The effect of combined aerobic and resistance exercise training on vascular function in type 2 diabetes

Maiorana, Andrew; O’Driscoll, Gerry; Cheetham, Craig; Dembo, L.; Stanton, K.; Goodman, Carmél; Taylor, Roger R.; Green, Daniel

doi:10.1016/s0735-1097(01)01439-5

Cited by 418 publications

(400 citation statements)

References 39 publications

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“…Regarding the impact of exercise training on endothelial function in type 2 diabetes and controls, we did not find a significant change in brachial artery FMD across the 8-week exercise training. This observation contrasts with previous studies that report an increase in FMD after training in type 2 diabetes (Colberg et al 2002;Maiorana et al 2001). However, a recent study by Barone Gibbs et al demonstrated no effect of exercise on FMD in type 2 diabetes, despite marked improvements in fitness, body composition, and glycaemic control (Barone Gibbs et al 2012).…”

Section: Discussioncontrasting

confidence: 99%

“…Although we did not include a non-exercising control group, previous experiments have shown that physical fitness was not altered in subjects that did not perform exercise training (Honkola et al 1997;Maiorana et al 2001). The magnitude of improvement in physical fitness after 8 weeks is in agreement with studies that used an exercise training program of similar duration and intensity (Dunstan et al 1997;Honkola et al 1997;Maiorana et al 2002).…”

Section: Discussionsupporting

confidence: 80%

“…Studies performed in patients at increased cardiovascular risk, such as those with type 2 diabetes, have demonstrated that exercise training improves vascular function (Maiorana et al 2001;Okada et al 2010), but the presence of time-dependent adaptations in this group has not, to our knowledge, been addressed. Given that a priori endothelial dysfunction is evident in subjects with type 2 diabetes, a different time-dependent adaptation in vascular function may be apparent compared to that observed in healthy young subjects.…”

Section: Introductionmentioning

confidence: 96%

“…The presence of time-dependent adaptations in vascular function in response to exercise training may partly explain this observation. Originally based on findings in animals (Laughlin 1995), human studies have also demonstrated that short-term exercise training enhances conduit artery function in subjects with cardiovascular risk factors or disease (Green et al 2004;Maiorana et al 2001;Watts et al 2004), whilst prolonged training induces structural changes (i.e. increased diameter) (Brown 2003;Prior et al 2003).…”

Section: Introductionmentioning

confidence: 99%

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Time-course of vascular adaptations during 8 weeks of exercise training in subjects with type 2 diabetes and middle-aged controls

et al. 2014

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endothelial and smooth muscle function using flow-mediated dilation (FMD) and glyceryl trinitrate (GTN) administration in 13 type 2 diabetes patients (59±6 years) and 10 healthy subjects (58±7 years) before, during (2-weekly) and after an 8-week training program.Arterial structure was assessed via peak blood flow and artery diameter. RESULTS Training increased peak oxygen uptake (P=0.03), comparable between groups (P=0.276). We observed a similar impact of training on brachial artery vasomotor function across the training period in diabetes patients and controls (FMD/GTN-ratio), with a higher FMD/GTN-ratio at 2, 6 and 8 weeks (P=0.036). Artery diameter, peak blood flow or peak diameter had not changed after training. CONCLUSION Training leads to rapid improvement in brachial artery vascular function in diabetes patients and controls. In contrast to previous observations in healthy young subjects, the increase in function was preserved after 8 weeks of training in middleaged diabetes patients and controls, suggesting a different time-course in vascular adaptations in subjects with endothelial dysfunction.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

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Time-course of vascular adaptations during 8 weeks of exercise training in subjects with type 2 diabetes and middle-aged controls

et al. 2014

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“…Of the studies otherwise meeting the inclusion criteria, two trials (three articles) were not included since the fitness test was not a maximal aerobic test [35,36,37], three trials (four articles) were excluded because they included a large resistance training component combined with non-continuous aerobic exercise [38,39,40,41] and two articles were excluded since we were unable to differentiate between subjects with and without diabetes [42,43]. Four of the potential articles did not have baseline and post-training VO 2max data available [44,45,46,47] while one trial (two articles) measured post training VO 2max 6 months after the initiation of the 10-week exercise intervention [48,49] and was therefore excluded.…”

