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

12 augusti 2026 uppdaterad av: The 95th Hospital of Putian，Putian, Fujian, China

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.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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).

Studietyp

Interventionell

Inskrivning (Beräknad)

120

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studera Kontakt Backup

Studieorter

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

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen

Tar emot friska volontärer

Nej

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Enda

Vapen och interventioner

Deltagargrupp / 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
Beteende: 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
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
Beteende: Rowing Ergometer High-Intensity Interval Training

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
Experimentell: 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
Beteende: Combined Training Standard

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

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
inflammatory cytokines
Tidsram: 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
Tidsram: 1.4 weeks
DEXA to detect body fat percentage (BF%) and skeletal muscle index (SMI)
1.4 weeks
maximal oxygen uptake (VO₂max)
Tidsram: 1.4 weeks
Cardiopulmonary exercise testing to determine maximal oxygen uptake (VO₂max)
1.4 weeks

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Postprandial Blood Glucose Fluctuations
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 1.4 weeks
Body Mass Index (BMI) = Weight (kg) / Height (m)²
1.4 weeks

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

The 95th Hospital of Putian，Putian, Fujian, China

Utredare

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

Publikationer och användbara länkar

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Studieavstämningsdatum

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Studera stora datum

Studiestart (Beräknad)

1 oktober 2026

Primärt slutförande (Beräknad)

10 oktober 2028

Avslutad studie (Beräknad)

11 december 2028

Studieregistreringsdatum

Först inskickad

1 augusti 2026

Först inskickad som uppfyllde QC-kriterierna

12 augusti 2026

Första postat (Faktisk)

18 augusti 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

18 augusti 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

12 augusti 2026

Senast verifierad

1 augusti 2026

Mer information

Termer relaterade till denna studie

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • 2025-js025

Plan för individuella deltagardata (IPD)

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IPD-planbeskrivning

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