the aerobic and resistance training groups. CONCLUSION: Either aerobic or resistance training alone improves glycemic control in type 2 diabetes, but the improvements are greatest with combined aerobic and resistance training. ClinicalTrials.gov registration number: NCT00195884. SN - 1539-3704 UR - https://www.unboundmedicine.com/medline/citation/17876019/Effects_of_aerobic_training_resistance_training_or_both_on_glycemic_control_in_type_2_diabetes:_a_randomized_trial_ L2 - https://www.annals.org/article.aspx?volume=147&issue=6&page=357 DB - PRIME DP - Unbound Medicine ER -