None listed
Conditions
Brief summary
People with type 2 diabetes require a disproportionate amount of New Zealand’s medical resources. These patients are twice as likely to have cardiovascular and cerebrovascular disease as non-diabetics. In fact, 65% of cardiovascular and cerebrovascular disease admissions are people with type 2 diabetes, and account for ~30% of inpatient hospitalisation cost, which is predicted to increase in the future. Therefore, prevention of diabetic cerebrovascular disease is important for directing the development of preventative strategies to mitigate the social and economic burden for New Zealand. Stroke the most severe outcome of cerebrovascular disease causes prolonged morbidity and consumes ~$50,000 per case. We know that people with diabetes are twice as likely to suffer from a stroke, which may be caused by alterations in brain blood flow or its reserve that appears to occur in people with diabetes. These changes elevate the risk of cerebrovascular disease including stroke in other populations. In addition, there is indirect evidence that brain blood flow is perturbed with diabetes, with multiple studies showing cognitive function is more commonly impaired. Impaired cognitive function is associated with reduced and/or abnormal brain blood flow in other populations. Three months of exercise training in healthy but previously sedentary people improves cognitive function, brain blood flow and its reserve. However the effect of exercise on brain blood flow has not been tested in people with diabetes. The clinical high-intensity exercise programme our laboratory uses, may offer a simple tool to improve brain blood flow, cognitive function and reduce the risk of cerebrovascular disease in people suffering from type 2 diabetes. Our research group has recently used HIT to improve daily blood glucose in a small group of pre-diabetic participants. High-intensity interval training interspaces bursts of intense exercise reaching 90% of individual maximum heart rates with periods of exercise at lower intensities. Importantly, HIT improves blood glucose and fitness more than traditional exercise recommendations, and seems to be more popular. We now propose to enrol diagnosed diabetic patients in a six month HIT program to test the hypothesis that this popular exercise method can improve brain blood flow, cognitive function and reduce cerebrovascular disease risk.
Interventions
Participants will be randomised to six months of high-intensity interval training will be compared to standard clinical management. For the first two months, the participants will be supervised by an exercise physiologist during exercise three times a week after which the participants will be encouraged to complete at least one session a week on their own (not compulsory). Cycling on a stationary ergometer will be completed during the supervised session at the School of Physical Education Sports
Participants will be randomised to six months of high-intensity interval training will be compared to standard clinical management. For the first two months, the participants will be supervised by an exercise physiologist during exercise three times a week after which the participants will be encouraged to complete at least one session a week on their own (not compulsory). Cycling on a stationary ergometer will be completed during the supervised session at the School of Physical Education Sports and Exercise Science, University of Otago, Dunedin. If the participants decide to complete a session on their own, they will be free to undertake an exercise modality of their choice as long as they are following the high-intensity interval protocol which is provided as an attachment. The sessions last for 20 – 30 min including a short warm up and cool down. The high-intensity interval training protocol is graduated targeting a heart rate of 90% of their age-predicted max (220 – age) see attached protocol which is attached to the ANZCTR registration form, interspaced lower intensity exercise which is participant self-selected. The participant’s heart rates will be recorded for each session using individualised Polar Heart Rate monitors. The Polar Heart Rate monitors are given to the participants randomised to high-intensity interval training for the duration of the study. These recordings will be used to assess adherence and compliance to the training protocol. The participants will be contacted by study personnel at least on a weekly basis in the high-intensity interval group.
Sponsors
University of Otago
Study design
Allocation
Randomised controlled trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
40 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
For those who identify as having type 2 diabetes. Confirmed diagnosis of Type 2 diabetes Aged between 40 - 65 years Able to give informed consent For those who identify as healthy volunteers. Aged between 40 - 65 years Able to give informed consent
Exclusion criteria
For those who identify as having type 2 diabetes. Unable to give informed consent Any pre-existing cardiovascular and cerebrovascular disease and peripheral neuropathy Currently treated with beta-blocker or rate control therapy For those who identify as healthy volunteers. Found to have undiagnosed type 2 diabetes. Unable to give informed consent Any pre-existing cardiovascular and cerebrovascular disease and peripheral neuropathy Currently treated with beta-blocker or rate control therapy
Outcome results
None listed