Abstract
BackgroundInterval walking training has demonstrated more pronounced positive effects on physical fitness and metabolism in type 2 diabetes (T2D), compared to continuous walking. One of the pathogenic mechanisms of T2D is associated with derangements in leptin/adiponectin axis, which might predispose affected individuals to vascular inflammation and albuminuria. The aim of this study was to investigate the effects of interval walking training delivered through smart mobile devices upon albuminuria and leptin/adiponectin ratio in patients with T2D.MethodsPatients with T2D aged 35–75 were randomized into control (n = 26) and interval training (IT, n = 14) groups. Patients in IT group had to perform three 60‐min interval walking sessions (3 min intervals of slow and fast walking with the intensity of 40% and 70% of the peak energy expenditure) per week delivered by smartphone application for four months. The adherence to training was monitored remotely. Outcome measures were albuminuria, leptin/adiponectin ratio, obesity indicators, and glycaemic control. Leptin and adiponectin concentration was measured in serum samples by Luminex technology.ResultsIn the IT group compared to control group, we observed a statistically significant decrease in albuminuria (p = .002) and leptin/adiponectin ratio (p = .01), as well as a decrease in HbA1c close to statistical significance (p = .09). In IT group, changes in leptin/adiponectin ratio correlated significantly with changes in hip circumference (p = .024).ConclusionInterval walking training is beneficial for vascular health in T2D via impact on albuminuria and leptin/adiponectin ratio.
Highlights
Patients with type 2 diabetes are at an increased risk for development of vascular complications, such as myocardial infarction, stroke, peripheral vascular disease, retinopathy, neuropathy and nephropathy (Cosentino et al, 2019)
The main findings of this study are that the 4-months of regular interval walking training resulted in a statistically significant decrease in albuminuria and leptin/adiponectin ratio, as well as moderate improvement in HbA1c level in patients with type 2 diabetes
The mechanisms by which physical activity might exert its positive effects on vasculature include adaptations of blood vessels to hemodynamic effects of training, reduction in insulin resistance, and improved oxygen supply (Green et al, 2017)
Summary
Patients with type 2 diabetes are at an increased risk for development of vascular complications, such as myocardial infarction, stroke, peripheral vascular disease, retinopathy, neuropathy and nephropathy (Cosentino et al, 2019). It has been shown that physical activity is associated with the reduction in albuminuria (Hellberg, Höglund, Svensson, & Clyne, 2019). The molecular mechanisms by which physical activity might prevent or slow down the development of vascular disease are under investigation nowadays. Interval walking training has demonstrated good tolerability and more pronounced positive effects on physical fitness and metabolism in type 2 diabetes, compared to continuous walking (Gibala, Little, MacDonald, & Hawley, 2012; Jelleyman et al, 2015; Karstoft et al, 2013; Morikawa et al, 2011). The effects of such training on markers of vascular health, including albuminuria and adipocytokine levels, have not been assessed. The aim of this study was to investigate the effects of personalized interval walking training delivered through smart mobile devices on albuminuria and leptin/adiponectin ratio in patients with type 2 diabetes
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