We want to find the effect of intensive exercise therapy on diabetic patients for reducing their blood glucose levels. Would like to know what kind of measurement tools can be used other than blood glucose readings, HbA1c levels.
Dear Ethirajulu,
maybe you can use the following information…
Madsen SM, Thorup AC, Overgaard K, Jeppesen PB. High intensity interval training improves glycaemic control and pancreatic β Cell function of type 2 diabetes patients. PLoS One. 2015;10(8):e0133286. http://www.plosone.org/article/fetchObject.action?uri=info:doi/10.1371/journal.pone.0133286&representation=PDF
Cassidy S, Thoma C, Hallsworth K, Parikh J, Hollingsworth KG, Taylor R, Jakovljevic DG, Trenell MI. High intensity intermittent exercise improves cardiac structure and function and reduces liver fat in patients with type 2 diabetes: a randomised controlled trial. Diabetologia. 2015 Sep 9. [Epub ahead of print]. http://download.springer.com/static/pdf/567/art%253A10.1007%252Fs00125-015-3741-2.pdf?originUrl=http%3A%2F%2Flink.springer.com%2Farticle%2F10.1007%2Fs00125-015-3741-2&token2=exp=1443529811~acl=%2Fstatic%2Fpdf%2F567%2Fart%25253A10.1007%25252Fs00125-015-3741-2.pdf%3ForiginUrl%3Dhttp%253A%252F%252Flink.springer.com%252Farticle%252F10.1007%252Fs00125-015-3741-2*~hmac=335dc76d91926019e44a131b08370de1d200eeb0dd90d8d2b29771918668c35f
Francois ME, Little JP. Effectiveness and safety of high-intensity interval training in patients with type 2 diabetes. Diabetes Spectr. 2015;28(1):39-44. http://spectrum.diabetesjournals.org/content/28/1/39.full
Francois ME, Baldi JC, Manning PJ, Lucas SJ, Hawley JA, Williams MJ, Cotter JD. 'Exercise snacks' before meals: a novel strategy to improve glycaemic control in individuals with insulin resistance. Diabetologia. 2014;57(7):1437-45. http://www.otago.ac.nz/diabetes/otago070120.pdf
Rynders CA, Weltman A. High-intensity exercise training for the prevention of type 2 diabetes mellitus. Phys Sportsmed. 2014;42(1):7-14. https://www.acefitness.org/continuingeducation/courses/support_items/OLC-PSM-T2D/DiabetesSeptember2014.pdf
Little JP, Francois ME. High-intensity interval training for improving postprandial hyperglycemia. Res Q Exerc Sport. 2014;85(4):451-6. http://www.pubfacts.com/detail/25412127/High-intensity-interval-training-for-improving-postprandial-hyperglycemia.
Carral F, Gutiérrez JV, Ayala Mdel C, García G, Aguilar M. Intense physical activity is associated with better metabolic control in patients with type 1 diabetes. Diabetes Res Clin Pract. 2013;101(1):45-9. http://www.diabetesresearchclinicalpractice.com/article/S0168-8227%2813%2900162-9/pdf
van Dijk JW, Venema M, van Mechelen W, Stehouwer CD, Hartgens F, van Loon LJ. Effect of moderate-intensity exercise versus activities of daily living on 24-hour blood glucose homeostasis in male patients with type 2 diabetes. Diabetes Care. 2013;36(11):3448-53. http://care.diabetesjournals.org/content/36/11/3448.full.pdf+html
van Dijk JW, Tummers K, Stehouwer CD, Hartgens F, van Loon LJ. Exercise therapy in type 2 diabetes: is daily exercise required to optimize glycemic control? Diabetes Care. 2012;35(5):948-54. http://care.diabetesjournals.org/content/35/5/948.full.pdf+html
Marliss EB, Vranic M. Intense exercise has unique effects on both insulin release and its roles in glucoregulation: implications for diabetes. Diabetes. 2002;51 Suppl 1:S271-83. http://diabetes.diabetesjournals.org/content/51/suppl_1/S271.full.pdf+html
Best wishes from Germany
Martin
Dear Ethirajulu,
maybe you can use the following information…
Madsen SM, Thorup AC, Overgaard K, Jeppesen PB. High intensity interval training improves glycaemic control and pancreatic β Cell function of type 2 diabetes patients. PLoS One. 2015;10(8):e0133286. http://www.plosone.org/article/fetchObject.action?uri=info:doi/10.1371/journal.pone.0133286&representation=PDF
Cassidy S, Thoma C, Hallsworth K, Parikh J, Hollingsworth KG, Taylor R, Jakovljevic DG, Trenell MI. High intensity intermittent exercise improves cardiac structure and function and reduces liver fat in patients with type 2 diabetes: a randomised controlled trial. Diabetologia. 2015 Sep 9. [Epub ahead of print]. http://download.springer.com/static/pdf/567/art%253A10.1007%252Fs00125-015-3741-2.pdf?originUrl=http%3A%2F%2Flink.springer.com%2Farticle%2F10.1007%2Fs00125-015-3741-2&token2=exp=1443529811~acl=%2Fstatic%2Fpdf%2F567%2Fart%25253A10.1007%25252Fs00125-015-3741-2.pdf%3ForiginUrl%3Dhttp%253A%252F%252Flink.springer.com%252Farticle%252F10.1007%252Fs00125-015-3741-2*~hmac=335dc76d91926019e44a131b08370de1d200eeb0dd90d8d2b29771918668c35f
Francois ME, Little JP. Effectiveness and safety of high-intensity interval training in patients with type 2 diabetes. Diabetes Spectr. 2015;28(1):39-44. http://spectrum.diabetesjournals.org/content/28/1/39.full
Francois ME, Baldi JC, Manning PJ, Lucas SJ, Hawley JA, Williams MJ, Cotter JD. 'Exercise snacks' before meals: a novel strategy to improve glycaemic control in individuals with insulin resistance. Diabetologia. 2014;57(7):1437-45. http://www.otago.ac.nz/diabetes/otago070120.pdf
Rynders CA, Weltman A. High-intensity exercise training for the prevention of type 2 diabetes mellitus. Phys Sportsmed. 2014;42(1):7-14. https://www.acefitness.org/continuingeducation/courses/support_items/OLC-PSM-T2D/DiabetesSeptember2014.pdf
Little JP, Francois ME. High-intensity interval training for improving postprandial hyperglycemia. Res Q Exerc Sport. 2014;85(4):451-6. http://www.pubfacts.com/detail/25412127/High-intensity-interval-training-for-improving-postprandial-hyperglycemia.
