Skip to main content
Top
Published in: Trials 1/2023

Open Access 01-12-2023 | Research

Effect of resistance vs. aerobic exercise in pre-diabetes: an RCT

Authors: Xijuan Luo, Zhengzhen Wang, Bowen Li, Xianbo Zhang, Xin Li

Published in: Trials | Issue 1/2023

Login to get access

Abstract

Background

This study aimed to assess the different impacts of aerobic and resistance exercise intervention on pre-diabetes and its possible influencing factor (obesity) to identify which exercise intervention mode was better for pre-diabetes to control their blood glucose levels.

Methods

Single-blind randomized controlled trial. Participants were recruited from Southwest Hospital between February 2016 and May 2017 and randomly divided into three groups using stratified randomization: aerobic exercise (A), resistance exercise (R), and control (C). The effects of each group were analyzed, and the relationship with obesity was investigated following a 12-week intervention.

Results

Eighty participants were enrolled (9 were lost, and 1 was excluded). Finally, 26 participants were included in group A, 23 in group R, and 21 in group C. In groups A and R, FPG, OGTT 2-h PG, and HOMA2-IR decreased by 6.17% (P = 0.001) and 4.81% (P = 0.019), 20.39% (P < 0.001) and 16.50% (P < 0.001), and 8.34% (P = 0.026) and 18.31% (P = 0.001, superior to that in group A), respectively (all P < 0.001 compared with group C, with no significant differences between groups A and R). The ratio of reversal to euglycemia was 69.2% (P = 0.003 compared with group C) in group A and 43.5% (P = 0.213 compared with group C) in group R. The decreased ratio of GSP in group R was greater (65.2%, P = 0.008 compared with group C) compared with group A (38.5%, P = 0.355 compared with group C). Decreases in the parameters BMI (3.1 ± 3.2% P < 0.001, moderately positive correlation with the decreased FPG level, r = 0.498, P = 0.010, two-tailed) and waist circumference (3.1 ± 2.7% P < 0.001) were noted in group A, but no significant correlations were noted between other indicators in group R.

Conclusions

Both resistance and aerobic exercise can control and reverse IGR. Compared with aerobic exercise, resistance exercise may be superior in terms of GSP and IR improvement. Aerobic exercise decreases blood glucose levels through weight loss. However, the effect of resistance exercise might not be mediated via weight loss and obesity control.

