(Press-News.org) Performing a combination of aerobic exercise and resistance training was associated with improved glycemic levels among patients with type 2 diabetes, compared to patients who did not exercise, according to a study in the November 24 issue of JAMA. The level of improvement was not seen among patients who performed either aerobic exercise or resistance training alone.
Although it is generally accepted that regular exercise provides substantial health benefits for individuals with type 2 diabetes, the exact exercise type (aerobic vs. resistance vs. both) has been unclear. "Given that the 2008 Federal Physical Activity Guidelines recommend aerobic exercise in combination with resistance training, the unanswered question as to whether for a given amount of time the combination of aerobic and resistance exercise is better than either alone has significant clinical and public health importance," the authors write.
Timothy S. Church, M.D., M.P.H., Ph.D., of Louisiana State University System, Baton Rouge, La., and colleagues conducted the HART-D trial, which compared among 262 sedentary women and men with type 2 diabetes the effect of aerobic training, resistance training, and a combination of both on change in hemoglobin A1c levels (HbA1c; a minor component of hemoglobin [the substance of red blood cells that carries oxygen to the cells] and to which glucose [blood sugar] is bound; HbA1c levels are used to monitor the control of diabetes mellitus). Study participants were 63.0 percent women, 47.3 percent nonwhite, average age of 56 years, HbA1c level of 7.7 percent and duration of diabetes of 7.1 years. The individuals were enrolled in the 9-month exercise program between April 2007 and August 2009. Forty-one participants were assigned to the nonexercise control group; 73 to resistance training sessions; 72 to aerobic exercise sessions; and 76 to combined aerobic and resistance training.
The researchers found that the absolute change in HbA1c in the combination training group vs. the control group was -0.34 percent. In neither the resistance training (-0.16 percent) nor the aerobic (-0.24 percent) groups were changes in HbA1c significant compared with those in the control group. The prevalence of increases in hypoglycemic medications were 39 percent in the control, 32 percent in the resistance training, 22 percent in the aerobic, and 18 percent in the combination training groups.
"Only the combination exercise group improved maximum oxygen consumption compared with the control group. All exercise groups reduced waist circumference from [-.75 to -1.1 inches] compared with the control group," the authors write. The resistance training group lost an average of 3.1 lbs. fat mass and the combination training group lost an average of 3.7 lbs., compared with the control group.
"The primary finding from this randomized, controlled exercise trial involving individuals with type 2 diabetes is that although both resistance and aerobic training provide benefits, only the combination of the 2 were associated with reductions in HbA1c levels," the researchers write. "It also is important to appreciate that the follow-up difference in HbA1c between the combination training group and the control group occurred even though the control group had increased its use of diabetes medications while the combination training group decreased its diabetes medication uses."
(JAMA. 2010;304[20]:2253-2262. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Please Note: For this study, there will be multimedia content available, including the JAMA Report video, embedded and downloadable video, audio files, text, documents, and related links. This content will be available at 3 p.m. CT Tuesday, November 23 at www.digitalnewsrelease.com/?q=jama_3766.
Editorial: Combined Aerobic and Resistance Exercise for Patients With Type 2 Diabetes
Ronald J. Sigal, M.D., M.P.H., of the University of Calgary, Alberta, Canada, and Glen P. Kenny, Ph.D., and Dr. Sigal of the University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada, write in an accompanying editorial that this study provides important evidence on the effects of aerobic and resistance training on improving hemoglobin A1c levels.
"Based on the results of the HART-D trial, patients with type 2 diabetes who wish to maximize the effects of exercise on their glycemic control should perform both aerobic and resistance exercise. The HART-D trial clarifies that, given a specific amount of time to invest in exercise, it is more beneficial to devote some time to each form of exercise rather than devoting all the time to just one form of exercise."
(JAMA. 2010;304[20]:2298-2299. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including financial disclosures, funding and support, etc.
INFORMATION:
To contact Timothy S. Church, M.D., M.P.H., Ph.D., call Angela deGravelles at 225-202-5073 or email prpro@eatel.net. To contact editorial co-author Ronald J. Sigal, M.D., M.P.H., call Marta Cyperling at 403-210-3835 or email marta.cyperling@ucalgary.ca.
For More Information: Contact the JAMA/Archives Media Relations Department at 312-464-JAMA or email: mediarelations@jama-archives.org.
END
A comparison of two strategies to determine the stage of suspected non-small cell lung cancer (NSCLC) finds that the less invasive method is more effective at identifying a type of lung cancer that has spread, and may result in a reduction of unnecessary surgical procedures and associated adverse effects for certain patients, according to a study in the November 24 issue of JAMA.
