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Rowing and Cycling Reduce Inflammation in Early-Stage Type 2 Diabetes

Effects of Different Modes of Rowing Combined With Cycling Exercise on Inflammatory Markers in Newly Diagnosed Type 2 Diabetes Patients

This multicenter randomized controlled trial evaluates the short-term (7-day) effects of different rowing-cycling exercise regimens on postprandial glycemic excursions in newly diagnosed type 2 diabetes patients (aged 18-60 years, diagnosis ≤12 months, drug-naïve). A total of 120 participants will be randomized into five groups: control, moderate-intensity continuous cycling, high-intensity interval rowing, and standard combined exercise (rowing + cycling, 50 min). The primary outcome is inflammatory cytokines (IL-6, TNF-α, IL-1β, IL-1ra, IL-10, hs-CRP), body Composition and functional Indicators. Secondary outcomes include change in continuous glucose monitoring-derived glycemic variability (CONGA), and time-in-range. Mixed-effects models will quantify dose-response relationships and identify key effect modifiers (e.g., age). This study aims to establish an evidence-based precision exercise prescription for early-stage type 2 diabetes management.

Studieoversigt

Detaljeret beskrivelse

Study Process

  1. Screening & enrolment - We recruit 128 adults (18-60 years) who have been diagnosed with type 2 diabetes within the last 12 months and have never taken diabetes medication.
  2. Baseline assessments - Before starting, all participants undergo blood tests (glucose, insulin, inflammatory markers), a continuous glucose monitor (CGM) is placed on their arm, and they wear an activity tracker for 7 days.
  3. Randomization - Participants are randomly assigned to one of four groups (32 people each):

    Control - usual care, no exercise

    Cycling - 40 min of moderate-intensity cycling per day

    Rowing (HIIT) - 24 min of high-intensity interval rowing per day

    Combined - 20 min rowing + 20 min cycling (50 min total)

  4. Intervention - All exercise groups train once a day for 7 consecutive days at the research centre under supervision. Heart rate is monitored throughout.
  5. Continuous monitoring - The CGM records glucose levels every 15 minutes during the whole 7-day period. Activity trackers record physical activity outside the exercise sessions.
  6. Post-intervention assessments - On day 8, we repeat all blood tests, measure inflammatory markers again, and collect the CGM data.

9. Data analysis - We compare changes in blood sugar fluctuations and inflammation between the groups, and use statistical models to find which exercise regimen works best and for whom (e.g., younger vs. older patients).

The entire study takes about 9 days per participant (1 week of exercise + 2 days of testing).

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

120

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

    • Fujian
      • Putian, Fujian, Kina, 351100
        • The Ethics Committee of Putian 95 Hospital
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen

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Ingen

Beskrivelse

Inclusion Criteria:

  1. Age between 18-60 years, no gender limited;
  2. Meeting the WHO 1999 diagnostic criteria for T2DM, with a diagnosis time ≤12 months;
  3. Not having received hypoglycemic drug treatment (or only lifestyle intervention, and stopped medication ≥4 weeks before enrollment);
  4. Fasting blood glucose 7.0-13.9 mmol/L, glycated hemoglobin (HbA1c) 6.5%-10.0%;
  5. No regular exercise in the past 3 months (less than 2 times per week of moderate or higher intensity exercise, each <30 minutes);
  6. Voluntarily signing the informed consent form.

Exclusion Criteria:

  1. Type 1 diabetes, gestational diabetes, or other special types of diabetes;
  2. Severe cardiovascular or cerebrovascular diseases (NYHA heart function ≥III, recent myocardial infarction or unstable angina);
  3. Uncontrolled hypertension (resting systolic blood pressure ≥160 mmHg or diastolic blood pressure ≥100 mmHg);
  4. Severe liver or kidney dysfunction (ALT/AST ≥3 times the upper limit of normal, or eGFR<60 mL/min/1.73m²);
  5. Severe diabetic complications (such as proliferative retinopathy, severe neuropathy, diabetic foot);
  6. Pregnant or breastfeeding women;
  7. Mental illness or cognitive impairment that prevents compliance with the study;
  8. Stress events such as infection, trauma, or surgery in the past month;
  9. Participation in other interventional clinical studies;
  10. Musculoskeletal diseases of the upper or lower limbs that affect rowing machine or bicycle exercise.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Continuous Exercise - Cycling Group
Warm-up: 5 minutes of low-intensity cycling (50-60 W, approximately 40%-50% HRmax of continuous power cycling at) Main Training: 40 minutes 65%-75% HRmax (approximately 60%-70% VO₂peak), maintaining a cadence of 60-80 rpm Cool-down: 5 minutes of low-intensity cycling followed by stretching Total Duration: 50 minutes
Warm-up: 5 minutes of low-intensity cycling (50-60 W, approximately 40%-50% HRmax of continuous power cycling at) Main Training: 40 minutes 65%-75% HRmax (approximately 60%-70% VO₂peak), maintaining a cadence of 60-80 rpm Cool-down: 5 minutes of low-intensity cycling followed by stretching Total Duration: 50 minutes
Aktiv komparator: Rowing Ergometer High-Intensity Interval Training (RE-HIIT)

Warm-up:

5 minutes of low-intensity rowing at approximately 50% of maximum heart rate (HRmax).

Main Training:

24 minutes of interval training consisting of 4 sets of high-intensity rowing for 4 minutes each (85%-90% HRmax), with 2 minutes of low-intensity active recovery (50%-60% HRmax) between each set. Maintain a stroke rate of 24-30 strokes per minute (SPM) for high-intensity intervals and 18-22 SPM for recovery intervals.

