The relative benefits of endurance and strength training on the metabolic factors and muscle function of people with type 2 diabetes mellitus.
OBJECTIVE
To compare the effects of a 4-month strength training (ST) versus aerobic endurance training (ET) program on metabolic control, muscle strength, and cardiovascular endurance in subjects with type 2 diabetes mellitus (T2D).


METHODS
Randomized controlled trial.


METHODS
Large public tertiary hospital.


METHODS
Twenty-two T2D participants (11 men, 11 women; mean age +/- standard error, 56.2+/-1.1 y; diabetes duration, 8.8+/-3.5 y) were randomized into a 4-month ST program and 17 T2D participants (9 men, 8 women; mean age, 57.9+/-1.4 y; diabetes duration, 9.2+/-1.7 y) into a 4-month ET program.


METHODS
ST (up to 6 sets per muscle group per week) and ET (with an intensity of maximal oxygen consumption of 60% and a volume beginning at 15 min and advancing to a maximum of 30 min 3x/wk) for 4 months.


METHODS
Laboratory tests included determinations of blood glucose, glycosylated hemoglobin (Hb A1c), insulin, and lipid assays.


RESULTS
A significant decline in Hb A1c was only observed in the ST group (8.3%+/-1.7% to 7.1%+/-0.2%, P=.001). Blood glucose (204+/-16 mg/dL to 147+/-8 mg/dL, P<.001) and insulin resistance (9.11+/-1.51 to 7.15+/-1.15, P=.04) improved significantly in the ST group, whereas no significant changes were observed in the ET group. Baseline levels of total cholesterol (207+/-8 mg/dL to 184+/-7 mg/dL, P<.001), low-density lipoprotein cholesterol (120+/-8 mg/dL to 106+/-8 mg/dL, P=.001), and triglyceride levels (229+/-25 mg/dL to 150+/-15 mg/dL, P=.001) were significantly reduced and high-density lipoprotein cholesterol (43+/-3 mg/dL to 48+/-2 mg/dL, P=.004) was significantly increased in the ST group; in contrast, no such changes were seen in the ET group.


CONCLUSIONS
ST was more effective than ET in improving glycemic control. With the added advantage of an improved lipid profile, we conclude that ST may play an important role in the treatment of T2D.
Cauza
Edmund
E
Department of Internal Medicine V, Department of Diabetes and Rheumatology, Wilhelminenspital, Vienna, Austria. edmund.cauza@wienkav.at
Hanusch-Enserer
Ursula
U
Strasser
Barbara
B
Ludvik
Bernhard
B
Metz-Schimmerl
Sylvia
S
Pacini
Giovanni
G
Wagner
Oswald
O
Georg
Petra
P
Prager
Rudolf
R
Kostner
Karam
K
Dunky
Attila
A
Haber
Paul
P
D000368:Aged; D000704:Analysis of Variance; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology* / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000502:physiology*; D010809:Physical Fitness; D012129:Respiratory Function Tests; D016896:Treatment Outcome
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D008055:Lipids