None listed
Conditions
Brief summary
The prevalence of type 2 diabetes has almost doubled since 1981 in Australia, which has one of the highest rates recorded anywhere in the world. Diabetes carries with it a great excess of suffering, mortality, and health care costs, particularly in relation to cardiovascular disease. Although diet and aerobic exercise have been advocated as the basis of treatment for type 2 diabetes, many older adults find that losing weight is nearly impossible, and aerobic exercise regimens may be difficult to start or comply with regularly. This is often due to other medical problems such as arthritis, foot pain, walking difficulty, cardiac disease, or shortness of breath, all of which are also common in overweight adults. Therefore, diabetic drug or insulin treatment has become the primary management tool of physicians. Drugs do not typically address these underlying problems of fat, muscle and fitness, however, and therefore do not directly change the disease process or the risk of cardiovascular disease. This study will assess the benefits of weight lifting exercise on health status in older adults with type 2 diabetes. Weight lifting decreases fat and increases muscle, while making the body more sensitive to the action of insulin. Although a few studies strongly suggest that weight lifting exercise is very beneficial for diabetes and its associated conditions, there is a need for well-designed, large, long-term trials of this mode of therapy. This treatment regimen, if successful, could simultaneously improve metabolism of glucose and insulin, physical fitness, blood pressure, cardiovascular disease risk, muscle mass, and fat mass, even without an overall change in body weight. Older adults with diabetes will be randomly assigned to either supervised weight lifting or a very low intensity program with no training effect, for 3 days per week for one year, in addition to their usual health care. Measures of disease control and physical fitness will be assessed at 0, 6 and 12 months in all subjects.
Interventions
For one year, experimental subjects will receive high intensity progressive resistance training of the major muscle groups 3 days per week using pneumatic resistance equipment, under supervision, in a community exercise facility. The exercises targeted include the majority of the large muscle groups: chest press, upper back, leg press, knee extension, hip extension, hip flexion and hip abduction. For each exercise, subjects will perform 3 sets of 8 repetitions with a fast concentric and slow ecc
For one year, experimental subjects will receive high intensity progressive resistance training of the major muscle groups 3 days per week using pneumatic resistance equipment, under supervision, in a community exercise facility. The exercises targeted include the majority of the large muscle groups: chest press, upper back, leg press, knee extension, hip extension, hip flexion and hip abduction. For each exercise, subjects will perform 3 sets of 8 repetitions with a fast concentric and slow eccentric phase on pneumatic resistance training machines (approximately 6 seconds per repetition, with 2 minutes of rest between sets), a regimen which has been shown to produce optimum adaptations in terms of fat, muscle, and lean mass, muscle power, strength, endurance, balance, depression, glucose homeostasis, and adiponectin increase in older adults. The intensity will be set at 80% of peak strength determined by the most recent 1 repetition maximum (1RM). Resistances used will be increased as tolerated using Borg scale rating of perceived exertion on a continuous basis throughout the 12 months, and 1RM testing will be repeated at 4-week intervals to ascertain progress and regulate intensity. Subjects will be followed for five years after the initial 12 months to track changes in lifestyle and clinical outcomes.
Sponsors
Diabetes Australia
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Community dwelling men and women previously diagnosed with type 2 diabetes and meeting the current definition of metabolic syndrome according to the International Diabetes Federation. Subjects may be treated with diet alone, insulin or oral medications, or a combination of these treatments at the time of enrolment.
Exclusion criteria
Any change in type or dosage of diabetic medication in past 3 months, current fasting glucose > 11.1mmol/l,significant cognitive impairment, non-ambulatory status or lower extremity amputation other than toes, alcohol or substance abuse or specific contraindications to resistance training such as unstable cardiovascular disease, aortic aneurysm, symptomatic hernias, proliferative diabetic retinopathy, uncontrolled hypertension or rapidlyprogressive terminal illness.
Outcome results
None listed