Sigal Ronald J, Yardley Jane E, Perkins Bruce A, Riddell Michael C, Goldfield Gary S, Donovan Lois, Malcolm Janine, Hadjiyannakis Stasia, Edwards Alun L, Gougeon Réjeanne, Wells George A, Pacaud Danièle, Woo Vincent, Ford Gordon T, Coyle Doug, Phillips Penny, Doucette Steve, Khandwala Farah, Kenny Glen P
Departments of Medicine, Cardiac Sciences and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2T 5C7, Canada.
Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada.
J Clin Endocrinol Metab. 2023 Apr 13;108(5):e63-e75. doi: 10.1210/clinem/dgac682.
Resistance exercise training (strength training) and aerobic exercise training are both recommended for people with type 1 diabetes, but it is unknown whether adding resistance exercise provides incremental benefits in people with this condition who already perform aerobic exercise regularly.
This work aimed to evaluate the incremental effect of resistance training on glycated hemoglobin A1c (HbA1c), fitness, body composition, and cardiometabolic risk factors in aerobically active people with type 1 diabetes.
The Resistance Exercise in Already-active Diabetic Individuals (READI) trial (NCT00410436) was a 4-center, randomized, parallel-group trial. After a 5-week run-in period with diabetes management optimization, 131 aerobically active individuals with type 1 diabetes were randomly assigned to resistance exercise (n = 71, intervention-INT) or control (n = 60, CON) for 22 additional weeks. Both groups maintained their aerobic activities and were provided dietary counseling throughout. Exercise training was 3 times per week at community-based facilities. The primary outcome was HbA1c, and secondary outcomes included fitness (peak oxygen consumption, muscle strength), body composition (anthropometrics, dual-energy x-ray absorptiometry, computed tomography), and cardiometabolic risk markers (lipids, apolipoproteins). Assessors were blinded to group allocation.
There were no significant differences in HbA1c change between INT and CON. Declines in HbA1c (INT: 7.75 ± 0.10% [61.2 ± 1.1 mmol/mol] to 7.55 ± 0.10% [59 ± 1.1 mmol/mol]; CON: 7.70 ± 0.11% [60.7 ± 1.2 mmol/mol] to 7.57 ± 0.11% [59.6 ± 1.3 mmol/mol]; intergroup difference in change -0.07 [95% CI, -0.31 to 0.18]). Waist circumference decreased more in INT than CON after 6 months (P = .02). Muscular strength increased more in INT than in CON (P < .001). There were no intergroup differences in hypoglycemia or any other variables.
Adding resistance training did not affect glycemia, but it increased strength and reduced waist circumference, in aerobically active individuals with type 1 diabetes.
抗阻运动训练（力量训练）和有氧运动训练都推荐用于1型糖尿病患者，但对于已经经常进行有氧运动的此类患者，增加抗阻运动是否能带来额外益处尚不清楚。
这项研究旨在评估抗阻训练对已进行有氧运动的1型糖尿病患者糖化血红蛋白A1c（HbA1c）、体能、身体成分和心脏代谢危险因素的额外影响。
“已活跃糖尿病个体的抗阻运动（READI）试验”（NCT00410436）是一项4中心、随机、平行组试验。在进行为期5周的糖尿病管理优化导入期后，131名已进行有氧运动的1型糖尿病患者被随机分配至抗阻运动组（n = 71，干预组-INT）或对照组（n = 60，CON），再进行22周试验。两组均维持其有氧运动，并在整个试验过程中接受饮食咨询。运动训练在社区设施中每周进行3次。主要结局指标为HbA1c，次要结局指标包括体能（峰值摄氧量、肌肉力量）、身体成分（人体测量学、双能X线吸收法、计算机断层扫描）和心脏代谢风险标志物（血脂、载脂蛋白）。评估人员对分组情况不知情。
INT组和CON组之间HbA1c变化无显著差异。HbA1c下降情况（INT组：从7.75±0.10%[61.2±1.1 mmol/mol]降至7.55±0.10%[59±1.1 mmol/mol]；CON组：从7.70±0.11%[60.7±1.2 mmol/mol]降至7.57±0.11%[59.6±1.3 mmol/mol]；组间变化差异为-0.07[95%CI，-0.31至0.18]）。6个月后，INT组腰围比CON组下降更多（P = 0.02）。INT组肌肉力量比CON组增加更多（P < 0.001）。低血糖或任何其他变量在组间无差异。
对于已进行有氧运动的1型糖尿病患者，增加抗阻训练不影响血糖水平，但可增加力量并减小腰围。
