The Effects of Free-Living Interval-Walking Training on Glycemic Control, Body Composition, and Physical Fitness in Type 2 Diabetic Patients

Karstoft, Kristian; Winding, Kamilla; Knudsen, Sine H.; Nielsen, Jens Steen; Thomsen, Carsten; Pedersen, Bente Klarlund

doi:10.2337/dc12-0658

Cited by 299 publications

(394 citation statements)

References 39 publications

Supporting

Mentioning

364

Contrasting

Unclassified

Order By: Relevance

“…Since five individuals initially randomised to the CON group were re-randomised to either IWT or CWT after the CON period, the final study population consisted of n=27 individuals with n=32 pre-/post-intervention trial participants included for statistical analysis (CON, n=8; CWT, n=12; IWT, n=12). The randomisation procedure and the body composition, physical fitness and glycaemic control data have been reported in full elsewhere [6]. Written informed consent was obtained from all individuals.…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, all training sessions were performed with a heart rate monitor (Polar RS400; Polar, Kempele, Finland). The training protocol has been described in detail elsewhere [6]. Briefly, CWT consisted of continuous walking at individualised moderate intensity (≥55% of the individual's peak energy expenditure rate for walking [V ⋅ O 2peak ]), whereas IWT consisted of alternating 3 min intervals of fast (≥70% of V ⋅ O 2peak ) and slow (~40% of V ⋅ O 2peak ) walking.…”

Section: Interventionsmentioning

confidence: 99%

“…During interval training (training with alternating intensities), peak exercise intensity is increased, which theoretically should be advantageous for improving glycaemic control [3], and recent studies of interval training programmes have shown remarkable results on glycaemic control [4,5]. In this context, we have shown that interval walking training (IWT) more favourably improves glycaemic control in type 2 diabetic individuals when compared with energy expenditurematched continuous walking training (CWT) [6]. Glycaemic control is primarily determined by insulin sensitivity and pancreatic endocrine function, both of which are impaired in individuals with type 2 diabetes.…”

Section: Introductionmentioning

confidence: 96%

See 2 more Smart Citations

Mechanisms behind the superior effects of interval vs continuous training on glycaemic control in individuals with type 2 diabetes: a randomised controlled trial

et al. 2014

Self Cite

View full text Add to dashboard Cite

Aims/hypothesis By use of a parallel and partly crossover randomised, controlled trial design we sought to elucidate the underlying mechanisms behind the advantageous effects of interval walking training (IWT) compared with continuous walking training (CWT) on glycaemic control in individuals with type 2 diabetes. We hypothesised that IWT, more than CWT, would improve insulin sensitivity including skeletal muscle insulin signalling, insulin secretion and disposition index (DI).Methods By simple randomisation (sequentially numbered, opaque sealed envelopes), eligible individuals (diagnosed with type 2 diabetes, no exogenous insulin treatment) were allocated to three groups: a control group (CON, n=8), an IWT group (n=12) and an energy expenditure-matched CWT group (n=12). Training groups were prescribed free-living training, five sessions per week (60 min/session). A threestage hyperglycaemic clamp, including glucose isotope tracers and skeletal muscle biopsies, was performed before and after a 4 month intervention in a hospitalised setting. No blinding was performed. Results The improved glycaemic control, which was only seen in the IWT group, was consistent with IWT-induced increases in insulin sensitivity index (49.8 ± 14.6%; p<0.001), peripheral glucose disposal (14.5±4.9%; p<0.05) and DI (66.2±21.8%; p<0.001), with no changes in the CWT or CON group. Moreover, only IWT improved insulin signalling in skeletal muscle via increased insulin-stimulated phosphorylation of AS160 (29.0±10.8%; p<0.05). No changes were seen in insulin secretion during hyperglycaemia alone, hyperglycaemia + glucagon-like peptide 1 infusion or arginine injection. Conclusions/interpretation IWT maintains insulin secretion and improves insulin sensitivity and DI, in contrast to energy expenditure-matched CWT. These results suggest that training with alternating intensity, and not just training volume and mean intensity, is a key determinant of changes in whole body glucose disposal in individuals with type 2 diabetes. Trial registration: ClinicalTrials (NCT01234155).

