title: Determinants of changes in blood glucose response to short-term exercise training in patients with Type 2 diabetes.
abstract: The aim of the present study was to determine the effects of a 4-week exercise training intervention on blood glucose, insulin sensitivity, BMI (body mass index) and cardiorespiratory fitness in patients with Type 2 diabetes, and to identify and establish criteria for patients who are more likely to improve their blood glucose from short-term exercise training. A randomized, controlled trial of exercise training, comprising two supervised and one non-supervised sessions of individualized cardiorespiratory and resistance exercise per week, was performed in 132 healthy patients with Type 2 diabetes (exercise training group, n=68), with the aim of accumulating a minimum of 150 min of moderate-intensity exercise for 4 weeks. BMI, waist circumference, blood pressure, blood lipid profile, blood glucose, insulin, insulin sensitivity [calculated by HOMA(IR) (homoeostasis model assessment of insulin resistance) and QUICKI (quantitative insulin check index)], beta-cell function (calculated by HOMA(beta-Cell)), HbA(1c) (glycated haemoglobin) and VO(2max) (maximal oxygen consumption) were measured at baseline and at 4 weeks. The exercise training group had significant improvements in VO(2max), BMI and triacylglycerols (triglycerides). There were no significant changes in blood glucose, HOMA(IR), QUICKI or HOMA(beta-Cell). Decreases in blood glucose were significantly predicted by baseline blood glucose and HbA(1c), with these variables accounting for 15.9% of the change in blood glucose (P<0.001). ROC (receiver operator characteristic) curve analysis revealed that patients with a blood glucose >8.85 mmol/l (sensitivity=73%, specificity=78%) and HbA(1c) >7.15% (sensitivity=79%, specificity=60%) were more likely to achieve a clinically significant decrease in blood glucose. In conclusion, in apparently healthy patients with Type 2 diabetes, a 4-week exercise intervention improved cardiorespiratory fitness, BMI and triacylglycerols. Elevated blood glucose and HbA(1c) predicted improvements in blood glucose.
authors.affiliation: School of Medicine, University of Queensland, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia. m.hordern@uq.edu.au
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Hordern
authors.forename: Louise M
authors.initials: LM
authors.lastname: Cooney
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Beller
authors.forename: Johannes B
authors.initials: JB
authors.lastname: Prins
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Marwick
authors.forename: Jeff S
authors.initials: JS
authors.lastname: Coombes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D018579:Patient Selection; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D008055:Lipids