Resistance and aerobic exercise combo tied to superior Blood sugar control in diabetes: Study
A new research indicates that combined resistance and aerobic training regimens and High Intensity Training convey superior improvements in blood sugar control in diabetes.
Sweden: Training regimens that improve fitness and metabolism are beneficial for controlling blood sugar in patients with type 2 diabetes (T2D) and hence, they should be encouraged to do the same, suggests a recent study in the journal Diabetologia.
Exercise training in general improves blood sugar control in types 2 diabetes patients. However there is no information on the precise training regimen that confers the most beneficial metabolic adaptations for glycemic and blood sugar control in this population.
Blood sugar is commonly considered too high if it is higher than 130 mg/dl before a meal or higher than 180 mg/dl two hours after the first bite of a meal. However, most of the signs and symptoms of high blood sugar don't appear until the blood sugar level is higher than 250 mg/dl.
Exercising leads to high energy demands that stimulate cardiorespiratory function and substrate mobilization and oxidation. Repeated exercise bouts improve athletic performance through whole-body adaptations. Specific physiological challenges are being posed by distinct exercise modalities and intensities and nutritional conditions. This subsequently induces different adaptations to the training. Athletes achieve individualized training goals and maximize performance by modifying these variables.
In this review, Mladen Savikj & Juleen R. Zierath from Karolinska Institutet, Stockholm, Sweden, discussed how modifying exercise type, intensity and modality, and nutritional status affects the beneficial effects of exercise on blood sugar control in individuals with type 2 diabetes.
Key findings of the study include:
- Both aerobic and resistance exercise acutely enhances insulin sensitivity (~20%). Either traning regimen further increases insulin sensitivity (>40%) and improves HbA1c levels by ~0.4 to 0.5 (~4.1 to 5.1 mmol/mol).
- Combined aerobic and resistance training regimens improve insulin sensitivity (~70%) and lower HbA1c levels (~0.9%; ~10.6 mmol/mol) and these changes are greater than those observed with either training regimen alone.
- Exercise-induced improvements in insulin sensitivity correlate with work intensity (50% VO2 max) and intense (80% VO2 max) efforts enhance insulin sensitivity by 50% and 80% respectively.
- Moderate intensity and vigorous exercise training programmes improve glycemic control.
- Training-induced reductions in HbA1c are coupled to exercise intensity and volume.
- Training with low carbohydrate avaialability ('training low') is practiced by athletes to achieve superior performance improvements.
- The effect on low-intensity exercise on glycemic control is further enhanced when work bouts are performed in the postprandial state, with high substrate availability.
- The effect of HIT on glycemic control is further enhanced when work bouts are performed in the fasted state, with low substrate availability.
- The efficacy and safety of longer 'training low' regimens for type 2 diabetes patients warrants further study.
Examinations of various training regimens are warranted to assess the safety,efficacy, feasibility, and beneficial effects in the type 2 diabetes population. Just like competitive athletes, individuals with type 2 diabetes should be encouraged to adopt training regimens that improve fitness and metabolism," concluded the authors.
The study, "Train like an athlete: applying exercise interventions to manage type 2 diabetes," is published in the journal Diabetologia.
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