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Interventionsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

See 1 more Smart Citation

Mechanisms behind the superior effects of interval vs continuous training on glycaemic control in individuals with type 2 diabetes: a randomised controlled trial

et al. 2014

Self Cite

View full text Add to dashboard Cite

show abstract

“…Finally, exercise helps to normalise plasma glucose [23] and serum lipids [24] in individuals with, or at risk of, diabetes. These factors when chronically elevated are known to cause beta cell death.…”

Section: Search Strategymentioning

confidence: 99%

The time has come to test the beta cell preserving effects of exercise in patients with new onset type 1 diabetes

et al. 2014

View full text Add to dashboard Cite

Type 1 diabetes is characterised by immunemediated destruction of insulin-producing beta cells. Significant beta cell function is usually present at the time of diagnosis with type 1 diabetes, and preservation of this function has important clinical benefits. The last 30 years have seen a number of largely unsuccessful trials for beta cell preservation, some of which have been of therapies that have potential for significant harm. There is a need to explore new, more tolerable approaches to preserving beta cell function that can be implemented on a large clinical scale. Here we review the evidence for physical exercise as a therapy for the preservation of beta cell function in patients with newly diagnosed type 1 diabetes. We highlight possible mechanisms by which exercise could preserve beta cell function and then present evidence from other models of diabetes that demonstrate that exercise preserves beta cell function. We conclude by proposing that there is now a need for studies to explore whether exercise can preserve beta cell in patients newly diagnosed with type 1 diabetes.

show abstract

“…Accordingly, the effect of different intensities and types of physical activity may have different effects on glucose metabolism. This has mainly been investigated in low risk populations, and the findings are equivocal [14][15][16][17][18]. Furthermore, studies have found that CRF changes the direction and/or strength of the association between PAEE and cardiometabolic risk factors [19,20], suggesting that the beneficial effect of PAEE is dependent on the intensity of the activities contributing to PAEE.…”

Section: Introductionmentioning

confidence: 99%

Physical activity energy expenditure vs cardiorespiratory fitness level in impaired glucose metabolism

et al. 2015

View full text Add to dashboard Cite

Aim/hypothesis Little is known about the relative roles of physical activity energy expenditure (PAEE) and cardiorespiratory fitness (CRF) as determinants of glucose regulation. The aim of this study was to examine the associations of PAEE and CRF with markers of glucose metabolism, and to test the hypothesis that CRF modifies the association between PAEE and glucose metabolism. Methods We analysed cross-sectional data from 755 adults from the Danish ADDITION-PRO study. On the basis of OGTT results, participants without known diabetes were classified as having normal glucose tolerance, isolated impaired fasting glycaemia (i-IFG), isolated impaired glucose tolerance (i-IGT), combined IFG + IGT or screen-detected diabetes mellitus. Markers of insulin sensitivity and beta cell function were determined. PAEE was measured using a combined heart rate and movement sensor. CRF (maximal oxygen uptake) was estimated using a submaximal 8 min step test. The associations were examined by linear regression analysis. Results were adjusted for relevant confounders. Results PAEE and CRF were reduced in individuals with i-IGT, combined IFG + IGT and screen-detected diabetes mellitus, but were not significantly different in individuals with i-IFG compared with those with normal glucose tolerance. When adjusting CRF for PAEE and vice versa, PAEE and CRF were both associated with lower fasting and 2 h insulin and higher peripheral insulin sensitivity. CRF was additionally associated with lower fasting and 2 h glucose and higher insulin sensitivity and beta cell function. There was no interaction between CRF and PAEE for any markers of glucose metabolism. Conclusions/interpretation Only CRF, not PAEE, appears to be independently associated with plasma glucose levels and beta cell function, suggesting that CRF may be particularly important for glycaemic control.

show abstract

The Effects of Free-Living Interval-Walking Training on Glycemic Control, Body Composition, and Physical Fitness in Type 2 Diabetic Patients

Cited by 299 publications

References 39 publications

Mechanisms behind the superior effects of interval vs continuous training on glycaemic control in individuals with type 2 diabetes: a randomised controlled trial

Mechanisms behind the superior effects of interval vs continuous training on glycaemic control in individuals with type 2 diabetes: a randomised controlled trial

The time has come to test the beta cell preserving effects of exercise in patients with new onset type 1 diabetes

Physical activity energy expenditure vs cardiorespiratory fitness level in impaired glucose metabolism

Contact Info

Product

Resources

About