title: The relationship of fasting hyperglycemia to changes in fat and muscle mass after exercise training in type 2 diabetes.
abstract: OBJECTIVE
  Exercise training (ET) has been variably associated with body composition changes among persons with type 2 diabetes (T2DM). The degree to which these changes are related to hyperglycemia remains unclear. Our objective was to investigate the relationship of baseline fasting glucose (FG) to the magnitude of muscle gains and fat loss after ET in individuals with T2DM.
  
  
  METHODS
  Participants were enrolled in the SHAPE-2 trial, a six month supervised aerobic and resistance training intervention (three days/week), at Johns Hopkins. This was a post hoc single arm intervention study of participants who completed the exercise intervention (n=50). Participants were aged 40-65years and had T2DM that was not treated with insulin. Body composition was assessed by DEXA.
  
  
  RESULTS
  After 6months of ET, total fat mass decreased (-2.1±3.1kg) and total lean body mass (LBM) increased (0.5±2.0kg) overall, but there was variability among individual participants. There was an increase in % total LBM (1.4±1.9%) and decrease in % total body fat mass (-1.5±2.0%) after ET. Interestingly, each standard deviation (SD) increase in baseline FG (mean=135.5mg/dl; SD=39.0mg/dl) was related to a significant increase in % total LBM (0.54±0.26%, p=0.048) and decrease in % total body fat (-0.57±0.27%, p=0.04) after ET among individual participants.
  
  
  CONCLUSIONS
  Our data demonstrate that muscle gains and fat loss after ET are positively related to baseline hyperglycemia. Further studies are needed to characterize differences in metabolic response following ET among persons with diabetes.
authors.affiliation: Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, The Johns Hopkins University, Baltimore, MD, United States.
authors.forename: Swaytha V
authors.initials: SV
authors.lastname: Yalamanchi
authors.affiliation: Division of Cardiology, Department of Medicine, The Johns Hopkins University, Baltimore, MD, United States.
authors.forename: Kerry J
authors.initials: KJ
authors.lastname: Stewart
authors.affiliation: Welch Center for Prevention, Epidemiology, and Clinical Research, The Johns Hopkins University, Baltimore, MD, United States.
authors.forename: Nan
authors.initials: N
authors.lastname: Ji
authors.affiliation: Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, The Johns Hopkins University, Baltimore, MD, United States; Welch Center for Prevention, Epidemiology, and Clinical Research, The Johns Hopkins University, Baltimore, MD, United States.
authors.forename: Sherita H
authors.initials: SH
authors.lastname: Golden
authors.affiliation: Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, The Johns Hopkins University, Baltimore, MD, United States.
authors.forename: Adrian
authors.initials: A
authors.lastname: Dobs
authors.affiliation: Division of General Internal Medicine, The Johns Hopkins University, Baltimore, MD, United States.
authors.forename: Diane M
authors.initials: DM
authors.lastname: Becker
authors.affiliation: Division of General Internal Medicine, The Johns Hopkins University, Baltimore, MD, United States.
authors.forename: Dhananjay
authors.initials: D
authors.lastname: Vaidya
authors.affiliation: Division of Cardiology, Department of Medicine, The Johns Hopkins University, Baltimore, MD, United States; Division of General Internal Medicine, The Johns Hopkins University, Baltimore, MD, United States.
authors.forename: Brian G
authors.initials: BG
authors.lastname: Kral
authors.affiliation: Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, The Johns Hopkins University, Baltimore, MD, United States; Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, MD, United States. Electronic address: rrastogi@jhmi.edu.
authors.forename: Rita R
authors.initials: RR
authors.lastname: Kalyani
mesh_terms: D000328:Adult; D000368:Aged; D001823:Body Composition; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000534:rehabilitation; D005215:Fasting / Q000097:blood*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood* / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000378:metabolism*; D055070:Resistance Training / Q000379:methods*
keywords: Diabetes; Exercise training; Lean body mass; Muscle function