Trial registration

Chinese Clinical Trial Registry ChiCTR2000038304. Registered on September 17, 2020.
Literature
2.
go back to reference Li Y, Teng D, Shi X, Qin G, Qin Y, Quan H, et al. Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study. BMJ. 2020;369:m997.CrossRefPubMedPubMedCentral Li Y, Teng D, Shi X, Qin G, Qin Y, Quan H, et al. Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study. BMJ. 2020;369:m997.CrossRefPubMedPubMedCentral
3.
go back to reference Xu Y, Wang L, He J, Bi Y, Li M, Wang T, et al. Prevalence and control of diabetes in Chinese adults. JAMA. 2013;310:948–59.CrossRefPubMed Xu Y, Wang L, He J, Bi Y, Li M, Wang T, et al. Prevalence and control of diabetes in Chinese adults. JAMA. 2013;310:948–59.CrossRefPubMed
4.
go back to reference American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33 Suppl 1:S62-9. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33 Suppl 1:S62-9.
5.
go back to reference Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393–403.CrossRefPubMed Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393–403.CrossRefPubMed
6.
go back to reference Albright AL, Gregg EW. Preventing type 2 diabetes in communities across the U.S.: the National Diabetes Prevention Program. Am J Prev Med. 2013;44:S346–51.CrossRefPubMedPubMedCentral Albright AL, Gregg EW. Preventing type 2 diabetes in communities across the U.S.: the National Diabetes Prevention Program. Am J Prev Med. 2013;44:S346–51.CrossRefPubMedPubMedCentral
7.
go back to reference Hoskin MA, Bray GA, Hattaway K, Khare-Ranade PA, Pomeroy J, Semler LN, et al. Prevention of Diabetes Through the Lifestyle Intervention: Lessons Learned from the Diabetes Prevention Program and Outcomes Study and its Translation to Practice. Curr Nutr Rep. 2014;3:364–78.CrossRefPubMedPubMedCentral Hoskin MA, Bray GA, Hattaway K, Khare-Ranade PA, Pomeroy J, Semler LN, et al. Prevention of Diabetes Through the Lifestyle Intervention: Lessons Learned from the Diabetes Prevention Program and Outcomes Study and its Translation to Practice. Curr Nutr Rep. 2014;3:364–78.CrossRefPubMedPubMedCentral
8.
go back to reference Minges KE, Magliano DJ, Owen N, Daly RM, Salmon J, Shaw JE, et al. Associations of strength training with impaired glucose metabolism: the AusDiab Study. Med Sci Sports Exerc. 2013;45:299–303.CrossRefPubMed Minges KE, Magliano DJ, Owen N, Daly RM, Salmon J, Shaw JE, et al. Associations of strength training with impaired glucose metabolism: the AusDiab Study. Med Sci Sports Exerc. 2013;45:299–303.CrossRefPubMed
9.
go back to reference Shiroma EJ, Cook NR, Manson JE, Moorthy MV, Buring JE, Rimm EB, et al. Strength Training and the Risk of Type 2 Diabetes and Cardiovascular Disease. Med Sci Sports Exerc. 2017;49:40–6.CrossRefPubMedPubMedCentral Shiroma EJ, Cook NR, Manson JE, Moorthy MV, Buring JE, Rimm EB, et al. Strength Training and the Risk of Type 2 Diabetes and Cardiovascular Disease. Med Sci Sports Exerc. 2017;49:40–6.CrossRefPubMedPubMedCentral
10.
go back to reference Lippincott W, Wilkins. ACSM’s guidelines for exercise testing and prescription. 10th ed: American College of Sports Medicine; 2016. p. 25–37. 52-4 Lippincott W, Wilkins. ACSM’s guidelines for exercise testing and prescription. 10th ed: American College of Sports Medicine; 2016. p. 25–37. 52-4
11.
go back to reference American College of Sports Medicine. American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Med Sci Sports Exerc. 2009;41:687–708. American College of Sports Medicine. American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Med Sci Sports Exerc. 2009;41:687–708.
12.
go back to reference Durstine JL, Benjamin G, Wang ZZ, Luo XJ. Chronic disease and the link to physical activity. J Sport Health Sci. 2013,2(1):3–11. Durstine JL, Benjamin G, Wang ZZ, Luo XJ. Chronic disease and the link to physical activity. J Sport Health Sci. 2013,2(1):3–11.
13.
go back to reference China MohPR. Chinese guidelines of preventing and controlling overweight and obesity in adults: People’s Medical Publishing House; 2006. p. 2–3. China MohPR. Chinese guidelines of preventing and controlling overweight and obesity in adults: People’s Medical Publishing House; 2006. p. 2–3.
15.
go back to reference Qu NN, Li KJ. Study on the reliability and validity of international physical activity questionnaire (Chinese Vision, IPAQ). Zhonghua Liu Xing Bing Xue Za Zhi. 2004;25:265–8.PubMed Qu NN, Li KJ. Study on the reliability and validity of international physical activity questionnaire (Chinese Vision, IPAQ). Zhonghua Liu Xing Bing Xue Za Zhi. 2004;25:265–8.PubMed
16.
go back to reference Jenkins NT, Hagberg JM. Aerobic training effects on glucose tolerance in prediabetic and normoglycemic humans. Med Sci Sports Exerc. 2011;43:2231–40.CrossRefPubMed Jenkins NT, Hagberg JM. Aerobic training effects on glucose tolerance in prediabetic and normoglycemic humans. Med Sci Sports Exerc. 2011;43:2231–40.CrossRefPubMed
17.
go back to reference Sepah SC, Jiang L, Peters AL. Long-term outcomes of a Web-based diabetes prevention program: 2-year results of a single-arm longitudinal study. J Med Internet Res. 2015;17:e92.CrossRefPubMedPubMedCentral Sepah SC, Jiang L, Peters AL. Long-term outcomes of a Web-based diabetes prevention program: 2-year results of a single-arm longitudinal study. J Med Internet Res. 2015;17:e92.CrossRefPubMedPubMedCentral
18.
