Background: As part of type 2 diabetes mellitus (T2DM) lifestyle management, exercise programs must be demonstrably effective and safe. Objectives: A randomized controlled trial (RCT) was used to evaluate the results of glycemic control and oxidative stress of a new T2DM management exercise program in a training facility setting. Methods: The study participants were randomly allocated into either an experimental (EXP) group who participated in the new training program or a control (CTR) group who participated in continuous cardiorespiratory exercise. Each participant's glycemic control (glycated hemoglobin A, HbA1c), fitness level (maximum oxygen uptake, VO2max), and oxidative stress (malondialdehyde, MDA and superoxide dismutase, SOD) were measured before and after the training program. The 12-week training program combined high-intensity interval training (HIIT) three times a week with resistance training (RT) twice a week while gradually increasing the intensity. The HIIT element was comprised of one minute of high-intensity exercise and four minutes of low-intensity exercise. The RT element was comprised of nine exercises for the core, upper extremities, and lower extremities. Results: The 42 T2DM patients who participated in this RCT were 35-64 years old. The HbA1c level of the EXP group decreased (∆ =-0.43 ± 1.01%), although not significantly. The VO2max was higher in the EXP group (38.13 ± 5.93 mL/kg/min) than in the CTR group (32.09 ± 5.24 mL/kg/min, P = 0.004). The overall oxidative stress decreased in the EXP group (MDA level ∆ =-0.14 ± 0.39 nm/mL) when compared to the CTR group (MDA level ∆ = 0.18 ± 0.26 nm/mL, P = 0.011), and the SOD level significantly increased more in the EXP group [median ∆ = 0.47 U/mL (interquartile range = 0.08-0.74 U/mL)] when compared to the CTR group (∆ = 0.14 ± 0.35 U/mL, P = 0.036). The EXP group's composite effects score was significantly higher (8.72 ± 1.27) than the CTR group's score (7.20 ± 1.08, P = 0.001). Conclusions: The combined HIIT and RT exercise program was not significantly improving glycemic control, however it lowered oxidative stress.

BACKGROUND: Complex aerobic exercise is believed to induce positive effects on neuron structure and cognitive function. Long-term and continual cognitive stimulation increases neuroplasticity by stimulating the synthesis of neuronal growth proteins and the formation of new synapses. Exercise also increases the ability of neurons to survive and improves brain vascularization. Further investigations should be conducted to explore what types of aerobic exercise are beneficial for cognitive function. AIM: This study investigated the effects of hurdle aerobic exercise on developmentally regulated brain protein-A (Drebrin-A) as a neuroplasticity indicator, and on vascular endothelial growth factor (VEGF) as an angiogenesis marker in the hippocampus. METHODS: This study was an experimental study with post-test only control group design. Thirty-three adult mice were divided into control, hurdle aerobic runner (HAR), and plain aerobic runner (PAR) groups (n = 11 for each group). Fiberglass running wheels were originally designed and modified to assemble hurdles inside with adjustable speed. Speed adaptation was intended to achieve aerobic intensity. The experiment was performed 5 times a week for 8 weeks. The Morris water maze test (MWMT) was used to assess spatial memory ability. One day after the last running exercise and final MWMT, the mice were sacrificed and the right side of the hippocampus was obtained for Drebrin-A analysis by enzyme-linked immunosorbent assay (ELISA). The entire right side brain tissue after hippocampus was removed then used for the neuroglobin ELISA assay. To analyze VEGF expression and calculation of blood vessel, the left side of the brain was prepared for hematoxylin eosin and immunohistochemistry staining. To assess the effect of exercise on vascular widening, the analysis of the slides was performed by calculating the percentage of blood vessels with diameters more than 15 μm. One-way ANOVA and Fisher’s least significant difference test was used for statistical analysis. RESULTS: There was a significant difference in the levels of Drebrin-A between the HAR and PAR groups. Both exercise groups had higher levels of Drebrin-A than the control group. HAR and PAR groups exhibited significantly higher percentages of blood vessels expressing VEGF in hippocampus compared to control. HAR and PAR groups had the higher percentages of larger vessels compare to control. There was no significant difference of neuroglobin levels among the three groups. Both the HAR and PAR groups exhibited better spatial memory than the control group. CONCLUSION: Both aerobic exercises induced positive effects on brain angiogenesis, while the intensity of aerobic exercises did not result in high hypoxic stress in the brain.