Shakil-Ur-Rehman Syed, Karimi Hossein, Gillani Syed Amir
Syed Shakil-ur-Rehman, PhD Physical Therapy Scholar. Principal/Associate Professor, Riphah College of Rehabilitation Sciences, Riphah International University, Islamabad, Pakistan. University Institute of Physical Therapy, Faculty of Allied Health Sciences, University of Lahore, Lahore, Pakistan.
Hossein Karimi, Associate Professor (Emeritus), Adjunct Faculty, University Institute of Physical Therapy, Faculty of Allied Health Sciences, University of Lahore, Lahore, Pakistan.
Pak J Med Sci. 2017 May-Jun;33(3):576-580. doi: 10.12669/pjms.333.12023.
To determine the effects of supervised structured aerobic exercise training (SSAET) program on fasting blood glucose level (FBGL), plasma insulin level (PIL), glycemic control (GC), and insulin resistance (IR) in type 2 diabetes mellitus (T2DM).
Riphah Rehabilitation and Research Centre (RRRC) was the clinical setting for this randomized controlled trial, located at Pakistan Railways General Hospital (PRGH), Rawalpindi, Pakistan. Study duration was 18 months from January 1, 2015 to June 30, 2016. Patients of both genders ranging 40-70 years of age with at least one year of history of T2DM were considered eligible according to WHO criteria, while patients with other chronic diseases, history of smoking, regular exercise and diet plan were excluded. Cohorts of 195 patients were screened out of whom 120 fulfilled the inclusion criteria. Amongst them 102 agreed to participate and were assigned to experimental (n=51) and control (n=51) groups. Experimental group underwent SSAET program, routine medication and dietary plan, whereas the control group received routine medication and dietary plan, while both group received treatment for 25 weeks. The blood samples were taken at baseline and on the completion of 25 weeks. The investigation of fasting blood glucose level, plasma insulin level, and glycemic control was conducted to calculate IR.
Patients with T2DM in experimental group (n=51) treated with SSAET program, routine medication and dietary plan significantly improved FBGL (pre-mean= 276.41±25.31, post-mean=250.07±28.23), PIL (pre-mean=13.66±5.31, post-mean=8.91±3.83), GC (pre-mean=8.31±1.79, post-mean 7.28±1.43), and IR (pre-mean=64.95±27.26, post-mean 37.97±15.58), as compared with patients in control group treated with routine medication and dietary plan in whom deteriorations were noted in FBGL (pre-mean=268.19±22.48, post-mean=281.41±31.30), PIL(pre-mean=14.14±5.48, post-mean=14.85±5.27) GC (pre-mean=8.15±1.74, post-mean=8.20±1.44, and IR (pre-mean=64.49±23.63. post-mean=70.79 ±23.30). Statistically at the baseline the results were not significant (p>0.05), but at the completion of 25 weeks intervention all the variable showed significant results (p<0.05.
It is concluded that a 25 weeks SSAET program along with routine medical management is more effective treatment in the management of fasting blood glucose level, glycemic control, plasma insulin level and insulin resistance as compared with routine medical management and dietary plan in the management of T2DM.
确定有监督的结构化有氧运动训练(SSAET)计划对2型糖尿病(T2DM)患者空腹血糖水平(FBGL)、血浆胰岛素水平(PIL)、血糖控制(GC)和胰岛素抵抗(IR)的影响。
里法赫康复与研究中心(RRRC)是这项随机对照试验的临床研究地点,位于巴基斯坦拉瓦尔品第的巴基斯坦铁路总医院(PRGH)。研究持续时间为2015年1月1日至2016年6月30日的18个月。根据世界卫生组织标准,年龄在40 - 70岁、患有T2DM至少一年的男女患者被认为符合条件,而患有其他慢性病、有吸烟史、经常运动和有饮食计划的患者被排除。从195名患者中筛选出队列,其中120名符合纳入标准。其中102名同意参与并被分配到实验组(n = 51)和对照组(n = 51)。实验组接受SSAET计划、常规药物治疗和饮食计划,而对照组接受常规药物治疗和饮食计划,两组均接受25周的治疗。在基线和25周结束时采集血样。对空腹血糖水平、血浆胰岛素水平和血糖控制进行调查以计算IR。
接受SSAET计划、常规药物治疗和饮食计划的实验组(n = 51)T2DM患者的FBGL(治疗前均值 = 276.41±25.31,治疗后均值 = 250.07±28.23)、PIL(治疗前均值 = 13.66±5.31,治疗后均值 = 8.91±3.83)、GC(治疗前均值 = 8.31±1.79,治疗后均值7.28±1.43)和IR(治疗前均值 = 64.95±27.26,治疗后均值37.97±15.58)有显著改善,而接受常规药物治疗和饮食计划的对照组患者的FBGL(治疗前均值 = 268.19±22.48,治疗后均值 = 281.41±31.30)、PIL(治疗前均值 = 14.14±5.48,治疗后均值 = 14.85±5.27)、GC(治疗前均值 = 8.15±1.74,治疗后均值 = 8.20±1.44)和IR(治疗前均值 = 64.49±23.63,治疗后均值 = 70.79 ±23.30)出现恶化。在统计学上,基线时结果无显著差异(p>0.05),但在25周干预结束时所有变量均显示出显著结果(p<0.05)。
得出结论,与常规药物治疗和饮食计划相比,25周的SSAET计划联合常规医疗管理在T2DM管理中对空腹血糖水平、血糖控制、血浆胰岛素水平和胰岛素抵抗的治疗更有效。