Exercise training improves vascular function in adolescents with type 2 diabetes

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 (normalV˙normalO2peak), 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.

Vascular Adaptation to Exercise in Humans: Role of Hemodynamic Stimuli

“…Exercise training in middle-aged subjects improved forearm resistance vessel endothelial function (65) and NO bioavailability (281). Exercise training also improves endothelial function and/or increases the contribution of NO to basal tone in subjects with cardiovascular risk including hypertension (131), T2DM (193,223), obesity (202) and hypercholesterolemia (183,316) and in subjects with coronary artery disease (114, 315) and heart failure (115,116,192,194 plasma levels were found in postmenopausal women (227) and hypertensive subjects (123).…”

Markers and Biomarkers of Endothelium: When Something Is Rotten in the State

“…At the same time, endothelial progenitors can be mobilized by noninvasive "technique"-yes, with nutraceuticals: Stem-Kine complex augmented hemopoietic and endothelial progenitors (CD133+ and KDR-1/CD34+) just the next day after beginning of administration [266]. Moreover, moderate exercises actually improve vascular function in patients with type 2 diabetes [267], thus giving us confidence in elaborating more natural approaches to solve the problems of vascular health and disease. Now, we have to finalize and feel obliged to offer some advice, so we will try.…”

Increased vascular function and superoxide dismutase activity in physically active vs inactive adults living with HIV

“…For instance, our group has already reported that low‐intensity aerobic exercise training, performed at least three times per week, increased endothelial‐dependent capillary reactivity in patients with type 1 diabetes and coronary artery disease . Prior research has also demonstrated that exercise training improved endothelial function in adolescents with type 2 diabetes and chronic heart failure, compared to sedentary patients who received only standard clinical care. Although our results of vascular function seem to be aligned to prior research in other cohorts, we cannot assure whether there is any peculiarity in HIV‐infected patients compared to other cohorts of sedentary vs active individuals, as comparison between them is lacking.…”