Home-Based Resistance Training Is Not Sufficient to Maintain Improved Glycemic Control Following Supervised Training in Older Individuals With Type 2 Diabetes

  1. David W. Dunstan, PHD1,
  2. Robin M. Daly, PHD2,
  3. Neville Owen, PHD3,
  4. Damien Jolley, MSC4,
  5. Elena Vulikh, BSC1,
  6. Jonathan Shaw, MD1 and
  7. Paul Zimmet, PHD1
  1. 1International Diabetes Institute, Melbourne, Australia
  2. 2School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
  3. 3Cancer Prevention Research Centre, School of Population Health, The University of Queensland, Brisbane, Australia
  4. 4School of Health and Social Development, Deakin University, Melbourne, Australia
  1. Address correspondence and reprint requests to Dr. David Dunstan, International Diabetes Institute, 250 Kooyong Rd., Caulfield, Victoria, Australia 3162. E-mail: ddunstan{at}idi.org.au

Abstract

OBJECTIVE—To examine whether improvements in glycemic control and body composition resulting from 6 months of supervised high-intensity progressive resistance training could be maintained after an additional 6 months of home-based resistance training.

RESEARCH DESIGN AND METHODS—We performed a 12-month randomized controlled trial in 36 sedentary, overweight men and women with type 2 diabetes (aged 60–80 years) who were randomly assigned to moderate weight loss plus high-intensity progressive resistance training (RT&WL group) or moderate weight loss plus a control program (WL group). Supervised gymnasium-based training for 6 months was followed by an additional 6 months of home-based training. Glycemic control (HbA1c), body composition, muscle strength, and metabolic syndrome abnormalities were assessed at 0, 3, 6, 9, and 12 months.

RESULTS—Compared with the WL group, HbA1c decreased significantly more in the RT&WL group (−0.8%) during 6 months of supervised gymnasium-based training; however, this effect was not maintained after an additional 6 months of home-based training. In contrast, the greater increase in lean body mass (LBM) observed in the RT&WL group compared with the WL group (0.9 kg, P < 0.05) after the gymnasium-based training tended to be maintained after the home-based training (0.8 kg, P = 0.08). Similarly, the gymnasium-based increases in upper body and lower body muscle strength in the RT&WL group were maintained over the 12 months (P < 0.001). There were no between-group differences for changes in body weight, fat mass, fasting glucose, or insulin at 6 or 12 months.

CONCLUSIONS—In older adults with type 2 diabetes, home-based progressive resistance training was effective for maintaining the gymnasium-based improvements in muscle strength and LBM but not glycemic control. Reductions in adherence and exercise training volume and intensity seem to impede the effectiveness of home-based training for maintaining improved glycemic control.

Footnotes

  • A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    • Accepted September 16, 2004.
    • Received July 5, 2004.
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