Aerobic and strength training in concomitant metabolic syndrome and type 2 diabetes

Med Sci Sports Exerc. 2014 Jul;46(7):1293-301. doi: 10.1249/MSS.0000000000000242.

Abstract

Purpose: Concomitant type 2 diabetes (T2D) and metabolic syndrome exacerbates mortality risk; yet, few studies have examined the effect of combining (AER + RES) aerobic (AER) and resistance (RES) training for individuals with T2D and metabolic syndrome.

Methods: We examined AER, RES, and AER + RES training (9 months) commensurate with physical activity guidelines in individuals with T2D (n = 262; 63% female, 44% black). Primary outcomes were change in, and prevalence of, metabolic syndrome score at follow-up (mean and 95% confidence interval [CI]). Secondary outcomes included maximal cardiorespiratory fitness (VO2peak) and estimated METs from time-to-exhaustion (TTE) and exercise efficiency calculated as the slope of the line between ventilatory threshold, respiratory compensation, and maximal fitness. General linear models and bootstrapped Spearman correlations were used to examine changes in metabolic syndrome associated with training primary and secondary outcome variables.

Results: We observed a significant decrease in metabolic syndrome scores (P for trend = 0.003) for AER (-0.59, 95% CI = -1.00 to -0.21) and AER + RES (-0.79, 95% CI = -1.40 to -0.35), both being significant (P ≤ 0.02) versus control (0.26, 95% CI = -0.58 to 0.40) and RES (-0.13, 95% CI = -1.00 to 0.24). This led to a reduction in metabolic syndrome prevalence for the AER (56% vs 43%) and AER + RES (55% vs 46%) groups between baseline and follow-up. The observed decrease in metabolic syndrome was mediated by significant improvements in exercise efficiency for the AER and AER + RES training groups (P < 0.05), which was more strongly related to TTE (25%-30%; r = -0.38, 95% CI = -0.55 to -0.19) than VO2peak (5%-6%; r = -0.24, 95% CI = -0.45 to -0.01).

Conclusions: AER and AER + RES training significantly improved metabolic syndrome scores and prevalence in patients with T2D. These improvements appear to be associated with improved exercise efficiency and are more strongly related to improved TTE versus VO2peak.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetes Mellitus, Type 2 / therapy*
  • Female
  • Glycated Hemoglobin A / analysis
  • Humans
  • Male
  • Metabolic Syndrome / complications
  • Metabolic Syndrome / epidemiology
  • Metabolic Syndrome / physiopathology
  • Metabolic Syndrome / therapy*
  • Middle Aged
  • Oxygen Consumption
  • Physical Education and Training / methods*
  • Physical Fitness
  • Prevalence
  • Resistance Training*
  • Respiration
  • Weight Lifting
  • Young Adult

Substances

  • Glycated Hemoglobin A