Original article
The Relative Benefits of Endurance and Strength Training on the Metabolic Factors and Muscle Function of People With Type 2 Diabetes Mellitus

https://doi.org/10.1016/j.apmr.2005.01.007Get rights and content

Abstract

Cauza E, Hanusch-Enserer U, Strasser B, Ludvik B, Metz-Schimmerl S, Pacini G, Wagner O, Georg P, Prager R, Kostner K, Dunky A, Haber P. The relative benefits of endurance and strength training on the metabolic factors and muscle function of people with type 2 diabetes mellitus.

Objective

To compare the effects of a 4-month strength training (ST) versus aerobic endurance training (ET) program on metabolic control, muscle strength, and cardiovascular endurance in subjects with type 2 diabetes mellitus (T2D).

Setting

Large public tertiary hospital.

Participants

Twenty-two T2D participants (11 men, 11 women; mean age ± standard error, 56.2±1.1y; diabetes duration, 8.8±3.5y) were randomized into a 4-month ST program and 17 T2D participants (9 men, 8 women; mean age, 57.9±1.4y; diabetes duration, 9.2±1.7y) into a 4-month ET program.

Interventions

ST (up to 6 sets per muscle group per week) and ET (with an intensity of maximal oxygen consumption of 60% and a volume beginning at 15min and advancing to a maximum of 30min 3×/wk) for 4 months.

Main Outcome Measures

Laboratory tests included determinations of blood glucose, glycosylated hemoglobin (Hb A1c), insulin, and lipid assays.

Results

A significant decline in Hb A1c was only observed in the ST group (8.3%±1.7% to 7.1%±0.2%, P=.001). Blood glucose (204±16mg/dL to 147±8mg/dL, P<.001) and insulin resistance (9.11±1.51 to 7.15±1.15, P=.04) improved significantly in the ST group, whereas no significant changes were observed in the ET group. Baseline levels of total cholesterol (207±8mg/dL to 184±7mg/dL, P<.001), low-density lipoprotein cholesterol (120±8mg/dL to 106±8mg/dL, P=.001), and triglyceride levels (229±25mg/dL to 150±15mg/dL, P=.001) were significantly reduced and high-density lipoprotein cholesterol (43±3mg/dL to 48±2mg/dL, P=.004) was significantly increased in the ST group; in contrast, no such changes were seen in the ET group.

Conclusions

ST was more effective than ET in improving glycemic control. With the added advantage of an improved lipid profile, we conclude that ST may play an important role in the treatment of T2D.

Section snippets

Study Population

We randomized 43 patients from our diabetes outpatient department—22 men (mean age ± standard error [SE], 56.5±0.9y; range, 51–69y) and 21 women (mean age, 57.4±0.9y; range, 50–70y)—between September 2000 and May 2002 who had T2D and no complications or comorbid conditions. The patients were consecutively divided into 2 groups (ST vs ET); none from either group was involved in organized ET programs. One subject did not complete the study because of health reasons unrelated to the investigation

Results

At study entry, both exercise groups had similar profiles for all parameters examined except for TG and FBG. Participants who undertook ST had both higher TG baseline levels (229±25mmol/L vs 146±14mmol/L, P=.01) and FBG baseline levels (204±16 vs 160±9, P=.04) than the ET group.

After the 4-month ST period, there were highly significant changes in the maximum strength of all muscle groups, as well as a highly significant increase of LBM. In addition, there were significant changes in glycemic

Discussion

We found significant improvements in long-term glycemic control, as shown by reduced Hb A1c levels and an improved IR estimated by HOMA, in participants with diabetes on ST. The effects of ET on the respective parameters, however, were only moderate.

Maximum strength (1-RM) of all muscle groups increased after 4 months of ST in contrast with no improvements after 4 months of ET, with the exception of a small increase in leg press. Additional improvements were observed in Vo2peak after ET,

Conclusions

ST was better than ET in all metabolic parameters measured in regard to an improvement in metabolic parameters. The positive changes observed in the muscular system coincided with highly significant improvements in metabolic control that resulted in a decreased atherogenic lipid profile. With the advantage of an improved lipid profile, we recommend ST for the treatment of T2D.

Acknowledgments

We thank Heinz Tüchler for his statistical analysis.

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    Supported by the Jubiläumsfond of the Austrian National Bank (project no. 8537).

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