Diabetes Mellitus, Type 2
Conditions
Keywords
Vitamin D, Aerobic training, Resistance training, Insulin resistance
Brief summary
The purpose of this study protocol is to assess the effect of concurrent aerobic and resistance training in patients with type 2 diabetes on vitamin D treatment
Detailed description
Aerobic and resistance training can effectively improve clinical management in people with type 2 diabetes (T2D), leading to improvements in various health parameters, including cardiovascular health, insulin sensitivity, and muscle mass. Low vitamin D (VitD) levels are associated with T2D risk and metabolic disturbances, and some studies suggest that VitD may help reduce this risk, particularly in individuals with low VitD levels. In this line, it is widely recognized that many individuals with T2D, who may also be elderly or have osteoporosis, regularly include vitamin D treatment in their healthcare routines. Although the impact of exercise has been extensively studied, its effect on diabetic patients taking vitamin D remains inconclusive due to limited and inconsistent research findings. The aim of this study is to investigate the effect of aerobic and resistance training on clinical parameters in patients with T2D already taking VitD. The DIAVITEX study is a double-blind randomized clinical trial, including 80 individuals of both sexes (female, male) with a confirmed diagnosis of T2D and on a VitD treatment where a combination of exercises will be performed. Patients will be selected at the Primary Care Centers assigned for the study and randomly assigned to four groups: 1-Training-VitD (n=20); 2- Training (n=20), 3- VitD (n=20) and 4- No VitD (n=20). In this study, a sarcoplasm stimulating training program will be carried out online, three sessions per week for a total of 16 weeks. Before and after the physical activity subjects will perform fitness tests, as well as analysis of glycated hemoglobin, insulin resistance, lipid profile and blood inflammatory biomarkers. Nutritional education programs based on the Spanish Society of Diabetes will be provided to all participants to normalize their diets for study consistency. Expected improvements in insulin resistance, glycated hemoglobin, lipid profile, and inflammatory markers are anticipated following a 16-week regimen of exercise in patients with T2D on VitD.
Interventions
OTHERResistance training
Sarcoplasm stimulating training system. This program will run for a total of 16 weeks and three sessions a week. This exercise plan is designed in three 5-week periods plus a familiarization session.
Sponsors
University of Barcelona
Islamic Azad University, Sanandaj
Fundacio d'Investigacio en Atencio Primaria Jordi Gol i Gurina
Institut Català de la Salut
University Ramon Llull
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
40 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults (females or males) older than 18 years old with a diagnosis of T2D in the clinic database * Patients who have been taking the combination therapy of metformin + sodium-glucose transport protein 2 inhibitors (iSGLT2), as recommended by the redGDPS 2023, with stable medication for the past 6 months. * Diabetic patients taking prescribed VitD treatment for at least 6 months (intervention group) and diabetic patients not taking prescribed VitD (control group) * Patients who signed the informed consent * Patients capable of performing mild to moderate physical activity (to walk steadily and independently for at least 6 minutes)
Exclusion criteria
* Patients taking other medication different than metformin + iSGLT2 (including combinations and insulin) * Patients taking polyvitaminic supplementation at the inclusion for at least, 1 month before the intervention * Female subjects who are pregnant * Patients who did not sign the informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Vitamin D | Beginning of the study | Determination of Vitamin D levels in blood (ng/mL) |
| Change in serum lipid profile | Beginning of the study and after 4 months | Total cholesterol and High-density lipoprotein (HDL) cholesterol and triglyceride levels (mg/dL). Analysis ill be performed by the fully automatic Mindray BS380 using photometry-fixed time and point turbidimetry. |
| Change in weight | Beginning of the study and after 4 months | Anthropometric measurements (weight in kilograms) |
| Change in waist circumference | Beginning of the study and after 4 months | Anthropometric measurements (waist circumference in centimetre) |
| Change in Body Mass Index (BMI) | Beginning of the study and after 4 months | (BMI \[weight and height will be combined to report BMI\] in kg/m2 |
| Change in Homeostatic Model Assessment of Insulin Resistance (HOMA IR) | Beginning of the study and after 4 months | HOMA-IR index will be calculated by using formula (HOMA-IR=fasting glucose in mmol/l\*fasting insulin in μU/ml/22.5) to determine insulin resistance |
| Change in Homeostasis model assessment of β-cell function (HOMA-β) | Beginning of the study and after 4 months | The HOMA-B index will be used to quantify the pancreatic beta cells function (HOMA-B360 x fasting insulin (μU/mL) / (fasting glucose (mg/dL) - 63)). |
| Change in serum levels of Hemoglobin A1c. | Beginning of the study and after 4 months | Serum levels of hemoglobin A1c will be tested in the laboratory from blood draws conducted at initial visit from a fasting blood sample. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Activity degree | Beginning of the study | To evaluate the degree of activity, the International Physical Activity Questionnaire (IPAQ) will be administered to measure the physical activity, which through an interview assessing different items will allow to obtain the usual physical activity, being able to classify individuals in sedentary, moderate sedentary or active lifestyles. The IPAQ questionnaires quantifies the activity: walk, activities of moderate intensity and vigorous intensity activities assigned to each activity about energy requirements defined in metabolic equivalent tasks (METs), being multiples of the rate of metabolic rate equivalent to kilocalories for a 60 kg. |
| Psychological Well-being | Beginning of the study | The psychological subjective welfare will be measured through the Psychological Well-being Index, which refers to happiness or well-being. A 42-item self-rating scale, which includes six dimensions: self-acceptance, positive relations with others, autonomy, environmental mastery, purpose in life and personal growth. The respondents are asked to indicate on a 6-likert scale the extent to which they agree with each statement. Each dimension may range from 7-42, with higher scores indicating greater psychological well-being. |
| Food consumption and adherence to the Mediterranean diet | Beginning of the study | A 14-item questionnaire designed to assess adherence to the traditional Mediterranean Diet will be administered. Values of 0 or 1 are assigned to each item, the maximum adherence to the Mediterranean Diet is indicated by a 14-point score. A validated food frequency questionnaire with 140 items will also be administered |
| Sociodemographic data | Beginning of the study | Sociodemographic data (age, sex, ethnicity, occupation, employment status, education level, household income, alcohol intake, smoking status, current medications, family medical history, current medications taken) via questionnaire. Additionally, participants may be required to list answers to the questions e.g. list any current medications taken or age. This will all be measured in the baseline case report form. |
Countries
Spain
Contacts
Primary ContactJoel Montane, PhD
Outcome results
None listed