Issue: February 2011
February 01, 2011
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Combination aerobic, resistance training superior to training alone in type 2 diabetes

Issue: February 2011
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Performing a combination of aerobic exercise and resistance training was associated with improved glycemic levels among patients with type 2 diabetes compared with patients who do not exercise, according to results of the HART-D study.

The level of improvement was not seen among patients who performed either aerobic exercise or resistance training alone.

“Although both resistance and aerobic training provide benefits, only the combination of the two were associated with reductions in HbA1c levels,” Timothy S. Church, MD, MPH, PhD, of Louisiana State University System, Baton Rouge, La., and colleagues wrote in the Journal of the American Medical Association.

HART-D study

The Health Benefits of Aerobic and Resistance Training in Individuals with Type 2 Diabetes (HART-D) study included 262 sedentary men and women with diabetes who were aged 30 to 75 years. The researchers randomly assigned participants to one of four exercise regimens: supervised aerobic training only; supervised resistance training only (n=73); supervised aerobic plus resistance training (n=72); or self-directed exercise, which served as the control group (n=41). The individuals were enrolled in the 9-month exercise program between April 2007 and August 2009.

Each exercise program was designed so that participants completed at least 150 minutes of training per week. The researchers observed the effects of each training program for 9 months.

Improvements after exercise

At baseline, the mean HbA1c level of the entire cohort was 7.7%. The researchers found that the absolute change in HbA1c in the combination training group vs. the control group was –0.34%. In neither the resistance training (–0.16%) nor the aerobic (–0.24%) groups were changes in HbA1c significant compared with those in the control group, according to the results.

“Only the combination exercise group improved maximum oxygen consumption compared with the control group. All exercise groups reduced waist circumference from (–.75 inches to –1.1 inches) compared with the control group,” the researchers wrote.

In addition, the resistance training group lost an average of 3.1 lb fat mass and the combination training group lost an average of 3.7 lb compared with the control group.

Results also showed that the prevalence of increases in hypoglycemic medications were 39% in the control group, 32% in the resistance training group, 22% in the aerobic training group and 18% in the combination training group.

“It is also important to appreciate that the follow-up difference in HbA1c between the combination training group and the control group occurred even though the control group had increased its use of diabetes medications while the combination training group decreased its diabetes medication uses,” the researchers wrote.

Endocrine Today previously reported the results of this trial when they were presented by Church at the Obesity Society’s 28th Annual Scientific Meeting in October.

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