Lisa Van Ryckeghem1,2, Charly Keytsman3,4, Jana De Brandt3,4, Kenneth Verboven3,4, Elvire Verbaanderd5, Nastasia Marinus3,4, Wouter M A Franssen3,4, Ines Frederix4,6,7,8, Elise Bakelants6,9, Thibault Petit6,10, Siddharth Jogani6, Sarah Stroobants6, Paul Dendale4,6, Virginie Bito4, Jan Verwerft6, Dominique Hansen3,4,6. 1. REVAL-Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan, Building A, 3590, Diepenbeek, Belgium. lisavanryckeghem@hotmail.com. 2. BIOMED-Biomedical Research Centre, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium. lisavanryckeghem@hotmail.com. 3. REVAL-Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan, Building A, 3590, Diepenbeek, Belgium. 4. BIOMED-Biomedical Research Centre, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium. 5. Physical Activity, Sport and Health Research Group, Faculty of Movement Sciences, KU Leuven, Leuven, Belgium. 6. Department of Cardiology, Virga Jessa Hospital, Heart Centre Hasselt, Hasselt, Belgium. 7. Faculty of Medicine and Health Sciences, Antwerp University, Antwerp, Belgium. 8. Department of Cardiology, Antwerp University Hospital, Edegem, Belgium. 9. Hôpitaux Universitaires de Genève (HUG), Geneva, Switzerland. 10. Department of Cardiology, Hospital Oost-Limburg, Genk, Belgium.
Abstract
PURPOSE: Exercise training improves exercise capacity in type 2 diabetes mellitus (T2DM). It remains to be elucidated whether such improvements result from cardiac or peripheral muscular adaptations, and whether these are intensity dependent. METHODS: 27 patients with T2DM [without known cardiovascular disease (CVD)] were randomized to high-intensity interval training (HIIT, n = 15) or moderate-intensity endurance training (MIT, n = 12) for 24 weeks (3 sessions/week). Exercise echocardiography was applied to investigate cardiac output (CO) and oxygen (O2) extraction during exercise, while exercise capacity [([Formula: see text] (mL/kg/min)] was examined via cardiopulmonary exercise testing at baseline and after 12 and 24 weeks of exercise training, respectively. Changes in glycaemic control (HbA1c and glucose tolerance), lipid profile and body composition were also evaluated. RESULTS: 19 patients completed 24 weeks of HIIT (n = 10, 66 ± 11 years) or MIT (n = 9, 61 ± 5 years). HIIT and MIT similarly improved glucose tolerance (pTime = 0.001, pInteraction > 0.05), [Formula: see text] (mL/kg/min) (pTime = 0.001, pInteraction > 0.05), and exercise performance (Wpeak) (pTime < 0.001, pInteraction > 0.05). O2 extraction increased to a greater extent after 24 weeks of MIT (56.5%, p1 = 0.009, pTime = 0.001, pInteraction = 0.007). CO and left ventricular longitudinal strain (LS) during exercise remained unchanged (pTime > 0.05). A reduction in HbA1c was correlated with absolute changes in LS after 12 weeks of MIT (r = - 0.792, p = 0.019, LS at rest) or HIIT (r = - 0.782, p = 0.038, LS at peak exercise). CONCLUSION: In patients with well-controlled T2DM, MIT and HIIT improved exercise capacity, mainly resulting from increments in O2 extraction capacity, rather than changes in cardiac output. In particular, MIT seemed highly effective to generate these peripheral adaptations. TRIAL REGISTRATION: NCT03299790, initially released 09/12/2017.
PURPOSE: Exercise training improves exercise capacity in type 2 diabetes mellitus (T2DM). It remains to be elucidated whether such improvements result from cardiac or peripheral muscular adaptations, and whether these are intensity dependent. METHODS: 27 patients with T2DM [without known cardiovascular disease (CVD)] were randomized to high-intensity interval training (HIIT, n = 15) or moderate-intensity endurance training (MIT, n = 12) for 24 weeks (3 sessions/week). Exercise echocardiography was applied to investigate cardiac output (CO) and oxygen (O2) extraction during exercise, while exercise capacity [([Formula: see text] (mL/kg/min)] was examined via cardiopulmonary exercise testing at baseline and after 12 and 24 weeks of exercise training, respectively. Changes in glycaemic control (HbA1c and glucose tolerance), lipid profile and body composition were also evaluated. RESULTS: 19 patients completed 24 weeks of HIIT (n = 10, 66 ± 11 years) or MIT (n = 9, 61 ± 5 years). HIIT and MIT similarly improved glucose tolerance (pTime = 0.001, pInteraction > 0.05), [Formula: see text] (mL/kg/min) (pTime = 0.001, pInteraction > 0.05), and exercise performance (Wpeak) (pTime < 0.001, pInteraction > 0.05). O2 extraction increased to a greater extent after 24 weeks of MIT (56.5%, p1 = 0.009, pTime = 0.001, pInteraction = 0.007). CO and left ventricular longitudinal strain (LS) during exercise remained unchanged (pTime > 0.05). A reduction in HbA1c was correlated with absolute changes in LS after 12 weeks of MIT (r = - 0.792, p = 0.019, LS at rest) or HIIT (r = - 0.782, p = 0.038, LS at peak exercise). CONCLUSION: In patients with well-controlled T2DM, MIT and HIIT improved exercise capacity, mainly resulting from increments in O2 extraction capacity, rather than changes in cardiac output. In particular, MIT seemed highly effective to generate these peripheral adaptations. TRIAL REGISTRATION: NCT03299790, initially released 09/12/2017.
Authors: D Hansen; P Dendale; R A M Jonkers; M Beelen; R J F Manders; L Corluy; A Mullens; J Berger; R Meeusen; L J C van Loon Journal: Diabetologia Date: 2009-04-16 Impact factor: 10.122
Authors: Siri M Hollekim-Strand; Marit R Bjørgaas; Grethe Albrektsen; Arnt E Tjønna; Ulrik Wisløff; Charlotte B Ingul Journal: J Am Coll Cardiol Date: 2014-10-21 Impact factor: 24.094
Authors: Dominique Hansen; Paul Dendale; Karin Coninx; Luc Vanhees; Massimo F Piepoli; Josef Niebauer; Veronique Cornelissen; Roberto Pedretti; Eva Geurts; Gustavo R Ruiz; Ugo Corrà; Jean-Paul Schmid; Eugenio Greco; Constantinos H Davos; Frank Edelmann; Ana Abreu; Bernhard Rauch; Marco Ambrosetti; Simona S Braga; Olga Barna; Paul Beckers; Maurizio Bussotti; Robert Fagard; Pompilio Faggiano; Esteban Garcia-Porrero; Evangelia Kouidi; Michel Lamotte; Daniel Neunhäuserer; Rona Reibis; Martijn A Spruit; Christoph Stettler; Tim Takken; Cajsa Tonoli; Carlo Vigorito; Heinz Völler; Patrick Doherty Journal: Eur J Prev Cardiol Date: 2017-04-18 Impact factor: 7.804