Most Effective Exercise to Reduce
Insulin Resistance in Type 2 Diabetes
Aerobic exercise alone is not sufficient
The purpose of this study was to evaluate
whether a combined resistance and aerobic
training program would improve insulin
sensitivity compared with aerobic training alone
in postmenopausal women with type 2 diabetes. A
second objective was to relate the improved
insulin sensitivity to changes in abdominal
adipose tissue (AT) and thigh muscle density.
The study included a total of 28 obese
postmenopausal women with type 2 diabetes were
randomly assigned to one of three 16-week
treatments: control, aerobic only training (Ae
only), or aerobic plus resistance training (Ae+RT).
Pre- and posttreatment outcome measures included
glucose disposal by hyperinsulinemic-euglycemic
clamp and computed tomography scans of abdominal
AT and mid-thigh skeletal muscle.
The results showed that glucose infusion
rates increased significantly (P <
0.05) in the Ae+RT group. Both exercise groups
had reduced abdominal subcutaneous and visceral
AT and increased muscle density. The Ae+RT
training group exhibited a significantly greater
increase in muscle density than the Ae only
group. Improved glucose disposal was
independently associated with changes in
subcutaneous AT, visceral AT, and muscle
density. Muscle density retained a relationship
with glucose disposal after controlling for
abdominal AT.
From the results it was concluded that
enhanced glucose uptake was seen in
postmenopausal women with type 2 diabetes after
a combined aerobic plus resistance training
program. This improvement was related to losses
of AT area from abdominal subcutaneous depot and
to increases in thigh muscle cross-sectional
area and thigh muscle attenuation
characteristics. We conclude that a combined
endurance plus resistance training program is
most effective in improving insulin sensitivity
in these women and that the improvements are
associated with changes in muscle
characteristics brought about by strength
training.
Adding resistance training to aerobic
training enhanced glucose disposal in
postmenopausal women with type 2 diabetes. The
improved insulin sensitivity is related to loss
of abdominal subcutaneous and visceral AT and to
increased muscle density.
Diabetes Care: Vol 26 No 12, 2003
