Abstract
The impact of exercise training on vascular health in adolescents with type 2 diabetes has not been previously studied. We hypothesized that exercise training would improve micro‐ and macrovascular health in adolescents with type 2 diabetes. Thirteen adolescents (13–21 years, 10F) with type 2 diabetes were recruited from Princess Margaret Hospital. Participants were randomized to receive either an exercise program along with standard clinical care (n = 8) or standard care alone (n = 5). Those in the intervention group received 12 weeks of gym‐based, personalized, and supervised exercise training. Those in the control group were instructed to maintain usual activity levels. Assessments were conducted at baseline and following week 12. The exercise group was also studied 12 weeks following the conclusion of their program. Assessments consisted of conduit artery endothelial function (flow‐mediated dilation, FMD) and microvascular function (cutaneous laser Doppler). Secondary outcomes included body composition (dual‐energy X‐ray absorptiometry, DXA), glycemic control (whole body insulin sensitivity, M) assessed using the euglycemic–hyperinsulinemic clamp protocol, cardiorespiratory fitness (V˙O2peak), and muscular strength (1RM). Exercise training increased FMD (P < 0.05), microvascular function (P < 0.05), total lean mass (P < 0.05), and muscle strength (P < 0.001). There were no changes in cardiorespiratory fitness, body weight, BMI, or M. In the control group, body weight (P < 0.01), BMI (P < 0.01), and total fat mass (P < 0.05) increased. At week 24, improvements in vascular function were reversed. This study indicates that exercise training can improve both conduit and microvascular endothelial function and health, independent of changes in insulin sensitivity in adolescents with type 2 diabetes.
Highlights
Type 2 diabetes in the young is an emerging paediatric health concern with profound societal implications (Riddoch, 1998)
Impact of exercise training on body weight and composition There was no increase in body weight and BMI following the 12 week intervention period in participants who received the exercise program, but a significant increase in weight and BMI was observed in the control group during this period
Body composition (DXA) measures revealed a significant effect on total fat mass, with a mean reduction of total fat mass by 1.10kg in the exercise group and an increase of 1.96kg in the control group
Summary
Type 2 diabetes in the young is an emerging paediatric health concern with profound societal implications (Riddoch, 1998). The prevalence of type 2 diabetes in adolescents increased approximately 10 fold between 1996 and 2002 (Hotu et al, 2004), with a report from our group indicating a similar trend (Davis et al, 2002). We have previously published data indicating that early signs of vascular dysfunction are apparent in children and adolescents with obesity and type 2 diabetes, compared to both lean and BMI-matched counterparts (Naylor et al, 2011). An International Diabetes Federation consensus statement concluded that the “onset of diabetes in childhood or adolescence heralds many years of disease and an increased risk that the full range of both micro- and macrovascular complications will occur when affected individuals are still relatively young” (Alberti et al., 2004). Little is known about the most effective treatment approaches to reduce cardiovascular disease in these young patients (Kaufman, 2002; Copeland et al, 2013), in whom surgical and medication strategies are not without risk and largely unproven in terms of long term efficacy
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
