Supervised exercise training counterbalances the adverse effects of insulin therapy in overweight/obese subjects with type 2 diabetes
Stefano Balducci, Silvano Zanuso, Patrizia Cardelli, Gerardo Salerno, Sara Fallucca, Antonio Nicolucci, Giuseppe Pugliese, Italian Diabetes Exercise Study (IDES) Investigators, Francesco Fallucca, Giuseppe Pugliese, Serena Missori, Maria Cristina Ribaudo, Elena Alessi, Alessandra Bazuro, Felice Strollo, Massimo Morè, Pietro Alimonti, Nicolina Di Biase, Filomena Lasaracina, Graziano Santantonio, Laura Cruciani, Mario Manunta, Maurizio Di Mauro, Giorgio Sesti, Luigi Puccio, Mauro Cignarelli, Vincenzo Nicastro, Sabrina Piemontese, Gerardo Corigliano, Ernesto Rossi, Marco Corigliano, Pierpaolo De Feo, Cristina Fatone, Cristiana Baggiore, Roberto Russo, Massimo Boemi, Luigi Lanari, Umberto Valentini, Angela Girelli, Paolo Di Bartolo, Francesca Pellicano, Paolo Mazzuca, Enrica Manicardi, Alberto Bruno, Maria Sambataro, Stefano Balducci, Antonio Pontiroli, Marco Laneri, Anna Boggio, Nunzio Zagari, Frederick Fernando, Carla Iacobini, Stefano Menini, Gianluca Balducci, Lorella Senigagliesi, Enza Spinelli, Alessandro Di Giovanni, Mariano Pineda, Umberto Pandolfo, Ciro Giordano, Antonella Settequattrini, Marco Gambacciani, Matteo Fabrizi, Adriano Ceccherini, Enrico Balducci, Mirko Quattrini, Massimo Massarini, Guiseppe Baggio, Marco Fornari, Davide Violi, Giancarlo Cherubini, Fabio Mastelloni, Valeria Micali, Daniela Cilano, Simone Di Luciano, Davide Canevari, Stefano Balducci, Silvano Zanuso, Patrizia Cardelli, Gerardo Salerno, Sara Fallucca, Antonio Nicolucci, Giuseppe Pugliese, Italian Diabetes Exercise Study (IDES) Investigators, Francesco Fallucca, Giuseppe Pugliese, Serena Missori, Maria Cristina Ribaudo, Elena Alessi, Alessandra Bazuro, Felice Strollo, Massimo Morè, Pietro Alimonti, Nicolina Di Biase, Filomena Lasaracina, Graziano Santantonio, Laura Cruciani, Mario Manunta, Maurizio Di Mauro, Giorgio Sesti, Luigi Puccio, Mauro Cignarelli, Vincenzo Nicastro, Sabrina Piemontese, Gerardo Corigliano, Ernesto Rossi, Marco Corigliano, Pierpaolo De Feo, Cristina Fatone, Cristiana Baggiore, Roberto Russo, Massimo Boemi, Luigi Lanari, Umberto Valentini, Angela Girelli, Paolo Di Bartolo, Francesca Pellicano, Paolo Mazzuca, Enrica Manicardi, Alberto Bruno, Maria Sambataro, Stefano Balducci, Antonio Pontiroli, Marco Laneri, Anna Boggio, Nunzio Zagari, Frederick Fernando, Carla Iacobini, Stefano Menini, Gianluca Balducci, Lorella Senigagliesi, Enza Spinelli, Alessandro Di Giovanni, Mariano Pineda, Umberto Pandolfo, Ciro Giordano, Antonella Settequattrini, Marco Gambacciani, Matteo Fabrizi, Adriano Ceccherini, Enrico Balducci, Mirko Quattrini, Massimo Massarini, Guiseppe Baggio, Marco Fornari, Davide Violi, Giancarlo Cherubini, Fabio Mastelloni, Valeria Micali, Daniela Cilano, Simone Di Luciano, Davide Canevari
Abstract
Objective: To examine the effect of supervised exercise on traditional and nontraditional cardiovascular risk factors in sedentary, overweight/obese insulin-treated subjects with type 2 diabetes from the Italian Diabetes Exercise Study (IDES).
