HIGH INTENSITY RESISTANCE TRAINING IMPROVES GLYCEMIC

CONTROL IN OLDER PATIENTS WITH TYPE 2 DIABETES

By Chris Defeyter and Ashlie Sklenicka

Type 2 Diabetes

Type 2 diabetes is when your body doesn’t use insulin properly.

At first your pancreas makes extra insulin to make up for it and over time it isn’t able to keep up and can’t make enough to keep your blood glucose levels normal.

Why we chose this topic? Little is known about the impact of

resistance training and diabetes The regimen for improving the metabolic

profile with resistance training of older patients with type two diabetes seemed interesting.

Diabetes is a growing problem in the US in all ages.

Characteristics of Population

Men and women ages 60-80 with type 2 diabetes

Subjects were overweight, sedentary, were not taking insulin, and nonsmokers.

110potential volunteers were invited to attend a 6 month clinical trial

Out of the 110 volunteers 47 were taken, 36 agreed to do the tests. After exclusions 29 were allowed to do the testings with an ending drop out rate of 19%

Exclusions History or physical findings of ischemic

heart disease Systemic diseases Uncontrolled hypertension Advanced diabetic neuropathy or

retinopathy. Subjects with severe orthopedic,

cardiovascular or respiratory conditions 6 people dropped out of the study after 8

weeks

Hypothesis

The aim of this randomized controlled trial was to examine the effects of a 6 month high- intensity progressive resistance training program, combined with a healthy eating designed to elicit moderate weight loss, on HbA1c and body composition in older adults with type 2 diabetes.

Testing of Hypothesis 6-month randomized controlled clinical trail

with repeated measurements performed at 3 month intervals. Subjects were randomly assigned to either a high- intensity progressive resistance training plus moderate weight loss group.

There was a resistance training and weight loss group and a control group that was just on a weight loss group.

Used specific machines that tested HbA1c levels in the patients.

Sessions

3 times per week on nonconsecutive days

5 min warm up and cool down of low intensity stationary cycling and a 45 minute of high-intensity resistance training

Goal: to achieve between 75 and 85% of the current 1-RM.

Sessions Progressive resistance

training program used free weights and a multiple-station weight machine.

Used 3 sets of 8-10 reps Training increased

regularly as tolerated for each muscle group and 1RM was reestablished every 12 weeks.

Used 9 different exercises

Bench press Leg extensions Upright row Lateral pull downs Standing leg curl Dumbbell seated

shoulder press Dumbbell seated bicep

curls Dumbbell triceps

kickbacks Abdominal curls

Results

HbA1c: in the RT and WL programa significant reduction in HbA1c at 3 and 6 months

There was no change for the WL group In body composition and changes in

Anthropometic there was a significant reduction for both RT and WL and just the WL groups

Expected muscle strength increased in RT and WL but no in the WL group

Conclusion

The reduction in the HbA1c after resistance training is likely to offered a prognostic advantage in older patients with type 2 diabetes.

Patients with type 2 diabetes have reported improved insulin sensitivity.

FITT recommendations

Frequency: 3-7days/ week Intensity: 40%-60% of VO2R Time: 150 min/ week Type: Emphasize activities that use

large muscle groups in a rhythmic and continuous fashion.

Special considerations Hypoglycemia is the most serious problem for

individuals with DM who exercise Blood glucose monitoring before and for

several hours following exercise The timing of exercise: using insulin, changing

insulin timing, reducing insulin dose. Physical activity combined with oral

hypoglycemic agents haven’t been studied and little is known about potential interactions.

Exercise PrescriptionAll are 65% of 1RM and will increase every 12 weeks

Monday Tuesday

5 minute warm up Bench Press 3x10 Shoulder Press 3x10 DB Flies 3x10 Biceps 2x10 Triceps 2x10 Core 3-5 min 5 minute cool down

Cycling 20 min

Elliptical 20 min

At a moderate intensity of 50%

All are 65% of 1RM and will increase every 12 weeks

Wednesday Thursday

5 minute warm up Leg press 3x10 Leg extension 3x10 DB Lunges 2x10 Lat pull down3x10 DB bent row 3x10 Core 3-5 min 5 minute cool down

Cycling 20 min

Elliptical 20 min

At a moderate intensity of 50%

All are 65% of 1RM and will increase every 12 weeks

Friday

5 minute warm up Bench press 3x10 Shoulder Press 3x10 Leg Press 3x10 Lat pull downs 3x10 Triceps 2x10 Biceps 2x10 Core 3-5 min 5 minute cool down