Issue 138 Item 8 Resistance Exercise Improves Glycemic Control in Older Diabetic

A program of high-intensity progressive resistance training (PRT) improves glycemic control and metabolic abnormalities in older patients with type 2 diabetes. In a 16-week, randomized, controlled study, Dr. Carmen Castaneda and colleagues from Tufts University, Boston, Massachusetts, assigned 62 patients (mean age 66 years) with type 2 diabetes to supervised PRT or to a control group. The exercise intervention consisted of three sessions a week in which the subjects performed three sets of eight repetitions on five pneumatic resistance training machines. Intensity progressively increased during the program.

Plasma glycosylated hemoglobin levels decreased from 8.7% to 7.6% in patients randomized to PRT, and muscle glycogen stores increased from 60.3 to 79.1 mmol glucose/kg muscle. In addition, 72% of patients in this group had a reduction in the dose of prescribed diabetes medication.

There was no change in glycosylated hemoglobin among control patients, while muscle glycogen decreased from 61.4 to 47.2 mmol glucose/kg. Also, there was a 42% increase in prescribed diabetes medications.

PRT subjects versus control subjects also increased in lean mass (+1.2 versus -0.1 kg), reduced systolic blood pressure (-9.7 versus +7.7 mm Hg), and decreased trunk fat mass (-0.7 versus +0.8 kg ), Dr. Castaneda reported.

They conclude that "appropriately prescribed and supervised" high intensity resistance exercise training is feasible and beneficial for older type 2 diabetics. Diabetes Care 2002;25:2335-2341. See this weeks “Tool for Your Practice”.