go back to reference Simpson KA, Mavros Y, Kay S, Meiklejohn J, de Vos N, Wang Y, et al. Graded Resistance Exercise And Type 2 Diabetes in Older adults (The GREAT2DO study): methods and baseline cohort characteristics of a randomized controlled trial. Trials. 2015;16:512.CrossRefPubMedPubMedCentral Simpson KA, Mavros Y, Kay S, Meiklejohn J, de Vos N, Wang Y, et al. Graded Resistance Exercise And Type 2 Diabetes in Older adults (The GREAT2DO study): methods and baseline cohort characteristics of a randomized controlled trial. Trials. 2015;16:512.CrossRefPubMedPubMedCentral
19.
go back to reference Brown EC, Franklin BA, Regensteiner JG, Stewart KJ. Effects of single bout resistance exercise on glucose levels, insulin action, and cardiovascular risk in type 2 diabetes: A narrative review. J Diabetes Complications. 2020;34:107610.CrossRefPubMed Brown EC, Franklin BA, Regensteiner JG, Stewart KJ. Effects of single bout resistance exercise on glucose levels, insulin action, and cardiovascular risk in type 2 diabetes: A narrative review. J Diabetes Complications. 2020;34:107610.CrossRefPubMed
20.
go back to reference Liu Y, Ye W, Chen Q, Zhang Y, Kuo CH, Korivi M. Resistance Exercise Intensity is Correlated with Attenuation of HbA1c and Insulin in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2019;16:140.CrossRefPubMedPubMedCentral Liu Y, Ye W, Chen Q, Zhang Y, Kuo CH, Korivi M. Resistance Exercise Intensity is Correlated with Attenuation of HbA1c and Insulin in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2019;16:140.CrossRefPubMedPubMedCentral
21.
go back to reference Yang Z, Scott CA, Mao C, Tang J, Farmer AJ. Resistance exercise versus aerobic exercise for type 2 diabetes: a systematic review and meta-analysis. Sports Med. 2014;44:487–99.CrossRefPubMed Yang Z, Scott CA, Mao C, Tang J, Farmer AJ. Resistance exercise versus aerobic exercise for type 2 diabetes: a systematic review and meta-analysis. Sports Med. 2014;44:487–99.CrossRefPubMed
22.
go back to reference Nery C, Moraes SRA, Novaes KA, Bezerra MA, Silveira PVC, Lemos A. Effectiveness of resistance exercise compared to aerobic exercise without insulin therapy in patients with type 2 diabetes mellitus: a meta-analysis. Braz J Phys Ther. 2017;21:400–15.CrossRefPubMedPubMedCentral Nery C, Moraes SRA, Novaes KA, Bezerra MA, Silveira PVC, Lemos A. Effectiveness of resistance exercise compared to aerobic exercise without insulin therapy in patients with type 2 diabetes mellitus: a meta-analysis. Braz J Phys Ther. 2017;21:400–15.CrossRefPubMedPubMedCentral
23.
go back to reference American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37 Suppl 1:S81–90. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37 Suppl 1:S81–90.
24.
go back to reference Prior SJ, Blumenthal JB, Katzel LI, Goldberg AP, Ryan AS. Increased skeletal muscle capillarization after aerobic exercise training and weight loss improves insulin sensitivity in adults with IGT. Diabetes Care. 2014;37:1469–75.CrossRefPubMedPubMedCentral Prior SJ, Blumenthal JB, Katzel LI, Goldberg AP, Ryan AS. Increased skeletal muscle capillarization after aerobic exercise training and weight loss improves insulin sensitivity in adults with IGT. Diabetes Care. 2014;37:1469–75.CrossRefPubMedPubMedCentral
26.
go back to reference Gidlund EK, von Walden F, Venojärvi M, Risérus U, Heinonen OJ, Norrbom J, et al. Humanin skeletal muscle protein levels increase after resistance training in men with impaired glucose metabolism. Physiol Rep. 2016;4:e13063.CrossRefPubMedPubMedCentral Gidlund EK, von Walden F, Venojärvi M, Risérus U, Heinonen OJ, Norrbom J, et al. Humanin skeletal muscle protein levels increase after resistance training in men with impaired glucose metabolism. Physiol Rep. 2016;4:e13063.CrossRefPubMedPubMedCentral
27.
go back to reference Wycherley TP, Noakes M, Clifton PM, Cleanthous X, Keogh JB, Brinkworth GD. A high-protein diet with resistance exercise training improves weight loss and body composition in overweight and obese patients with type 2 diabetes. Diabetes Care. 2010;33:969–76.CrossRefPubMedPubMedCentral Wycherley TP, Noakes M, Clifton PM, Cleanthous X, Keogh JB, Brinkworth GD. A high-protein diet with resistance exercise training improves weight loss and body composition in overweight and obese patients with type 2 diabetes. Diabetes Care. 2010;33:969–76.CrossRefPubMedPubMedCentral
28.
go back to reference Pratte KA, Johnson A, Beals J, Bullock A, Manson SM, Jiang L. Regression to Normal Glucose Regulation in American Indians and Alaska Natives of a Diabetes Prevention Program. Diabetes Care. 2019;42:1209–16.CrossRefPubMedPubMedCentral Pratte KA, Johnson A, Beals J, Bullock A, Manson SM, Jiang L. Regression to Normal Glucose Regulation in American Indians and Alaska Natives of a Diabetes Prevention Program. Diabetes Care. 2019;42:1209–16.CrossRefPubMedPubMedCentral
29.
go back to reference Willey KA, Singh MA. Battling insulin resistance in elderly obese people with type 2 diabetes: bring on the heavy weights. Diabetes Care. 2003;26:1580–8.CrossRefPubMed Willey KA, Singh MA. Battling insulin resistance in elderly obese people with type 2 diabetes: bring on the heavy weights. Diabetes Care. 2003;26:1580–8.CrossRefPubMed
Metadata
Title
Effect of resistance vs. aerobic exercise in pre-diabetes: an RCT
Authors
Xijuan Luo
Zhengzhen Wang
Bowen Li
Xianbo Zhang
Xin Li
Publication date
01-12-2023
Publisher
BioMed Central
Published in
Trials / Issue 1/2023
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-023-07116-3

Other articles of this Issue 1/2023

Trials 1/2023 Go to the issue