Effect of high- versus low-intensity supervised aerobic and resistance training on modifiable cardiovascular risk factors in type 2 diabetes; the Italian Diabetes and Exercise Study (IDES).

BACKGROUND: While current recommendations on exercise type and volume have strong experimental bases, there is no clear evidence from large-sized studies indicating whether increasing training intensity provides additional benefits to subjects with type 2 diabetes. OBJECTIVE: To compare the effects...

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Main Authors: Stefano Balducci, Silvano Zanuso, Patrizia Cardelli, Laura Salvi, Alessandra Bazuro, Luca Pugliese, Carla Maccora, Carla Iacobini, Francesco G Conti, Antonio Nicolucci, Giuseppe Pugliese, Italian Diabetes Exercise Study (IDES) Investigators
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2012-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3504024?pdf=render
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spelling doaj-36a63c749a6144889019d676296f4da12020-11-25T00:11:16ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-01711e4929710.1371/journal.pone.0049297Effect of high- versus low-intensity supervised aerobic and resistance training on modifiable cardiovascular risk factors in type 2 diabetes; the Italian Diabetes and Exercise Study (IDES).Stefano BalducciSilvano ZanusoPatrizia CardelliLaura SalviAlessandra BazuroLuca PuglieseCarla MaccoraCarla IacobiniFrancesco G ContiAntonio NicolucciGiuseppe PuglieseItalian Diabetes Exercise Study (IDES) InvestigatorsBACKGROUND: While current recommendations on exercise type and volume have strong experimental bases, there is no clear evidence from large-sized studies indicating whether increasing training intensity provides additional benefits to subjects with type 2 diabetes. OBJECTIVE: To compare the effects of moderate-to-high intensity (HI) versus low-to-moderate intensity (LI) training of equal energy cost, i.e. exercise volume, on modifiable cardiovascular risk factors. DESIGN: Pre-specified sub-analysis of the Italian Diabetes and Exercise Study (IDES), a randomized multicenter prospective trial comparing a supervised exercise intervention with standard care for 12 months (2005-2006). SETTING: Twenty-two outpatient diabetes clinics across Italy. PATIENTS: Sedentary patients with type 2 diabetes assigned to twice-a-week supervised progressive aerobic and resistance training plus exercise counseling (n = 303). INTERVENTIONS: Subjects were randomized by center to LI (n = 142, 136 completed) or HI (n = 161, 152 completed) progressive aerobic and resistance training, i.e. at 55% or 70% of predicted maximal oxygen consumption and at 60% or 80% of predicted 1-Repetition Maximum, respectively, of equal volume. MAIN OUTCOME MEASURE(S): Hemoglobin (Hb) A(1c) and other cardiovascular risk factors; 10-year coronary heart disease (CHD) risk scores. RESULTS: Volume of physical activity, both supervised and non-supervised, was similar in LI and HI participants. Compared with LI training, HI training produced only clinically marginal, though statistically significant, improvements in HbA(1c) (mean difference -0.17% [95% confidence interval -0.44,0.10], P = 0.03), triglycerides (-0.12 mmol/l [-0.34,0.10], P = 0.02) and total cholesterol (-0.24 mmol/l [-0.46, -0.01], P = 0.04), but not in other risk factors and CHD risk scores. However, intensity was not an independent predictor of reduction of any of these parameters. Adverse event rate was similar in HI and LI subjects. CONCLUSIONS: Data from the large IDES cohort indicate that, in low-fitness individuals such as sedentary subjects with type 2 diabetes, increasing exercise intensity is not harmful, but does not provide additional benefits on cardiovascular risk factors. TRIAL REGISTRATION: www.ISRCTN.org ISRCTN-04252749.http://europepmc.org/articles/PMC3504024?pdf=render
collection DOAJ
language English
format Article
sources DOAJ
author Stefano Balducci
Silvano Zanuso
Patrizia Cardelli
Laura Salvi
Alessandra Bazuro
Luca Pugliese
Carla Maccora
Carla Iacobini
Francesco G Conti
Antonio Nicolucci
Giuseppe Pugliese
Italian Diabetes Exercise Study (IDES) Investigators
spellingShingle Stefano Balducci
Silvano Zanuso
Patrizia Cardelli
Laura Salvi
Alessandra Bazuro
Luca Pugliese
Carla Maccora
Carla Iacobini
Francesco G Conti
Antonio Nicolucci
Giuseppe Pugliese
Italian Diabetes Exercise Study (IDES) Investigators
Effect of high- versus low-intensity supervised aerobic and resistance training on modifiable cardiovascular risk factors in type 2 diabetes; the Italian Diabetes and Exercise Study (IDES).