Section: Resultsmentioning

confidence: 99%

Meta-analysis of the effect of structured exercise training on cardiorespiratory fitness in Type 2 diabetes mellitus

et al. 2003

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Aims/hypothesis. Low cardiorespiratory fitness is a powerful and independent predictor of mortality in people with diabetes. Several studies have examined the effects of exercise on cardiorespiratory fitness in Type 2 diabetic individuals. However, these studies had relatively small sample sizes and highly variable results. Therefore the aim of this study was to systematically review and quantify the effects of exercise on cardiorespiratory fitness in Type 2 diabetic individuals. Methods. MEDLINE, EMBASE, and four other databases were searched up to March 2002 for randomized, controlled trials evaluating effects of structured aerobic exercise interventions of 8 weeks or more on cardiorespiratory fitness in adults with Type 2 diabetes. Cardiorespiratory fitness was defined as maximal oxygen uptake (VO 2max ) during a maximal exercise test.Results. Seven studies, presenting data for nine randomized trials comparing exercise and control groups (overall n=266), met the inclusion criteria. Mean exercise characteristics were as follows: 3.4 sessions per week, 49 min per session for 20 weeks. Exercise intensity ranged from 50% to 75% of VO 2max . There was an 11.8% increase in VO 2max in the exercise group and a 1.0% decrease in the control group (post intervention standardized mean difference =0.53, p<0.003). Studies with higher exercise intensities tended to produce larger improvements in VO 2max . Exercise intensity predicted post-intervention weighted mean difference in HbA 1c (r=−0.91, p=0.002 Meta-analysis of the effect of structured exercise training on cardiorespiratory fitness in Type 2 diabetes mellitus N. G. Boulé 1 , G. P. Kenny 1 , E. Haddad 2 , G. A. Wells 3, 4 , R. J. Sigal 1, 3 1 School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada 2 Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada 3 Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada 4 Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada pacities of athletes. In recent decades, VO 2max has had a growing importance in clinical settings and has become the gold standard measure of cardiovascular fitness and exercise capacity [1]. There is evidence from large cohort studies that low cardiorespiratory fitness is a powerful and independent predictor of long-term cardiac mortality in people with diabetes [2,3,4], even after controlling for traditional risk factors such as age, hypercholesterolaemia, smoking, and hypertension and excluding individuals with evidence of coronary ischaemia during testing. Furthermore, in non-diabetic subjects undergoing repeated maximalThe maximal amount of oxygen consumed during exercise (VO 2max ) has been used for decades by exercise physiologists to determine the maximum exercise ca-

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Exercise Training and the Cardiovascular Consequences of Type 2 Diabetes and Hypertension

Stewart¹

2002

JAMA

237

136

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The coexistence of type 2 diabetes and hypertension is especially damaging to cardiovascular health. Most trials of exercise training for these conditions have focused on glycemic control and blood pressure reduction. Less is known about the effects of exercise on the cardiovascular consequences of diabetes and hypertension. This article reviews the available evidence and plausible mechanisms by which exercise training may improve the cardiovascular health of persons with type 2 diabetes and hypertension and provides practical guidelines for exercise prescription. A MEDLINE search was performed for January 1985 to June 2002. Bibliographies from relevant articles, professional society clinical practice guidelines, and books were also reviewed. Because few large, randomized trials exist on these topics, meta-analyses, smaller trials, nonrandomized trials, and animal studies were also considered. Data quality was determined by publication in peer-reviewed journals or professional society literature. Type 2 diabetes and hypertension result in abnormalities in central and peripheral parameters of cardiovascular structure and function. Evidence for an exercise training benefit is strongest for improvements in endothelial vasodilator function and left ventricular diastolic function. The data for exercise training's improvement of arterial stiffness and system inflammation and reduction of left ventricular mass are less robust. However, this assertion is based more on a lack of randomized controlled trials rather than data to the contrary. Exercise training also reduces total and abdominal fat. These changes in body composition mediate improvements in insulin sensitivity and blood pressure and may improve endothelial vasodilator function. The current evidence, albeit not fully confirmed in randomized trials, suggests that the benefits of exercise training go beyond the recognized benefits of glycemic control and blood pressure reduction.

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The effect of combined aerobic and resistance exercise training on vascular function in type 2 diabetes

Abstract: If endothelial dysfunction is an integral component of the pathogenesis of vascular disease, as currently believed, this study supports the value of an exercise program in the management of type 2 diabetes.

Cited by 418 publications

References 39 publications

Time-course of vascular adaptations during 8 weeks of exercise training in subjects with type 2 diabetes and middle-aged controls

Time-course of vascular adaptations during 8 weeks of exercise training in subjects with type 2 diabetes and middle-aged controls

Meta-analysis of the effect of structured exercise training on cardiorespiratory fitness in Type 2 diabetes mellitus

Exercise Training and the Cardiovascular Consequences of Type 2 Diabetes and Hypertension

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