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- Title
Changes in insulin resistance and HbA1c are related to exercise-mediated changes in body composition in older adults with type 2 diabetes: interim outcomes from the GREAT2DO trial.
- Authors
Mavros, Yorgi; Kay, Shelley; Anderberg, Kylie A; Baker, Michael K; Wang, Yi; Zhao, Renru; Meiklejohn, Jacinda; Climstein, Mike; O'Sullivan, Anthony; de Vos, Nathan; Baune, Bernhard T; Blair, Steven N; Simar, David; Rooney, Kieron; Singh, Nalin; Fiatarone Singh, Maria A
- Abstract
<bold>Objective: </bold>To investigate changes in body composition after 12 months of high-intensity progressive resistance training (PRT) in relation to changes in insulin resistance (IR) or glucose homeostasis in older adults with type 2 diabetes.<bold>Research Design and Methods: </bold>One-hundred three participants were randomized to receive either PRT or sham exercise 3 days per week for 12 months. Homeostasis model assessment 2 of insulin resistance (HOMA2-IR) and glycosylated hemoglobin (HbA1c) were used as indices of IR and glucose homeostasis. Skeletal muscle mass (SkMM) and total fat mass were assessed using bioelectrical impedance. Visceral adipose tissue, mid-thigh cross-sectional area, and mid-thigh muscle attenuation were quantified using computed tomography.<bold>Results: </bold>Within the PRT group, changes in HOMA2-IR were associated with changes in SkMM (r = -0.38; P = 0.04) and fat mass (r = 0.42; P = 0.02). Changes in visceral adipose tissue tended to be related to changes in HOMA2-IR (r = 0.35; P = 0.07). Changes in HbA1c were related to changes in mid-thigh muscle attenuation (r = 0.52; P = 0.001). None of these relationships were present in the sham group (P > 0.05). Using ANCOVA models, participants in the PRT group who had increased SkMM had decreased HOMA2-IR (P = 0.05) and HbA1c (P = 0.09) compared with those in the PRT group who lost SkMM. Increases in SkMM in the PRT group decreased HOMA2-IR (P = 0.07) and HbA1c (P < 0.05) compared with those who had increased SkMM in the sham group.<bold>Conclusions: </bold>Improvements in metabolic health in older adults with type 2 diabetes were mediated through improvements in body composition only if they were achieved through high-intensity PRT.
- Publication
Diabetes Care, 2013, Vol 36, Issue 8, p2372
- ISSN
0149-5992
- Publication type
journal article
- DOI
10.2337/dc12-2196