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Long-standing, insulin-treated type 2 diabetes patients with complications respond well to short-term resistance and interval exercise training

Department of Movement Sciences, Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Maastricht University, Maastricht, The Netherlands¹ Department of Sports Medicine, Máxima Medical Center, Veldhoven, The Netherlands² Department of Internal Medicine, Academic Hospital Maastricht, Maastricht, The Netherlands and³ Department of Human Physiology and Sports Medicine, Free University of Brussels, Brussels, Belgium

(Correspondence should be addressed to S F E Praet who is now at Department of Movement Sciences, Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands; Email: stephan.praet{at}bw.unimaas.nl)

Objective: To determine the feasibility and the benefits of combined resistance and interval exercise training on phenotype characteristics and skeletal muscle function in deconditioned, type 2 diabetes (T2D) patients with polyneuropathy.

Design: Short-term, single-arm intervention trial.

Methods: Eleven male T2D patients (age: 59.1±7.5 years; body mass index: 32.2±4.0 kg/m²) performed progressive resistance and interval exercise training thrice a week for 10 weeks. Besides primary diabetes outcome measures, muscle strength (MUST), maximal workload capacity (W_max), whole-body peak oxygen uptake (VO_2peak) and muscle oxidative capacity (MUOX), intramyocellular lipid (IMCL) and glycogen (IMCG) storage, and systemic inflammation markers were determined before and after training. Daily exogenous insulin requirements (EIR) and historic individualized EIR were gathered and analysed.

Results: MUST and W_max increased with 17% (90% confidence intervals 9–24%) and 14% (6–21) respectively. Furthermore, mean arterial blood pressure declined with 5.5 mmHg (–9.7 to –1.4). EIR dropped with 5.0 IU/d (–11.5 to 1.5) compared with baseline. A decline of respectively –0.7 mmol/l (–2.9 to 1.5) and –147 µmol/l (–296 to 2) in fasting plasma glucose and non-esterified fatty acids concentrations were observed following the intervention, but these were not accompanied by changes in VO_2peak, MUOX, IMCL or IMCG, and blood glycolysated haemoglobin, adiponectin, tumor necrosis factor- and/or cholesterol concentrations.

Conclusion: Short-term resistance and interval exercise training is feasible in deconditioned T2D patients with polyneuropathy and accompanied by moderate improvements in muscle function and blood pressure. Such a specific exercise regimen may provide a better framework for future exercise intervention programmes in the treatment of deconditioned T2D patients.