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Exercise helps control diabetes regardless of cardiorespiratory fitness improvement
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Adults with type 2 diabetes who do not see an improvement in cardiorespiratory fitness with exercise may still see a reduction in body fat and waist size, and improved blood glucose, according to research in Diabetes Care.
In a secondary analysis of a larger study evaluating the benefits of exercise training in adults with type 2 diabetes, researchers found that a subgroup of exercisers with type 2 diabetes, known as nonresponders, are unable to improve their cardiorespiratory fitness despite following a clinician-guided workout regimen. Still, those same adults saw improvements in HbA1c, waist circumference and body fat percentage.
Jarett Berry
“What we observed is that exercise improves diabetes control regardless of improvement in exercise capacity,” Jarett Berry, MD, an associate professor of internal medicine and clinical sciences at University of Texas Southwestern Medical Center, said in a press release.
Berry and colleagues analyzed data from 202 adults with type 2 diabetes (mean age, 57 years; 63% women) participating in the HART-D study. Within the cohort, 161 adults were randomly assigned to one of three supervised exercise groups — aerobic training, resistance training or combination training — and 41 adults assigned to a control group with no exercise for 9 months. Researchers measured peak absolute oxygen uptake and metabolic profiles from baseline to follow-up.
Fitness responders and nonresponders showed significant improvements in HbA1c (–0.26% for both groups), waist circumference (–2.6 cm for responders; –1.8 cm for nonresponders) and body fat (–1.07% for responders; –0.75% for nonresponders).
Researchers did not observe significant changes in metabolic parameters between the responders and nonresponders. Control group participants had no significant changes in any metabolic parameters, according to researchers.
“The prevalence of fitness nonresponse among [type 2 diabetes] patients observed in the current study is greater than that previously reported among healthy adults,” the researchers wrote. “This is particularly significant since the dose of exercise used in the current study was similar to that recommended by the National Institutes of Health.”
Berry noted that the results suggest that exercise-training programs for adults with diabetes should focus less on cardiorespiratory fitness and more on measureable metabolic parameters.
Future studies are needed, researchers said, to confirm how exercise training improves metabolic parameters among fitness nonresponders.
“This finding suggest that our definition of ‘nonresponder’ is too narrow,” Berry said. “We need to broaden our understanding of what it means to respond to exercise training.” – by Regina Schaffer
Disclosure: Berry reports no relevant financial disclosures. One of the other researchers reports honoraria from and a consulting role with AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Cubist, Eisai, Eli Lilly, GlaxoSmithKline, Janssen, Lexicon, Merck, Novo Nordisk, Orexigen, Regeneron, Takeda Pharmaceuticals and The Medicines Company.
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