Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes

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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.



Ann Intern Med. 2007 Sep 18;147(6):357-69.

Effects of aerobic training, resistance training, or both on glycemic
control in type 2 diabetes: a randomized trial.
Sigal RJ, Kenny GP, Boulé NG, Wells GA, Prud'homme D, Fortier M, Reid
RD, Tulloch H, Coyle D, Phillips P, Jennings A, Jaffey J.
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
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.
PMID: 17876019 [PubMed - in process]

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