Effect of Physical Exercise on Endothelial Function in Patients With Type 2 Diabetes Mellitus

March 20, 2014 updated by: Geraldo Bezerra da Silva Junior, Universidade Federal do Ceará
Endothelial dysfunction precedes the development of cardiovascular disease and it is common in patients with diabetes mellitus. The aim of this study is to identify the effect of two different physical training programs, using ultrasound techniques, on the endothelial function of patients with type 2 DM.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Subjects Subjects with type 2 DM, of both genders, aged between 40 and 65 years, without coronary artery disease, characterized by a negative maximum exercise test, will be studied. This study will be carried out at the Prevention and Cardiovascular Rehabilitation Unit Unicardio, in Hospital Santa Catarina, in the city of Blumenau, State of Santa Catarina, South of Brazil. The patients will be invited to participate in the study as they are treated at the clinic during regular medical consultations, with approximately 235 patients per month. After that, patient randomization will be carried out, by dividing the patients in the groups: intervention (a group undergoing high-intensity exercise and another one undergoing low-intensity exercise) and control group (patients not submitted to the physical exercise program, but went to the health care center to undergo blood pressure and heart rate measurement).

The following exclusion criteria will be used: subjects in whom, for reasons related to clinical screening, it is not possible to withdrawn medications with known endothelial function effect, such as angiotensin-converting enzyme inhibitors, calcium channel blockers, nitrates, beta-blockers, anti-oxidizers, hormonal replacement therapy, insulin; subjects with altered maximum exercise test (positive); cigarette smoking history in the last 12 months; participation in a physical exercise program in the last 12 months; chronic obstructive pulmonary disease; high blood pressure levels (systolic blood pressure > 180mmHg and diastolic blood pressure > 110mmHg); osteoporosis and diabetic neuropathy.

The study protocol is in accordance with the Declaration of Helsinki. All participants will be informed of the objectives of the study and possible risks and discomforts involved with their participation in the experiments, and will be included only after signing the informed consent term. The study protocol was approved by the Ethics Committee of Hospital Santa Catarina (Blumenau, Santa Catarina, Brazil).

Study Protocol All study subjects will undergo an initial clinical examination performed by a cardiologist. Before and after 6 weeks of intervention, the patients will undergo the maximum exercise test, physical examination and endothelial function evaluation. The participants will be submitted to a program of physical exercise in the Prevention and Cardiovascular Rehabilitation Unit Unicardio of Hospital Santa Catarina, in Blumenau, Brazil. After the maximum exercise test is limited by fatigue, the participants will be referred, based on their individual exercise prescription and randomized to a low (50 to 60% of maximum heart rate) or high intensity (75 to 85% of maximum heart rate) exercise program. During the study period, the patients should maintain the same doses of medications.

All patients will undergo a non-invasive evaluation of endothelial function, performed at Clínica Uniangio, in the city of Blumenau, Brazil. Two investigators will perform all the tests, while blinded to the group the patients were randomized to. All patients will undergo an 8-12 hour period of food and water deprivation. The individuals will be placed in the supine position, with the arms placed along the body in a comfortable position to obtain image of the brachial artery, above the antecubital fossa, in the longitudinal plane.

An ultrasonic sound wave equipment will be used (Acuson, Model 128XP System, Mountain View, California, USA), with vascular software for two-dimensional images (2D), color Doppler with an internal electrocardiogram (ECG) monitor and a high-frequency vascular transducer (Acuson, Model L7 7,5-10 MHz, Mountain View, California, USA). After positioned, a segment with anterior and posterior interfaces with the arterial wall will be selected for 2D images. Arterial diameter values will be recorded in super-VHS for subsequent analysis.

Study Type

Interventional

Enrollment (Actual)

31

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Brazil
    • Santa Catarina
      • Blumenau, Santa Catarina, Brazil
        • Prevention and Cardiovascular Rehabilitation Unit Unicardio, in Hospital Santa Catarina

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

40 years to 65 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

Subjects with type 2 DM, of both genders, aged between 40 and 65 years, without coronary artery disease, characterized by a negative maximum exercise test

Exclusion Criteria:

-

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Diagnostic
  • Allocation: Randomized
  • Interventional Model: Single Group Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: high-intensity exercise group
Patients undergoing high-intensity exercise group. Intervention: high-intensity exercise.
Procedure: High-intensity exercise
Performance of high-intensity exercise
Experimental: low-intensity exercise group
Patients undergoing low-intensity exercise group Intervention: low-intensity exercise
Procedure: Low-intensity exercise
Performance of low-intensity exercise

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Arterial dilation
Time Frame: 6 weeks
6 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Universidade Federal do Ceará

Investigators

  • Principal Investigator: Carlos Alberto Silva, PhD, Universidade Federal Do Ceara

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

January 1, 2012

Primary Completion (Actual)

December 1, 2012

Study Completion (Actual)

December 1, 2012

Study Registration Dates

First Submitted

November 6, 2013

First Submitted That Met QC Criteria

November 6, 2013

First Posted (Estimate)

November 13, 2013

Study Record Updates

Last Update Posted (Estimate)

March 21, 2014

Last Update Submitted That Met QC Criteria

March 20, 2014

Last Verified

March 1, 2014

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 14343

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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