Dunstan David W, Vulikh Elena, Owen Neville, Jolley Damien, Shaw Jonathan, Zimmet Paul
International Diabetes Institute, 250 Kooyong Rd., Caulfield, Victoria, Australia 3162.
Diabetes Care. 2006 Dec;29(12):2586-91. doi: 10.2337/dc06-1310.
The purpose of this study was to determine whether beneficial effects on glycemic control of an initial laboratory-supervised resistance training program could be sustained through a community center-based maintenance program.
We studied 57 overweight (BMI >or=27 kg/m2) sedentary men and women aged 40-80 years with established (>6 months) type 2 diabetes. Initially, all participants attended a twice-weekly 2-month supervised resistance training program conducted in the exercise laboratory. Thereafter, participants undertook a resistance training maintenance program (2 times/week) for 12 months and were randomly assigned to carry this out either in a community fitness and recreation center (center) or in their domestic environment (home). Glycemic control (HbA1c [A1C]) was assessed at 0, 2, and 14 months.
Pooling data from the two groups for the 2-month supervised resistance training program showed that compared with baseline, mean A1C fell by -0.4% [95% CI -0.6 to -0.2]. Within-group comparisons showed that A1C remained lower than baseline values at 14 months in the center group (-0.4% [-0.7 to -0.03]) but not in the home group (-0.1% [-0.4 to 0.3]). However, no between-group differences were observed at each time point. Changes in A1C during the maintenance period were positively associated with exercise adherence in the center group only.
Center-based but not home-based resistance training was associated with the maintenance of modestly improved glycemic control from baseline, which was proportional to program adherence. Our findings emphasize the need to develop and test behavioral methods to promote healthy lifestyles including increased physical activity in adults with type 2 diabetes.
本研究旨在确定最初在实验室监督下进行的抗阻训练计划对血糖控制的有益效果能否通过基于社区中心的维持计划得以持续。
我们研究了57名年龄在40 - 80岁、超重(BMI≥27kg/m²)且久坐不动、患有2型糖尿病(病程>6个月)的男性和女性。最初,所有参与者参加了在运动实验室进行的为期2个月、每周两次的有监督的抗阻训练计划。此后,参与者进行了为期12个月的抗阻训练维持计划(每周2次),并被随机分配在社区健身和娱乐中心(中心组)或家中(家庭组)进行。在0、2和14个月时评估血糖控制情况(糖化血红蛋白[A1C])。
汇总两组在为期2个月的有监督抗阻训练计划的数据显示,与基线相比,平均A1C下降了-0.4%[95%CI -0.6至-0.2]。组内比较显示,中心组在14个月时A1C仍低于基线值(-0.4%[-0.7至-0.03]),而家庭组则没有(-0.1%[-0.4至0.3])。然而,在每个时间点均未观察到组间差异。仅在中心组中,维持期内A1C的变化与运动依从性呈正相关。
基于社区中心而非家庭的抗阻训练与从基线水平适度改善血糖控制的维持相关,且这种改善与计划依从性成正比。我们的研究结果强调了开发和测试行为方法以促进健康生活方式的必要性,包括增加2型糖尿病成年人的身体活动。