Intensive exercise lowers blood sugar by improving Beta-cell function in diabetes: Study

The study is published in the Diabetologia journal.

It is unclear whether a lifestyle intervention can maintain blood sugar control in patients with type 2 diabetes. This indicates that although the Diabetes Prevention Program (DPP) has established lifestyle changes (diet, exercise and weight loss) as the 'gold standard' preventive therapy for diabetes, the relative contribution of exercise alone to the overall utility of the combined diet and exercise effect of DPP is still unknown; furthermore, the optimal intensity of exercise for preventing progression to diabetes remains very controversial.

Therefore, Mette Y Johansen and colleagues from the Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, University of Copenhagen, Copenhagen, Denmark conducted a study which aimed to investigate whether an intensive lifestyle intervention, with high volumes of exercise, improves beta-cell function and further, to explore the role of low-grade inflammation and body weight.

The study was a randomized, assessor-blinded, controlled trial including ninety-eight individuals with type 2 diabetes (duration <10 years) having a BMI of 25-40 kg/m². The patients did not have a history of insulin intake and them were taking fewer than three blood sugar-lowering medications which were randomized (2:1) to either the standard care plus intensive lifestyle group or the standard care alone group.

Standard care consisted of individual guidance on disease management, lifestyle advice, and blinded regulation of medication following a pre-specified algorithm whereas the intensive lifestyle intervention consisted of aerobic exercise sessions that took place 5-6 times per week, combined with resistance exercise sessions 2-3 times per week, with a concomitant dietary intervention aiming for a BMI of 25 kg/m².

Based on the analysis, the following findings were noted-

1. The intensive lifestyle group showed 40% greater improvement in the disposition index compared with the standard care group from baseline to 12 months' follow-up.
2. Plasma concentration of IL-1 receptor antagonist (IL-1ra) decreased 30% more in the intensive lifestyle group compared with the standard care group.
3. Statistical single mediation analysis estimated that the intervention effect on the change in IL-1ra and the change in body weight explained to a similar extent (59%) the variance in the intervention effect on the disposition index.