Workouts that focus on resistance exercises are as effective as aerobic regimens at stopping the transition from prediabetes to type 2 diabetes, according to findings published in the Journal of Diabetes.
“It has been shown that [beta]-cell function is decreased in patients with prediabetes,” Qingqing Lou, from the department of health education at the Affiliated Hospital of Integrated Traditional Chinese and Western Medicine at Nanjing University of Chinese Medicine, and colleagues wrote. “To reverse the impending diabetes epidemic, it is clearly imperative to focus on prevention. Interventions for individuals with prediabetes should aim to improve insulin resistance, preserve islet beta-cell mass and prevent further loss of beta-cell function.”
Between January and April 2014, Lou and colleagues randomly assigned 248 adults with prediabetes who attended one of three hospital centers in China to 6-month regimens of aerobic exercise (n = 83; mean age, 60.93 years; 71.1% women), resistance exercise (n = 82; mean age, 59.91 years; 63.4% women) or a control regimen (n = 83; mean age, 60.73 years; 60.2% women). The aerobic regimen featured 1 hour of exercise in which participants maintained a heart rate between 60% and 70% of the maximum established in a pre-study treadmill test. The resistance regimen featured 1 hour of strengthening exercises focused on the arms, legs and abdomen using an exercise band. Both regimens were carried out three times per week for 6 months. The researchers instructed those in the control group to “maintain habitual physical activity.”
The researchers measured HbA1c and blood glucose with an oral glucose tolerance test while also monitoring changes from baseline in cholesterol, BMI, insulin resistance and beta-cell function, with the latter two factors evaluated via homeostatic model assessment.
Workouts that focus on resistance exercises are as effective as aerobic regimens at stopping the transition from prediabetes to type 2 diabetes.
Although the researchers found that there was a 0.05% increase in HbA1c for those in the control group compared with an increase of 0.01% in the resistance group (P = .02 ) and a 0.01% decrease in the aerobic group (P < .001), the difference between the two exercise regimens was not significant. In addition, compared with baseline measures, HbA1c alterations at 6 months did not reach significance for those in the resistance group, according to the researchers. Fasting blood glucose was similarly reduced by 0.04 mM in the aerobic group and by 0.07 mM in the resistance group compared with an increase of 0.06 mM in the control group (P < .001 for both).
In terms of insulin resistance and beta-cell function, neither exercise regimen significantly altered insulin resistance compared with the control group, but homeostatic model assessment of beta-cell function (HOMA2-beta) scores rose by 0.15 in the aerobic group and by 0.36 in the resistance group after 6 months compared with a decrease of 0.62 in the control group (P = .001 for both). Again, neither exercise regimen yielded a significant benefit compared with the other, although resistance training led to better insulin resistance (P = .005) and beta-cell function (P = .049) compared with baseline in that group, according to the researchers.
“Beta-cell function is a stronger predictor of change in glycemia control after an exercise intervention than is change in insulin sensitivity. Decreases in beta-cell function are key to developing diabetes,” the researchers wrote. “In addition, as with [aerobic training], [resistance training] can improve beta-cell function. For all these reasons, [resistance training] appears to have the potential to be an effective way to prevent [type 2 diabetes] in at-risk patients.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.