A new study shows that a combination of aerobic exercise and resistance training may offer the biggest benefits for people with type 2 diabetes in helping them control their disease. This combination improved HbA1c levels much better than either form alone. HbA1c levels denote long term sugar or glycemic control in a diabetic patient. Normal HbA1c is 6% or less. People with diabetes are urged to keep their HbA1c below 7%.
It is known that exercise can provide many health benefits for people with type 2 diabetes, but until now the exact type of exercise to optimize those benefits had been uncertain. The trial was named the HART-D trial. For the study the team compared the effects of a nine-month aerobic exercise program, a resistance training program, and combination exercise program vs. not exercising in 262 previously sedentary men and women with type 2 diabetes. During the study, participants in each of the three intervention groups spent about 140 minutes exercising each week, including warm-up and cool-down time.
Best improvements in HbA1c levels were seen in the combination group. For example, the improvement was -0.34% in the combination exercise group compared with the non-exercisers, while changes in these levels were not significant in those who did aerobic exercise or resistance training alone. Such a reduction might be expected to reduce cardiovascular disease risk by 5% to 7% and microvascular complications by 12%, according to the researchers. Also less people in the combination group needed to increase the amount of medications they required to control their disease, compared with the other groups. 39% of non-exercisers had to increase these medications compared with 32% in the resistance training group, 22% in the aerobic exercise group, and 18% in the combination group. All three of the exercise groups shaved 1.5 to 2.8 cm from their waists. Fat mass was reduced by 3 pounds in the resistance training group and 3.7 pounds in the combination training group.
Researcher Timothy S. Church of Louisiana State University System in Baton Rouge, La., and colleagues write in the paper published in the Journal of the American Medical Association, “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.”
In an accompanying editorial Ronald J. Sigal of the University of Calgary in Alberta, Canada, and Glen P. Kenny of the University of Ottawa and Ottawa Hospital Research Institute in Ottawa, Canada write that type 2 diabetics would benefit from this study in optimizing their exercise schedule. “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,” they write.
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