Resumen de Metabolic Effects of Aerobic Training and Resistance Training in Type 2 Diabetic Subjects: A randomized controlled trial (the RAED2 study)
Elisabetta Bacchi, Carlo Negri, Maria Elisabetta Zanolin, Chiara Milanese, Niccolò Faccioli, Maddalena Trombetta, Giacomo Zoppini, Antonio Cevese, Riccardo C Bonadonna, Federico Schena, Enzo Bonora, Massimo Lanza, P. Moghetti
To assess differences between the effects of aerobic and resistance training on HbA^sub 1c^ (primary outcome) and several metabolic risk factors in subjects with type 2 diabetes, and to identify predictors of exercise-induced metabolic improvement. Type 2 diabetic patients (n = 40) were randomly assigned to aerobic training or resistance training. Before and after 4 months of intervention, metabolic phenotypes (including HbA^sub 1c^, glucose clamp-measured insulin sensitivity, and oral glucose tolerance test-assessed ß-cell function), body composition by dual-energy X-ray absorptiometry, visceral (VAT) and subcutaneous (SAT) adipose tissue by magnetic resonance imaging, cardiorespiratory fitness, and muscular strength were measured. After training, increase in peak oxygen consumption (VO^sub 2peak^) was greater in the aerobic group (time-by-group interaction P = 0.045), whereas increase in strength was greater in the resistance group (time-by-group interaction P < 0.0001). HbA^sub 1c^ was similarly reduced in both groups (-0.40% [95% CI -0.61 to -0.18] vs. -0.35% [-0.59 to -0.10], respectively). Total and truncal fat, VAT, and SAT were also similarly reduced in both groups, whereas insulin sensitivity and lean limb mass were similarly increased. ß-Cell function showed no significant changes. In multivariate analyses, improvement in HbA^sub 1c^ after training was independently predicted by baseline HbA^sub 1c^ and by changes in VO^sub 2peak^ and truncal fat. Resistance training, similarly to aerobic training, improves metabolic features and insulin sensitivity and reduces abdominal fat in type 2 diabetic patients. Changes after training in VO^sub 2peak^ anc^ truncal fat may be primary determinants of exercise-induced metabolic improvement.