Research design and methods: The study randomized 73 insulin-treated patients to twice weekly supervised aerobic and resistance training plus structured exercise counseling (EXE) or to counseling alone (CON) for 12 months. Clinical and laboratory parameters were assessed at baseline and at the end of the study.
Results: The volume of physical activity was significantly higher in the EXE versus the CON group. Values for hemoglobin A(1c), BMI, waist circumference, high-sensitivity C-reactive protein, blood pressure, LDL cholesterol, and the coronary heart disease risk score were significantly reduced only in the EXE group. No major adverse events were observed.
Conclusions: In insulin-treated subjects with type 2 diabetes, supervised exercise is safe and effective in improving glycemic control and markers of adiposity and inflammation, thus counterbalancing the adverse effects of insulin on these parameters.
References
- Hansson GK, Robertson AK, Söderberg-Nauclér C. Inflammation and atherosclerosis. Annu Rev Pathol 2006;1:297–329
- Hayden JM, Reaven PD. Cardiovascular disease in diabetes mellitus type 2: a potential role for novel cardiovascular risk factors. Curr Opin Lipidol 2000;11:519–528
- Ridker PM, Rifai N, Rose L, Buring JE, Cook NR. Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. N Engl J Med 2002;347:1557–1565
- Ridker PM, Danielson E, Fonseca FA, et al. ; JUPITER Trial Study Group Reduction in C-reactive protein and LDL cholesterol and cardiovascular event rates after initiation of rosuvastatin: a prospective study of the JUPITER trial. Lancet 2009;373:1175–1182
- Balducci S, Zanuso S, Nicolucci A, et al. Anti-inflammatory effect of exercise training in subjects with type 2 diabetes and the metabolic syndrome is dependent on exercise modalities and independent of weight loss. Nutr Metab Cardiovasc Dis 2010;20:608–617
- Esposito K, Ciotola M, Maiorino MI, et al. Addition of neutral protamine lispro insulin or insulin glargine to oral type 2 diabetes regimens for patients with suboptimal glycemic control: a randomized trial. Ann Intern Med 2008;149:531–539
- Pradhan AD, Everett BM, Cook NR, Rifai N, Ridker PM. Effects of initiating insulin and metformin on glycemic control and inflammatory biomarkers among patients with type 2 diabetes: the LANCET randomized trial. JAMA 2009;302:1186–1194
- Aas AM, Seljeflot I, Torjesen PA, Diep LM, Thorsby PM, Birkeland KI. Blood glucose lowering by means of lifestyle intervention has different effects on adipokines as compared with insulin treatment in subjects with type 2 diabetes. Diabetologia 2006;49:872–880
- Mavridis G, Souliou E, Diza E, et al. Inflammatory cytokines in insulin-treated patients with type 2 diabetes. Nutr Metab Cardiovasc Dis 2008;18:471–476
- Balducci S, Zanuso S, Massarini M, et al. ; Italian Diabetes Exercise Study (IDES) Group The Italian Diabetes and Exercise Study (IDES): design and methods for a prospective Italian multicentre trial of intensive lifestyle intervention in people with type 2 diabetes and the metabolic syndrome. Nutr Metab Cardiovasc Dis 2008;18:585–595
- Balducci S, Zanuso S, Nicolucci A, et al. ; Italian Diabetes Exercise Study (IDES) Investigators Effect of an intensive exercise intervention strategy on modifiable cardiovascular risk factors in type 2 diabetes mellitus: a randomized controlled trial: the Italian Diabetes and Exercise Study (IDES). Arch Intern Med 2010;170:1794–1803
Source: PubMed