Carral F, Gutiérrez JV, Ayala Mdel C, García G, Aguilar M. Intense physical activity is associated with better metabolic control in patients with type 1 diabetes. Diabetes Res Clin Pract. 2013;101(1):45-9. http://www.diabetesresearchclinicalpractice.com/article/S0168-8227%2813%2900162-9/pdf
van Dijk JW, Venema M, van Mechelen W, Stehouwer CD, Hartgens F, van Loon LJ. Effect of moderate-intensity exercise versus activities of daily living on 24-hour blood glucose homeostasis in male patients with type 2 diabetes. Diabetes Care. 2013;36(11):3448-53. http://care.diabetesjournals.org/content/36/11/3448.full.pdf+html
van Dijk JW, Tummers K, Stehouwer CD, Hartgens F, van Loon LJ. Exercise therapy in type 2 diabetes: is daily exercise required to optimize glycemic control? Diabetes Care. 2012;35(5):948-54. http://care.diabetesjournals.org/content/35/5/948.full.pdf+html
Marliss EB, Vranic M. Intense exercise has unique effects on both insulin release and its roles in glucoregulation: implications for diabetes. Diabetes. 2002;51 Suppl 1:S271-83. http://diabetes.diabetesjournals.org/content/51/suppl_1/S271.full.pdf+html
Best wishes from Germany
Martin
Dear Ethirajulu Mahalakshmi
By 'intensive' do you mean 'high intensity exercise' as Dr Hofmeister has addressed well in his response, or are you referring to the intensity of the intervention used in terms of the time professionals spend with patients and other indicators of behaviour change intensity?
Also, are you planning on measuring blood glucose and HbA1c, or are you not intending to measure those and looking for alternatives, and if so why?
Kind regards,
Christian
Thanks you all
Dear Christian Thoma,
Intensive meaning the high intensity exercise like cardio vascular endurance, and increase the ex time also.
We are measuring bld glucose and HbA1c apart from these readings just want to know any other physio measurement tools can be used relative to diabetics and exercise.
Dear Ethirajulu,
In terms of measurements, postprandial glucose (e.g. an oral glucose tolerance test) may be informative, as might post-exercise glucose testing as this isn't often done. It really depends on what you want to know. Standard patient monitoring, so blood pressure, blood lipids, perhaps ALT and AST would make sense.
As people with type 2 diabetes would count as a high risk group based on American College of Sports Medicine criteria, you may wish to follow best practice and conduct an ECG monitored exercise stress test prior to prescribing high-intensity exercise.
In terms of papers, I believe no one has yet recommended: http://www.ncbi.nlm.nih.gov/pubmed/21868679
I also recommend you read the following blog series, which although not peer reviewed is based on a chapter in my thesis: http://www.builtformotion.co.nz/move/high-intensity-intermittent-training-for-health-part-1
Good luck with your intervention.
Kind regards,
Christian
All of the answers above are exceptional. We work in a clinical setting without the use of your type of laboratory testing, but have taught the patients to monitor their FBG level, exercise duration and HR response, and diet (through diet diaries). Those who develop the habit of exercise, diet diary, and monitoring have actually been able to predict their FBG level within specific glucose levels for a day based on the previous three days exercise and diet. This method has helped a federal marshal to stay on the job when he was faced with health related disability due to diabetes by allowing him to predict and maintain a normal FBG level using the previously mentioned information. While this is not exactly what you may mean, it does represent a useful tool for patient education for developing a self management system for the patients.
Dear Ethirajulu Mahalakshmi,
Maybe the following paper will help you.
Best regards
Eleftherios Dimitros
Article Effects of exercise training on cardiac autonomic function i...
In terms of long-term adaptations there is not much conclusive data. A typical characteristic in many people with T1DM is post-exercise hyperglycemia which is one of the top complaints in T1DM and one of top reasons why they don't stick to an exercise program. If high intensity exercise, not rare to see severe hypoglycemias in the middle of night. They take too much insulin to correct post-exercise hyperglycemia and they end up with hypos.
This project is for type 2 diabetes those with chronic disabilities such as CVA, MD, SMA, SCI. They are limited in their locomotion. Is there any exercise prescription to reduce blood glucose levels for those with chronic physical disabilities.
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