Tsang Tracey, Orr Rhonda, Lam Paul, Comino Elizabeth, Singh Maria Fiatarone
School of Exercise and Sport Science, Faculty of Health Sciences, University of Sydney, Australia.
Age Ageing. 2008 Jan;37(1):64-71. doi: 10.1093/ageing/afm127. Epub 2007 Oct 25.
a large proportion of adults with type 2 diabetes remain sedentary despite evidence of benefits from exercise for type 2 diabetes. Simplified Yang Tai Chi has been shown in one study to have no effect on insulin sensitivity in older adults. However, a modified Tai Chi form, Tai Chi for Diabetes (TCD) has recently been composed, claiming to improve diabetes control.
subjects were randomised to Tai Chi or sham exercise, twice a week for 16 weeks. Primary outcomes were insulin resistance 72 h post-exercise (HOMA2-IR), and long-term glucose control (HbA(1c)).
thirty-eight subjects (65 +/- 7.8 years, 79% women) were enrolled. Baseline BMI was 32.2 +/- 6.3 kg/m(2), 84% had osteoarthritis, 76% hypertension, and 34% cardiac disease. There was one dropout, no adverse events, and median compliance was 100 (0-100)%. There were no effects of time or group assignment on insulin resistance or HbA(1c) ( -0.07 +/- 0.4% Tai Chi versus 0.12 +/- 0.3% Sham; P = 0.13) at 16 weeks. Improvement in HbA(1c) was related to decreased body fat (r = 0.484, P = 0.004) and improvement in insulin resistance was related to decreased body fat (r = 0.37, P = 0.03) and central adiposity (r = 0.38, P = 0.02), as well as increased fat-free mass (r = -0.46, P = 0.005).
TCD did not improve glucose homeostasis or insulin sensitivity measured 72 h after the last bout of exercise. More intense forms of Tai Chi may be required to produce the body composition changes associated with metabolic benefits in type 2 diabetes.
尽管有证据表明运动对2型糖尿病有益，但很大一部分2型糖尿病成年人仍然久坐不动。一项研究表明，简化杨式太极拳对老年人的胰岛素敏感性没有影响。然而，最近创编了一种改良的太极拳形式——糖尿病太极拳（TCD），声称可以改善糖尿病控制。
将受试者随机分为太极拳组或假运动组，每周两次，共16周。主要结局指标为运动后72小时的胰岛素抵抗（HOMA2-IR）和长期血糖控制（糖化血红蛋白[HbA(1c)]）。
共纳入38名受试者（65±7.8岁，79%为女性）。基线体重指数为32.2±6.3kg/m²，84%患有骨关节炎，76%患有高血压，34%患有心脏病。有1名受试者退出，无不良事件发生，中位依从性为100（0-100）%。16周时，时间或分组对胰岛素抵抗或HbA(1c)均无影响（太极拳组为-0.07±0.4%，假运动组为0.12±0.3%；P=0.13）。HbA(1c)的改善与体脂减少有关（r=0.484，P=0.004），胰岛素抵抗的改善与体脂减少（r=0.37，P=0.03）、中心性肥胖（r=0.38，P=0.02）以及去脂体重增加（r=-0.46，P=0.005）有关。
最后一次运动72小时后测量，TCD并未改善葡萄糖稳态或胰岛素敏感性。可能需要更剧烈形式的太极拳才能产生与2型糖尿病代谢益处相关的身体成分变化。
