Hernandez Mario I, Devine Ansley B, Ramsey Joseph, Dow Emily, Johnston Carol S
College of Health Solutions, Arizona State University, Phoenix Campus, Phoenix, Arizona, USA.
Endocrinol Diabetes Metab Case Rep. 2024 Oct 3;2024(4). doi: 10.1530/EDM-24-0091. Print 2024 Oct 1.
Depression in type 2 diabetes (T2D) is estimated at 50% vs 18% among US adults, and markers of inflammation, which are tightly linked to hyperglycemia, are 5- to 50-fold higher in adults with T2D. Although lifestyle modifications are recommended for managing diabetes, resistance training (RT) is not commonly considered. This case report examined the practicality of implementing a structured RT protocol in a highly sedentary woman with T2D and depressive symptomology and assessed changes in strength, fitness, depression, and inflammation. The 59-year-old participant (body mass index: 38.1 kg/m2) was diagnosed in 2015. She had hypertension and bronchial asthma, was highly sedentary, and was clinically depressed based on validated measures: The Center for Epidemiological Studies Depression (CES-D) questionnaire and the Profile of Mood States (POMS) questionnaire. She had quit smoking 6 months earlier. The estimated 1RM guided the exercise prescription that used progressive overload to improve strength and promote the accretion of lean body mass. All exercise sessions (~45 minutes duration; 3× weekly) were supervised by trained personnel. After 8 weeks, total strength improved 135%. Heart rate was reduced by 14%, and depression symptomology fell into normal ranges. Although RT improved strength, fitness, and depressive symptomology, RT did not improve HbA1c, HOMA-IR, or inflammation emphasizing the need for a comprehensive treatment strategy. Simple assessments can be performed to determine the fitness and mental health of individuals with T2D, and incorporating an exercise prescription to standard care to address these key health determinants will empower patients to actively engage in their health care.
A progressive, individualized resistance training program is feasible and improves muscular strength, fitness level, and mental health in a high-risk individual with type 2 diabetes and multiple comorbidities. Flexibility with resistance training prescription to adapt to patient's needs and abilities contributes to exercise adherence and successful outcomes Physical activity assessment and exercise prescription should be a part of standard care for patients with diabetes.
据估计，美国成年人中2型糖尿病（T2D）患者的抑郁症患病率为50%，而普通成年人中这一比例为18%。炎症标志物与高血糖密切相关，T2D成年患者的炎症标志物水平比普通人高5至50倍。尽管建议通过生活方式的改变来控制糖尿病，但抗阻训练（RT）并不常用。本病例报告探讨了在一名久坐不动且患有T2D和抑郁症状的女性中实施结构化RT方案的可行性，并评估了其力量、体能、抑郁和炎症的变化。该59岁参与者（体重指数：38.1kg/m²）于2015年被诊断出患有T2D。她患有高血压和支气管哮喘，久坐不动，根据有效测量方法（流行病学研究中心抑郁量表（CES-D）问卷和情绪状态剖面图（POMS）问卷）被诊断为临床抑郁症。她在6个月前戒烟。估计的1RM指导运动处方，采用渐进性超负荷来增强力量并促进瘦体重的增加。所有运动课程（时长约45分钟；每周3次）均由训练有素的人员监督。8周后，总力量提高了135%。心率降低了14%，抑郁症状降至正常范围。虽然RT改善了力量、体能和抑郁症状，但并未改善糖化血红蛋白（HbA1c）、胰岛素抵抗稳态模型评估（HOMA-IR）或炎症，这强调了综合治疗策略的必要性。可以进行简单评估以确定T2D患者的体能和心理健康状况，将运动处方纳入标准护理以解决这些关键健康决定因素，将使患者能够积极参与自身的医疗保健。
渐进性、个体化的抗阻训练计划在患有2型糖尿病和多种合并症的高危个体中是可行的，并且可以改善肌肉力量、体能水平和心理健康。抗阻训练处方的灵活性以适应患者的需求和能力，有助于提高运动依从性和取得成功结果。身体活动评估和运动处方应成为糖尿病患者标准护理的一部分。
