Validating Exercise in T2DM

Exercise significantly improves metabolic parameters in type 2 diabetes mellitus (T2DM) patients, irrespective of improvement in cardiorespiratory fitness. Read about this and two additional studies that show the benefits of exercise in diabetes management.

Study 1: Metabolic Parameters Improve Even in Fitness Non-responders  

• Patients with T2DM who exercise can trim waist size and body fat, and control blood glucose, even if they do not see cardiorespiratory benefits.

• About 30% of exercisers are unable to improve their cardiorespiratory fitness levels despite diligent exercise (non-responders).

• These researchers evaluated the impact of exercise on metabolic parameters among 202 patients with T2DM who were non-responders to fitness training. The participants were part of the Health Benefits of Aerobic and Resistance Training in Individuals With Type 2 Diabetes trial.

• Waist circumference, percentage of body fat, and hemoglobin A1c levels all improved in diabetic patients who exercised compared to those who did not.

• Beneficial effects of exercise were seen in those who did aerobics, resistance training, or a combination of the 2 compared to a control group that did not exercise.

• The researchers suggest that exercise-training programs for people with T2DM should measure improvements in glycemic control, waist circumference, and percentage of body fat.

Study 2: Intensive Lifestyle Interventions Play a Prime Role in Diabetes Management

• Intensive lifestyle intervention in obese patients with T2DM should play a prime role in diabetes management, according to the results of a new retrospective observational study.

• These researchers evaluated diabetes remissions after 1 year of a 12-week intensive program for diabetes weight management in a real-world clinical practice.

• Among 120 obese patients with T2DM who completed the program, 88 patients returned for follow-up at 1 year.

• About one-quarter of patients (21.6%) had major improvement in their glycemic control.

• Four patients (4.5%) achieved either partial or complete diabetes remission on no anti-hyperglycemic medications for 1 year; 2 achieved partial remission (2.3%) and 2 achieved complete remission (2.3%).

• Patients who achieved diabetes remission had shorter diabetes duration (less than 5 years) and lower A1C (less than 8%) and were treated with fewer than 2 oral medications. They achieved a weight reduction of more than 7% after 12 weeks.

• The results indicate that a subset of obese patients with T2DM is appropriate for intensive lifestyle intervention with the aim of inducing diabetes remission.

Study 3: Aerobic Exercise Interferes with Pain of Diabetic Peripheral Neuropathy

• Painful diabetic peripheral neuropathy is a common complication of diabetes.

• These researchers examined the effect of aerobic exercise on pain and interference of pain in the daily lives of people with diabetic peripheral neuropathy.

• The pilot study included 20 patients who participated in 3 supervised aerobic exercises each week for 16 weeks.

• Patients experienced significantly less pain interference in walking, normal work, relationship with others, and sleep.

• There were no significant changes in pain intensity.

• The changes in pain interference but not pain intensity suggest a psychological component to an exercise program.

Take-home Messages

• Exercise improves diabetes control regardless of improvement in exercise capacity.

• A subset of obese patients with T2DM who go through intensive lifestyle interventions can achieve diabetes remission and stop using anti-hyperglycemic medications.

• Perceived pain interference may be reduced following an aerobic exercise intervention among people with painful diabetic peripheral neuropathy, without a change in pain intensity.