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Diabetes Care 26:2977-2982, 2003
© 2003 by the American Diabetes Association, Inc.


Clinical Care/Education/Nutrition
Original Article

Effective Exercise Modality to Reduce Insulin Resistance in Women With Type 2 Diabetes

Darcye J. Cuff, MSC1,2, Graydon S. Meneilly, MD3, Alan Martin, PHD2, Andrew Ignaszewski, MD, FRCPC1, Hugh D. Tildesley, MD1 and Jiri J. Frohlich, MD, FRCPC1

1 St. Paul’s Hospital, Vancouver, British Columbia, Canada
2 School of Human Kinetics, University of British Columbia, Vancouver, British Columbia, Canada
3 Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada

Address correspondence and reprint requests to Darcye Cuff, Healthy Heart Program, Rm. B180, St. Paul’s Hospital, 1081 Burrard St., Vancouver BC, Canada V6Z 1Y6. E-mail: dcuff{at}providencehealth.bc.ca

OBJECTIVE—The purpose of this study was to evaluate whether a combined resistance and aerobic training program would improve insulin sensitivity compared with aerobic training alone in postmenopausal women with type 2 diabetes. A second objective was to relate the improved insulin sensitivity to changes in abdominal adipose tissue (AT) and thigh muscle density.

RESEARCH DESIGN AND METHODS—A total of 28 obese postmenopausal women with type 2 diabetes were randomly assigned to one of three 16-week treatments: control, aerobic only training (Ae only), or aerobic plus resistance training (Ae+RT). Pre- and posttreatment outcome measures included glucose disposal by hyperinsulinemic-euglycemic clamp and computed tomography scans of abdominal AT and mid-thigh skeletal muscle.

RESULTS—Glucose infusion rates increased significantly (P < 0.05) in the Ae+RT group. Both exercise groups had reduced abdominal subcutaneous and visceral AT and increased muscle density. The Ae+RT training group exhibited a significantly greater increase in muscle density than the Ae only group. Improved glucose disposal was independently associated with changes in subcutaneous AT, visceral AT, and muscle density. Muscle density retained a relationship with glucose disposal after controlling for abdominal AT.

CONCLUSIONS—Adding resistance training to aerobic training enhanced glucose disposal in postmenopausal women with type 2 diabetes. The improved insulin sensitivity is related to loss of abdominal subcutaneous and visceral AT and to increased muscle density.

Abbreviations: Ae, aerobic only training • Ae+RT, aerobic plus resistance training • AT, adipose tissue • CT, computed tomography • HU, Hounsfield units


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