title: Effects of aerobic and resistance training on hemoglobin A1c levels in patients with type 2 diabetes: a randomized controlled trial.
abstract: BACKGROUND
  Exercise guidelines for individuals with diabetes include both aerobic and resistance training although few studies have directly examined this exercise combination.
  
  
  OBJECTIVE
  To examine the benefits of aerobic training alone, resistance training alone, and a combination of both on hemoglobin A(1c) (HbA(1c)) in individuals with type 2 diabetes.
  
  
  METHODS
  A randomized controlled trial in which 262 sedentary men and women in Louisiana with type 2 diabetes and HbA(1c) levels of 6.5% or higher were enrolled in the 9-month exercise program between April 2007 and August 2009.
  
  
  METHODS
  Forty-one participants were assigned to the nonexercise control group, 73 to resistance training 3 days a week, 72 to aerobic exercise in which they expended 12 kcal/kg per week; and 76 to combined aerobic and resistance training in which they expended 10 kcal/kg per week and engaged in resistance training twice a week. Main Outcome Change in HbA(1c) level. Secondary outcomes included measures of anthropometry and fitness.
  
  
  RESULTS
  The study included 63.0% women and 47.3% nonwhite participants who were a mean (SD) age of 55.8 years (8.7 years) with a baseline HbA(1c) level of 7.7% (1.0%). Compared with the control group, the absolute mean change in HbA(1c) in the combination training exercise group was -0.34% (95% confidence interval [CI], -0.64% to -0.03%; P = .03). The mean changes in HbA(1c) were not statistically significant in either the resistance training (-0.16%; 95% CI, -0.46% to 0.15%; P = .32) or the aerobic (-0.24%; 95% CI, -0.55% to 0.07%; P = .14) groups compared with the control group. Only the combination exercise group improved maximum oxygen consumption (mean, 1.0 mL/kg per min; 95% CI, 0.5-1.5, P < .05) compared with the control group. All exercise groups reduced waist circumference from -1.9 to -2.8 cm compared with the control group. The resistance training group lost a mean of -1.4 kg fat mass (95% CI, -2.0 to -0.7 kg; P < .05) and combination training group lost a mean of -1.7 (-2.3 to -1.1 kg; P < .05) compared with the control group.
  
  
  CONCLUSIONS
  Among patients with type 2 diabetes mellitus, a combination of aerobic and resistance training compared with the nonexercise control group improved HbA(1c) levels. This was not achieved by aerobic or resistance training alone.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT00458133.
authors.affiliation: Pennington Biomedical Research Center, Louisiana State University System, 6400 Perkins Rd, Baton Rouge, LA 70808-4124, USA. tim.church@pbrc.edu
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Church
authors.forename: Steven N
authors.initials: SN
authors.lastname: Blair
authors.forename: Shannon
authors.initials: S
authors.lastname: Cocreham
authors.forename: Neil
authors.initials: N
authors.lastname: Johannsen
authors.forename: William
authors.initials: W
authors.lastname: Johnson
authors.forename: Kimberly
authors.initials: K
authors.lastname: Kramer
authors.forename: Catherine R
authors.initials: CR
authors.lastname: Mikus
authors.forename: Valerie
authors.initials: V
authors.lastname: Myers
authors.forename: Melissa
authors.initials: M
authors.lastname: Nauta
authors.forename: Ruben Q
authors.initials: RQ
authors.lastname: Rodarte
authors.forename: Lauren
authors.initials: L
authors.lastname: Sparks
authors.forename: Angela
authors.initials: A
authors.lastname: Thompson
authors.forename: Conrad P
authors.initials: CP
authors.lastname: Earnest
mesh_terms: D000886:Anthropometry; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000628:therapy*; D005081:Exercise Therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D055070:Resistance Training; D016896:Treatment Outcome
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human