PLoS ONE
author_facet Stefano Balducci
Silvano Zanuso
Patrizia Cardelli
Laura Salvi
Alessandra Bazuro
Luca Pugliese
Carla Maccora
Carla Iacobini
Francesco G Conti
Antonio Nicolucci
Giuseppe Pugliese
Italian Diabetes Exercise Study (IDES) Investigators
author_sort Stefano Balducci
title Effect of high- versus low-intensity supervised aerobic and resistance training on modifiable cardiovascular risk factors in type 2 diabetes; the Italian Diabetes and Exercise Study (IDES).
title_short Effect of high- versus low-intensity supervised aerobic and resistance training on modifiable cardiovascular risk factors in type 2 diabetes; the Italian Diabetes and Exercise Study (IDES).
title_full Effect of high- versus low-intensity supervised aerobic and resistance training on modifiable cardiovascular risk factors in type 2 diabetes; the Italian Diabetes and Exercise Study (IDES).
title_fullStr Effect of high- versus low-intensity supervised aerobic and resistance training on modifiable cardiovascular risk factors in type 2 diabetes; the Italian Diabetes and Exercise Study (IDES).
title_full_unstemmed Effect of high- versus low-intensity supervised aerobic and resistance training on modifiable cardiovascular risk factors in type 2 diabetes; the Italian Diabetes and Exercise Study (IDES).
title_sort effect of high- versus low-intensity supervised aerobic and resistance training on modifiable cardiovascular risk factors in type 2 diabetes; the italian diabetes and exercise study (ides).
publisher Public Library of Science (PLoS)
series PLoS ONE
issn 1932-6203
publishDate 2012-01-01
description BACKGROUND: While current recommendations on exercise type and volume have strong experimental bases, there is no clear evidence from large-sized studies indicating whether increasing training intensity provides additional benefits to subjects with type 2 diabetes. OBJECTIVE: To compare the effects of moderate-to-high intensity (HI) versus low-to-moderate intensity (LI) training of equal energy cost, i.e. exercise volume, on modifiable cardiovascular risk factors. DESIGN: Pre-specified sub-analysis of the Italian Diabetes and Exercise Study (IDES), a randomized multicenter prospective trial comparing a supervised exercise intervention with standard care for 12 months (2005-2006). SETTING: Twenty-two outpatient diabetes clinics across Italy. PATIENTS: Sedentary patients with type 2 diabetes assigned to twice-a-week supervised progressive aerobic and resistance training plus exercise counseling (n = 303). INTERVENTIONS: Subjects were randomized by center to LI (n = 142, 136 completed) or HI (n = 161, 152 completed) progressive aerobic and resistance training, i.e. at 55% or 70% of predicted maximal oxygen consumption and at 60% or 80% of predicted 1-Repetition Maximum, respectively, of equal volume. MAIN OUTCOME MEASURE(S): Hemoglobin (Hb) A(1c) and other cardiovascular risk factors; 10-year coronary heart disease (CHD) risk scores. RESULTS: Volume of physical activity, both supervised and non-supervised, was similar in LI and HI participants. Compared with LI training, HI training produced only clinically marginal, though statistically significant, improvements in HbA(1c) (mean difference -0.17% [95% confidence interval -0.44,0.10], P = 0.03), triglycerides (-0.12 mmol/l [-0.34,0.10], P = 0.02) and total cholesterol (-0.24 mmol/l [-0.46, -0.01], P = 0.04), but not in other risk factors and CHD risk scores. However, intensity was not an independent predictor of reduction of any of these parameters. Adverse event rate was similar in HI and LI subjects. CONCLUSIONS: Data from the large IDES cohort indicate that, in low-fitness individuals such as sedentary subjects with type 2 diabetes, increasing exercise intensity is not harmful, but does not provide additional benefits on cardiovascular risk factors. TRIAL REGISTRATION: www.ISRCTN.org ISRCTN-04252749.
url http://europepmc.org/articles/PMC3504024?pdf=render
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