Cool-down:

5 minutes of low-intensity rowing combined with stretching.

Total Duration:

34 minutes

Warm-up:

5 minutes of low-intensity rowing at approximately 50% of maximum heart rate (HRmax).

Main Training:

24 minutes of interval training consisting of 4 sets of high-intensity rowing for 4 minutes each (85%-90% HRmax), with 2 minutes of low-intensity active recovery (50%-60% HRmax) between each set. Maintain a stroke rate of 24-30 strokes per minute (SPM) for high-intensity intervals and 18-22 SPM for recovery intervals.

Cool-down:

5 minutes of low-intensity rowing combined with stretching.

Total Duration:

34 minutes

Eksperimentel: Combined Training Standard (CT-S)

Warm-up:

5 minutes of low-intensity activity (choose either cycling or rowing).

Rowing Machine Segment:

20 minutes at an intensity of 65%-75% of maximum heart rate (HRmax) (approximately 60%-70% of VO₂peak), with a stroke rate of 22-26 strokes per minute (SPM).

Bicycle Segment:

20 minutes at an intensity of 65%-75% of HRmax (approximately 60%-70% of VO₂peak), with a cadence of 60-80 revolutions per minute (rpm).

Cool-down:

5 minutes of stretching.

Total Duration:

50 minutes

Warm-up:

5 minutes of low-intensity activity (choose either cycling or rowing).

Rowing Machine Segment:

20 minutes at an intensity of 65%-75% of maximum heart rate (HRmax) (approximately 60%-70% of VO₂peak), with a stroke rate of 22-26 strokes per minute (SPM).

Bicycle Segment:

20 minutes at an intensity of 65%-75% of HRmax (approximately 60%-70% of VO₂peak), with a cadence of 60-80 revolutions per minute (rpm).

Cool-down:

5 minutes of stretching.

Total Duration:

50 minutes

Ingen indgriben: Control Group (CG)
Maintain usual activity levels without engaging in any structured exercise training. Daily activity levels are recorded using an accelerometer.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
inflammatory cytokines
Tidsramme: 1.4 weeks

IL-6 (Interleukin-6) - The first muscle factor induced by exercise, is the core molecule connecting exercise to systemic anti-inflammatory effects. IL-6 produced by skeletal muscles during exercise inhibits TNF-α and stimulates IL-1ra to exert anti-inflammatory effects. Different exercise patterns have varying regulations on IL-6, with both aerobic training and combined training significantly reducing IL-6 levels in T2DM patients.

TNF-α (Tumor Necrosis Factor Alpha) - A key pro-inflammatory factor in insulin resistance in T2DM. Exercise improves insulin sensitivity by inhibiting the production of TNF-α. Meta-analyses confirm that exercise significantly reduces TNF-α levels in T2DM patients.

hs-CRP (High-sensitivity C-reactive protein) - A classic marker of systemic low-grade inflammation, identified as a key baseline biomarker to distinguish well-controlled T2DM patients from healthy adults.

1.4 weeks
Body Composition
Tidsramme: 1.4 weeks
DEXA to detect body fat percentage (BF%) and skeletal muscle index (SMI)
1.4 weeks
maximal oxygen uptake (VO₂max)
Tidsramme: 1.4 weeks
Cardiopulmonary exercise testing to determine maximal oxygen uptake (VO₂max)
1.4 weeks

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Postprandial Blood Glucose Fluctuations
Tidsramme: 1.4 weeks
Calculate the average blood glucose values and blood glucose fluctuation coefficients (CONGA) for 2-4 hours after breakfast, lunch, and dinner by using CGM, comparing the differences before and after intervention and between groups. CONGA is defined as the standard deviation of the differences between consecutive blood glucose measurements, reflecting the amplitude of blood glucose fluctuations.
1.4 weeks
Dynamic Blood Glucose Parameters
Tidsramme: 1.4 weeks
Time in Range (TIR): The percentage of time blood glucose is within the range of 3.9-10.0 mmol/L Time Above Range (TAR): The percentage of time blood glucose is >10.0 mmol/L Time Below Range (TBR): The percentage of time blood glucose is <3.9 mmol/L Mean Amplitude of Glycemic Excursions (MAGE) 24-hour average blood glucose Immediate post-exercise blood glucose decline and duration
1.4 weeks
Basal Metabolic Indicators
Tidsramme: 1.4 weeks
Fasting Plasma Glucose (FPG) 2-hour Postprandial Glucose (2hPG) Glycated Hemoglobin (HbA1c) Fasting Insulin (FINS) HOMA-IR Index Matsuda Insulin Sensitivity Index (ISI)
1.4 weeks
Anthropometric indicator
Tidsramme: 1.4 weeks
Body Mass Index (BMI) = Weight (kg) / Height (m)²
1.4 weeks

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Efterforskere

  • Studiestol: Rongfeng Zhu, The 95th Hospital of Putian

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. oktober 2026

Primær færdiggørelse (Anslået)

10. oktober 2028

Studieafslutning (Anslået)

11. december 2028

Datoer for studieregistrering

Først indsendt

1. august 2026

Først indsendt, der opfyldte QC-kriterier

12. august 2026

Først opslået (Faktiske)

18. august 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

18. august 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

12. august 2026

Sidst verificeret

1. august 2026

Mere information

Begreber relateret til denne undersøgelse

Plan for individuelle deltagerdata (IPD)

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IPD-planbeskrivelse

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