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Fitness & Exercise for Senior Citizens
Aerobic, Strength Training Greatly Improve Diabetes
Numbers
Best results in blood sugar control is combined
aerobic and resistance exercise
 Sept. 18, 2007 – A combination of aerobic exercise
and resistance training was the best help for people with type 2
diabetes on improving blood sugar control, according to the results of a
new study. Diabetes is a major chronic disease among senior citizens and
adults up to age 70 were included in this study.
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The study included 251 adults, between ages 39 and
70, who were not exercising regularly and had type 2 diabetes.
Participants were assigned to one of four groups: performing 45 minutes
of aerobic training three times per week, 45 minutes of resistance
training three times per week, 45 minutes each of both three times per
week, or no exercise.
Each participant was evaluated on changes in A1c
value, a number that reflects blood sugar concentrations over the
previous two or three months, and is expressed as a percent. An absolute
decrease of 1.0 percent in A1c value (e.g. from 8.5 percent to 7.5
percent) would be associated with a 15 percent to 20 percent decrease in
risk of heart attack or stroke, and a 25 percent to 40 percent decrease
in risk of diabetes-related eye disease or kidney disease.
Both the aerobic and the resistance training groups
had improved blood sugar control; their A1c values decreased by about
0.5 percent. The group that did both kinds of exercise had about twice
as much improvement as either of the other group alone; A1c value
decreased by 0.97 percent compared to the control group. The control
group, which did not exercise, had no change in A1c value.
"We know that aerobic exercise improves glycemic
control," said Ronald Sigal, MD, the lead author of the study. "But we
didn't know much about what kind of exercise is the most beneficial and
how much of it. In particular not much was known about resistance
exercises when we started planning this study. At the time, some thought
that resistance exercise is not useful or is even dangerous for some
people with diabetes."
Dr. Sigal, now an associate professor of medicine
and cardiac sciences at University of Calgary, oversaw the 26-week
study, conducted in centers in Canada.
"And even for people who had fairly good blood
sugar control at the beginning of our study, those who did both aerobic
and resistance exercise had further improvements in glucose control."
"The bottom line," said Dr. Sigal, "is that doing
both aerobic and resistance exercise is the way to maximize the effects
of exercise on blood glucose control in type 2 diabetes."
In an accompanying editorial, William E. Kraus, MD,
and Benjamin D. Levine, MD, say, "Imagine an inexpensive pill that could
decrease the hemoglobin A1c value by 1 percentage point, reduce
cardiovascular death by 25 percent, and substantially improve functional
capacity (strength, endurance, and bone density). Diabetes experts would
be quick to incorporate this pill into practice guidelines and
performance measures for diabetes. (These) study results should simulate
all clinicians to include exercise assessment and counseling into every
clinic visit."
The study, "Effects of Aerobic Training, Resistance
Training, or Both on Glycemic Control in Type 2 Diabetes," and the
editorial, "Exercise Training for Diabetes: The 'Strength' of the
Evidence," will be published in the in the Sept. 18, 2007, edition of
Annals of Internal Medicine.
Annals of Internal Medicine (www.annals.org) is one of the most
widely cited peer-reviewed medical journals in the world. The journal
has been published for 80 years and accepts only seven percent of the
original research studies submitted for publication. Annals of Internal
Medicine is published by the
American College of Physicians (www.acponline.org), the largest
medical specialty organization and the second-largest physician group in
the United States.
ACP members include 124,000 internal medicine
physicians (internists), related subspecialists, and medical students.
Internists specialize in the prevention, detection, and treatment of
illness in adults.
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