Abstract

Previous research has documented that type 2 diabetes mellitus (T2DM) is associated with cognitive impairment. Psychological variables were repeatedly investigated to understand why T2DM patients are poorly active, despite standards of medical care recommends performing aerobic and resistance exercise regularly and reducing the amount of time spent sitting. This exploratory study aims to investigate how affective variables as thoughts, feelings, and individuals’ stage of exercise adoption can modulate low cognitive performances during an experimental procedure based on exercise. The Exercise Thoughts Questionnaire (ETQ), Exercise-Induced Feeling Scale (EFI), and Physical Activity Stage of Change were administered to a sample of 12 T2DM patients. The Bivalent Shape Task (BST) alone (BST), BST with exercise [control exercise recovery (CER) + BST], and BST with metaboreflex [post-exercise muscle ischemia (PEMI) + BST] were used as mental task, and response time to congruent, incongruent, and neutral stimuli was recorded. Concomitant cerebral oxygenation (COX) was evaluated by near-infrared spectroscopy (NIRS). As expected, T2DM patients performed significantly better when the stimulus was presented in congruent trials (followed by neutral and incongruent). In the CER + BST session, T2DM patients showed longer reaction time to incongruent trials than in the PEMI + BST and BST alone sessions. Positive feelings toward exercise seem to modulate cognitive performances in high challenging task only if T2DM patients were conscious to play exercise. These results could provide some insights for health intervention targeting exercise for patients with T2DM in order to enhance cognitive performances.

Highlights

  • Diabetes is one of the fastest growing health challenges of the 21st century: the number of adults living with diabetes, estimated currently equal to 463 million, having more than tripled over the past 20 years

  • Since the results obtained in the laboratory are often not generalizable to everyday life, we have considered the assessment of the stage of exercise adoption, which has been proven to be a useful tool to target exercise interventions in Type 2 diabetes mellitus (T2DM) patients (Kim et al, 2004; Kirk et al, 2010)

  • Marginal mean comparisons with Sidak adjustment showed differences associated with congruent and incongruent stimuli for control exercise recovery (CER) + Bivalent Shape Task (BST) (p = 0.013) and BST (p = 0.011) sessions and with neutral and congruent stimuli for BST (p = 0.004; Table 2c)

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Summary

Introduction

Diabetes is one of the fastest growing health challenges of the 21st century: the number of adults living with diabetes, estimated currently equal to 463 million, having more than tripled over the past 20 years. The recommendations of the International Diabetes Federation (IDF) for managing type 2 diabetes encourage intensive therapeutic lifestyle changes such as exercise, the reduction of cholesterol, and the dietary intake of saturated fat (Aschner, 2017). Moderate aerobic physical activity such as walking for at least 150 min per week at intervals of no longer than 48 h was recommended. Resistance exercise such as moderate weightlifting or yoga can be included. A more intensive physical activity program including at least 275 min per week may be needed to assist weight loss and avoid regaining it (International Diabetes Federation, 2017)

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