South Pacific Islanders resist type 2 diabetes: comparison of aerobic and resistance training

Abstract

The purpose of this study was to evaluate the effectiveness of two exercise modalities for improving glycosylated hemoglobin (HbA1c) and associated clinical outcomes in Polynesian adults diagnosed with type 2 diabetes and visceral obesity. Twenty-six adults were randomized to receive resistance training or aerobic training, 3×/week, for 16 weeks. Dependent variables collected before and after intervention included: diabetes markers including HbA1c, blood lipids, relevant cytokines (C-reactive protein, adiponectin), and anthropometric and hemodynamic indices. Eighteen participants (72% female; age: 49.3 ± 5.3 years; waist circumference: 128.7 ± 18.7 cm) completed the intervention and follow-up assessments. Body mass index in the whole cohort at baseline indicated Class III (morbid) obesity (43.8 ± 9.5 kg/m(2)). Compliance to training was 73 ± 19 and 67 ± 18% in the aerobic and resistance training groups, respectively. HbA1c remained elevated in both groups after training. Aerobic training reduced systolic and diastolic blood pressure and increased serum triglycerides (all P < 0.05). No other exercise-induced adaptations were noted within or between groups. Post hoc analysis using pooled data indicated that higher adherence to training (≥75% attendance, n = 8) significantly reduced waist circumference (P < 0.001) and tended to reduce body weight and fasting insulin (all P ≤ 0.11) versus lower adherence (<75% attendance, n = 10). In conclusion, this study did not demonstrate an improvement in HbA1c with exercise in morbidly obese Polynesian people. Future investigations involving exercise regimens that are more practicable and which involve greater frequency and duration of training may be required to induce significant and clinically meaningful adaptations in this unique diabetes population.

Physical Exercise on Inflammatory Markers in Type 2 Diabetes Patients: A Systematic Review of Randomized Controlled Trials

“…However, upon reviewing the studies, it was impossible to perform this statistical procedure for the following reasons [19]:Seven studies presented pre- and posttreatment analytical data [20–25], while four reported pre- and posttreatment delta variations [26–29] and three studies presented some results in a graph form, without providing data that would enable this analysis [23, 24, 26]. …”

“…The authors were asked via email to provide data required to perform the meta-analysis, but only one group [24] answered and sent the requested data.…”

“…Among the studies that compared the two types of exercise (aerobic and resistance) [22, 24, 28, 29], only Kadaglou et al [29] demonstrated that aerobic exercise decreased the CRP levels in comparison to those individuals undergoing resistance training. Also, in this study, an increment in apelin and vaspin was found after aerobic training in comparison with the resistance group.…”

Impact of different training modalities on glycaemic control and blood lipids in patients with type 2 diabetes: a systematic review and network meta-analysis

“…Overall, a total of 14 trials (16 reports) extracted from 9,477 articles met the eligibility requirements and were included for the present systematic review and meta-analysis [15][16][17][18][19][20][31][32][33][34][35][36][37][38][39][40]. One study was excluded since it was not described as randomised [41], and two trials provided no information on whether the AET was supervised [42,43].…”

“…Seven trials reported random sequence generation [16,31,32,[36][37][38][39], and only five trials reported allocation concealment [16,31,32,37,38]. None of the studies reported the blinding of volunteers towards the mode of intervention (ESM Fig.…”