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Combine aerobics and weights for diabetes

Resistance and aerobic training seem best for people with diabetes

Louise Prime

Wednesday, 24 November 2010

A combination of aerobic exercise with resistance training seems to be the best approach for people with type 2 diabetes, research has shown. People who did both types of exercise had lower glycaemic levels than people who did no exercise, and better results than people who did either aerobic or resistance training alone, shows research in today’s JAMA .

Researchers from Louisiana, US, compared the effect of different types of exercise in people with type 2 diabetes because even though US guidelines from 2008 recommended a combination of resistance and aerobic exercise there had been no clear evidence about which type of exercise is most effective.

At the start of the study they measured levels of glycosylated haemoglobin (HbA1c) in 262 sedentary men and women with an average age of 56 years; their average HbA1c was 7.7%. Participants were randomised to one of four groups: a control group of 41 who did no exercise, and three groups who did resistance training only (73 people), aerobic exercise only (72), or a combination of resistance and aerobic training (76).

After a period of 9 months, participants’ HbA1c was measured again. In the combination training group there was an average absolute improvement of -0.34% in HbA1c compared with the control group. People in the aerobic and resistance training groups had non-significant reductions in HbA1c of -0.24% and -0.16% respectively, compared with controls.

Hypoglycaemic medication needed to be increased over the study period in 39% of the control group, 32% of the resistance training group, 22% in the aerobic exercise group and 18% in the combination training group.

The study’s authors said: “Only the combination exercise group improved maximum oxygen consumption compared with the control group. All exercise groups reduced waist circumference … compared with the control group.” They also found that compared with people in the control group, those doing resistance training lost 1.41kg fat mass on average, and those doing combination training lost 1.68kg fat.

“The primary finding from this randomized, controlled exercise trial involving individuals with type 2 diabetes is that although both resistance and aerobic training provide benefits, only the combination of the two were associated with reductions in HbA1c levels.

“It also is important to appreciate that the follow-up difference in HbA1c between the combination training group and the control group occurred even though the control group had increased its use of diabetes medications while the combination training group decreased its diabetes medication uses.”

Authors of an accompanying editorial say this study gives patients clear guidance on how to use their exercise time most effectively: “Based on the results of the HART-D trial, patients with type 2 diabetes who wish to maximise the effects of exercise on their glycaemic control should perform both aerobic and resistance exercise. The HART-D trial clarifies that, given a specific amount of time to invest in exercise, it is more beneficial to devote some time to each form of exercise rather than devoting all the time to just one form of exercise.”

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