Lung cancer is the most commonly diagnosed cancer worldwide (1.35 million/year) and also the most frequent cause of cancer death (1.2 million/year). Determining the stage of cancer is an important ...
Annual screening by fecal immunochemical testing—a test that detects blood in the stool, has high sensitivity and specificity, and might improve participation rates through increased patient acceptability—reduces the risk of colorectal cancer and colorectal cancer related deaths, and reduces healthcare costs in comparison to all other screening strategies and to no screening. These are the conclusions of a complete economic evaluation performed by Braden Manns and colleagues from the University of Calgary, Alberta, Canada, and published in this week's PLoS Medicine.
Clinical ...
China had an estimated 1.3 million new cases of tuberculosis (TB) in 2008, of which 112,000 were multi-drug resistant (MDR-TB). Over the period 2001, TB was the second largest cause of death among China's 39 notifiable communicable diseases. In a Policy Forum, published in this week's PLoS Medicine, Zhong-wei Jia (Peking University) and colleagues from Beijing, China, report on how a combination of increased domestic funding, supplemented by foreign loans and donations, led to a dramatic increase in TB case finding. The authors also highlight the way in which changes in ...
Every magnetic material is divided into such magnetic domains. Scientists call them "Weiss domains" after physicist Pierre-Ernest Weiss, who predicted their existence theoretically more than a hundred years ago. In 1907, he recognized that the magnetic moments of atoms within a bounded domain are equally aligned.
All pursuit of this theory has so far been limited to two-dimensional images and material surfaces. Accordingly, researchers have only ever been able to see a domain in cross section. Together with colleagues from the German Federal Institute for Materials Research ...
BIRMINGHAM, Ala. – So, why are we fat? And getting fatter? Most people would say it's simple: We eat too much and exercise too little. But University of Alabama at Birmingham obesity researcher David B. Allison, Ph.D., says that answer, while valid, may be a little too simple. Allison and colleagues think the more relevant question is this: Why do we eat too much and expend too little energy? And like good detectives, they've set out to identify a suspect, or suspects, that may be contributing to the obesity epidemic. The game, as they say, is afoot.
Allison, a professor ...
Giant pterosaurs – ancient reptiles that flew over the heads of dinosaurs – were at their best in gentle tropical breezes, soaring over hillsides and coastlines or floating over land and sea on thermally driven air currents, according to new research from the University of Bristol.
Pterosaurs (also referred to as pterodactyls) were too slow and flexible to use the stormy winds and waves of the southern ocean like the albatrosses of today, the research by Colin Palmer, an engineer turned paleontology PhD student in Bristol's School of Earth Sciences, found.
Their slow ...
The study, by Dr Lavinia Mitton and Mr Peter Aspinall of the University of Kent, finds that 'Black Africans' in the UK are a diverse group with a wide range of experience and needs depending on country of birth, religion and native language. Understanding these distinctions between different Black Africans is the first step to providing better support, improving their quality of life and helping integration into society.
There are now 737,000 'Black Africans' in England and Wales (according to an estimate by the Office for National Statistics for 2007) and they are one ...
BOSTON, Mass. (Nov. 23, 2010) — Pity the female fruit fly. Being a looker is simply not enough. To get a date, much less a proposal, you have to act like a girl, even smell like one. Otherwise, you might just have a fight on your hands.
Like most animals, fruit flies must distinguish between a potential mate and a potential competitor. When a male fruit fly suspects he's encountered a female, he'll court; when he senses the other is a male, he'll fight. What triggers these sex-specific responses?
According to new research by scientists at Harvard Medical School, the ...
Large predators are much more vulnerable than smaller species to environmental changes, such as over-hunting and habitat change, because they have to work so hard to find their next meal, according to a new study.
Scientists matched studies of predator populations to the abundance of their prey and found that the largest species, such as lions, tigers or polar bears, had much greater declines in population due to diminishing food supplies than smaller species, such as weasels or badgers.
The review of studies of eleven species of carnivores by researchers from Durham ...
Chicago, November 23, 2010 – Results of the world's first efficacy trial of an HIV-prevention approach called oral pre-exposure prophylaxis, or PrEP, were released online in the New England Journal of Medicine today. Data from this trial, called iPrEx, indicated an estimated 43.8% reduction of new HIV infections among men who took an antiretroviral tablet daily to prevent HIV, compared to those who took a placebo pill.
"This discovery alters the HIV prevention landscape forever. While this level of efficacy is relatively strong, PrEP is not quite ready for prime time ...
