Glycemic Effects Of Exercise In Sri Lankans Adults With Type 2 Diabetes Mellitus

Abstract

The prevalence of type 2 Diabetes Mellitus (T2DM) is rising in South Asia. Although exercise training is recommended for its management, the effects of exercise training on glycemic control in Sri Lankans with T2DM has not been studied. PURPOSE: To examine the effects of aerobic training (AT) and resistance training (RT) on glycemic control in Sri Lankan adults with T2DM. METHODS: 86 Sedentary Sri Lankans (50.1±8.7 years, 53% women) diagnosed with T2DM within last 6 years were randomized into AT (n=28), RT (n=28) or control (CN, n=30). Supervised exercise training was performed for 75 minutes per session, 2 days/week for 12 weeks. RT targeted 7 (i.e., 3 upper body, 3 lower body, 1 core) exercises. AT included brisk walking, stepping and stationary cycling at an intensity of 60-75% heart rate max. Fasting blood glucose (FBG), HbA1c, and fasting insulin (FI) were measured at baseline and post intervention. RESULTS: Baseline mean BMI, HbA1c, FBG and FI were 26.4 kg/m2±4.0, 8.2±1.7%, 146.9 ±54.1 mg/dl and 13.3±8.5 micIU/ml, respectively. Subject characteristics were similar among groups, except the CN group had higher mean HbA1c level (8.9 ± 1.7%). Absolute mean change in HbA1c was not significant across groups; RT 0.6 % (95% CI; 1.16% to -0.01%, p=0.8), AT 0.74 % (95% CI; 1.25% to -0.24 %, p=0.5) or CN 0.52% (95% CI, 1.1% to 0.03%.p= 0.8). Absolute mean change in FBG significantly improved in RT (−3.8 mg/dl [95% CI, 4.9 to -12.6 mg/dl; p=0.02]) and CN (25.6 mg/dl [95% CI; 48.5 to 3.0 mg/dl, p= 0.04]), but not AT (20.1 mg/dl [95% CI, 39.6 to 0.6 mg/dl, p= 0.5]). Absolute mean change in FI did not significantly increase in RT (0.2 micIU/ml [95% CI, (2.9 to -2.4 micIU/ml, p = 0.1]) or AT (0.2 micIU/ml [95% CI; 2.9 to -2.5 micIU/ml, p = 0.1]) but did in the CN group (3.0 micIU/ml [95% CI, 0.8 to -8.3 micIU/ml, p=0.00]). CONCLUSION: To our knowledge this is the first randomized controlled trial to study the effects of AT and RT on glycemic control in Sri Lankan diabetics. Intervention showed mixed effects in improvement in chronic glycemic control (HbA1c) and in short term glycemic control (FBG). FI did not increase in intervention groups which demonstrated reduced disease progression. Future studies with larger sample sizes are need for definitive conclusions.