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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #146726

Title: A RANDOMIZED CONTROLLED TRIAL OF RESISTANCE EXERCISE TRAINING TO IMPROVE GLYCEMIC CONTROL IN OLDER ADULTS WITH TYPE 2 DIABETES

Author
item CASTANDEA, CARMEN - HNRCA
item LAYNE, JENNIFER - HNRCA
item MUNOZ-ORTIZ, LEDA - HNRCA
item GORDON, PATRICIA - HNRCA
item WALSMITH, JOSEPH - HNRCA
item FOLDVARI, MONA - HNRCA
item ROUBENOFF, RONENN - HNRCA
item TUCKER, KATHERINE - HNRCA
item NELSON, MIRIAM - HNRCA

Submitted to: Diabetes Care
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/9/2002
Publication Date: 12/1/2002
Citation: Castandea, C., Layne, J., Munoz-Ortiz, L., Gordon, P.L., Walsmith, J., Foldvari, M., Roubenoff, R., Tucker, K., Nelson, M. 2002. A randomized controlled trial of resistance exercise training to improve glycemic control in older adults with type 2 diabetes. Diabetes Care. 25:2335-2341.

Interpretive Summary: More than 18% of the U.S. population 65 years of age and older have diabetes (1). According to the Third National Health and Nutrition Examination Survey (NHANES III), diabetes is becoming increasingly prevalent and undertreated in elderly people (2,3). Among Latinos, diabetes prevalence is double that of Caucasians (2). This is a concern given the disparate access and substandard health care among minorities (4), the rapid growth of the U.S. Latino population (5), and the economic cost and mortality associated with diabetes (6). Epidemiological and intervention studies of endurance exercise training strongly support its efficacy for diabetes prevention and management (7). In contrast, research on the effects of resistance exercise on diabetes management is sparse. The resistance training modality used in some of these studies has been based on moderate-intensity and high-volume exercises (8,–13). This type of exercise could have a significant aerobic component, which sedentary older adults may find difficult to tolerate. In contrast, high-intensity, low-volume resistance training may be a more tolerable exercise modality that additionally may increase muscle mass (14) and glucose uptake (15). Therefore, the purpose of this study was to determine the ability of high-intensity, low-volume progressive resistance training (PRT) to improve glycemic control and other metabolic abnormalities in a population of Latino older adults with poor glycemic control and no personal history of regular exercise. This study demonstrates for the first time that high-intensity PRT is effective in the management of diabetes in this high-risk population of Latino older adults with poor glycemic control. Resistance training significantly improved glycemic control, increased fat-free mass, reduced the requirement for diabetes medications, reduced abdominal adiposity and systolic blood pressure, and increased muscle strength and spontaneous physical activity.

Technical Abstract: OBJECTIVE-To determine the efficacy of high-intensity progressive resistance training (PRT) on glycemic control in older adults with type 2 diabetes. RESEARCH DESIGN AND METHODS-We performed a 16-week randomized controlled trial in 62 Latino older adults (40 women and 22 men; mean +/- SE age 66 +/- 8 years) with type 2 diabetes randomly assigned to supervised PRT or a control group. Glycemic control, metabolic syndrome abnormalities, body composition, and muscle glycogen stores were determined before and after the intervention. RESULTS-Sixteen weeks of PRT (three times per week) resulted in reduced plasma glycosylated hemoglobin levels (from 8.7 +/- 0.3 to 7.6 +/- 0.2%), increased muscle glycogen stores (from 60.3 +/- 3.9 to 79.1 +/- 5.0 mmol glucose/kg muscle), and reduced the dose of prescribed diabetes medication in 72% of exercisers compared with the control group, P = 0.004-0.05. Control subjects showed no change in glycosylated hemoglobin, a reduction in muscle glycogen (from 61.4 +/- 7.7 to 47.2 +/- 6.7 mmol glucose/kg muscle), and a 42% increase in diabetes medications. PRT subjects versus control subjects also increased lean mass (+1.2 +/- 0.2 vs. -0.1 +/- 0.1 kg), reduced systolic blood pressure (-9.7 +/- 1.6 vs. +7.7 +/- 1.9 mmHg), and decreased trunk fat mass (-0.7 +/- 0.1 vs. +0.8 +/- 0.1 kg; P = 0.01-0.05). CONCLUSIONS - PRT as an adjunct to standard of care is feasible and effective in improving glycemic control and some of the abnormalities associated with the metabolic syndrome among high-risk older adults with type 2 diabetes.