title: Exercise training improves vascular function in adolescents with type 2 diabetes.
abstract: The impact of exercise training on vascular health in adolescents with type 2 diabetes has not been previously studied. We hypothesized that exercise training would improve micro- and macrovascular health in adolescents with type 2 diabetes. Thirteen adolescents (13-21 years, 10F) with type 2 diabetes were recruited from Princess Margaret Hospital. Participants were randomized to receive either an exercise program along with standard clinical care (n = 8) or standard care alone (n = 5). Those in the intervention group received 12 weeks of gym-based, personalized, and supervised exercise training. Those in the control group were instructed to maintain usual activity levels. Assessments were conducted at baseline and following week 12. The exercise group was also studied 12 weeks following the conclusion of their program. Assessments consisted of conduit artery endothelial function (flow-mediated dilation, FMD) and microvascular function (cutaneous laser Doppler). Secondary outcomes included body composition (dual-energy X-ray absorptiometry, DXA), glycemic control (whole body insulin sensitivity, M) assessed using the euglycemic-hyperinsulinemic clamp protocol, cardiorespiratory fitness (V˙O2peak), and muscular strength (1RM). Exercise training increased FMD (P < 0.05), microvascular function (P < 0.05), total lean mass (P < 0.05), and muscle strength (P < 0.001). There were no changes in cardiorespiratory fitness, body weight, BMI, or M. In the control group, body weight (P < 0.01), BMI (P < 0.01), and total fat mass (P < 0.05) increased. At week 24, improvements in vascular function were reversed. This study indicates that exercise training can improve both conduit and microvascular endothelial function and health, independent of changes in insulin sensitivity in adolescents with type 2 diabetes.
authors.affiliation: School of Sport Science, Exercise & Health, The University of Western Australia, Crawley, Australia Louise.Naylor@uwa.edu.au.
authors.forename: Louise H
authors.initials: LH
authors.lastname: Naylor
authors.affiliation: School of Paediatric and Child Health, The University of Western Australia, Crawley, Australia Telethon Kids Institute, The University of Western Australia, Subiaco, Australia Department of Endocrinology and Diabetes, Princess Margaret Hospital, Subiaco, Australia.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Davis
authors.affiliation: Telethon Kids Institute, The University of Western Australia, Subiaco, Australia Department of Endocrinology and Diabetes, Princess Margaret Hospital, Subiaco, Australia.
authors.forename: Rachelle J
authors.initials: RJ
authors.lastname: Kalic
authors.affiliation: Telethon Kids Institute, The University of Western Australia, Subiaco, Australia Department of Endocrinology and Diabetes, Princess Margaret Hospital, Subiaco, Australia.
authors.forename: Niru
authors.initials: N
authors.lastname: Paramalingam
authors.affiliation: School of Paediatric and Child Health, The University of Western Australia, Crawley, Australia Department of Endocrinology and Diabetes, Princess Margaret Hospital, Subiaco, Australia.
authors.forename: Mary B
authors.initials: MB
authors.lastname: Abraham
authors.affiliation: School of Paediatric and Child Health, The University of Western Australia, Crawley, Australia Telethon Kids Institute, The University of Western Australia, Subiaco, Australia Department of Endocrinology and Diabetes, Princess Margaret Hospital, Subiaco, Australia.
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Jones
authors.affiliation: School of Sport Science, Exercise & Health, The University of Western Australia, Crawley, Australia Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Green
mesh_terms: D000293:Adolescent; D001823:Body Composition; D003924:Diabetes Mellitus, Type 2 / Q000473:pathology / Q000503:physiopathology / Q000534:rehabilitation*; D004730:Endothelium, Vascular / Q000473:pathology; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D015309:Glucose Clamp Technique; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D017078:Laser-Doppler Flowmetry; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D017551:Microdialysis; D053580:Muscle Strength / Q000502:physiology; D010809:Physical Fitness / Q000502:physiology; D014664:Vasodilation / Q000502:physiology; D055815:Young Adult
keywords: Diabetes; exercise training; vascular endothelium