Exercise, diet, and lifestyle modification

Addressing the debate over aerobic versus anaerobic exercise, Sigal et al. (abstract 371) reported results of the Diabetes Aerobic and Resistance Exercise (DARE) clinical trial of 251 previously inactive persons with type 2 diabetes exercising at local YMCAs, supervised by personal trainers. Both aerobic and resistance training improved HbA_1c (A1C) similarly over 6months, with the combination of both forms of exercise improving A1C more than either type alone. Goh et al. (abstract 1089) reported a similar study from Singapore comparing 22 persons with type 2 diabetes randomized to either aerobic exercise, with a 10/10-mmHg decrease in blood pressure and a 0.3% decrease in A1C, or resistance training, with a 0.6% decrease in A1C. Morrato et al. (abstracts 1041 and 1063), analyzing the national Medical Expenditure Panel Survey (2000–2002) found that 55% of 97,422 adults ≥18 years of age, but 39% of those with self-reported diabetes, stated they participated in moderate/vigorous activity for at least 30 min at least three times weekly. Among those with BMI <25, 25–29.9, 30–39.9, and ≥40 kg/m², the likelihood of diabetes was 52, 59, 41, and 13% greater in inactive than in active persons, respectively, adjusting for age, sex, education level, race, ethnicity, and cigarette smoking.

Gaillard et al. (abstract 1086) reported a study of 46 African-American women without diabetes, showing that those with moderately good aerobic fitness had lower weight and blood pressure and higher insulin sensitivity than those with low or very low levels of fitness. Similarly, Snitker et al. (abstract 1094) found that among 80 Amish persons, who habitually engage in physical exercise, the time spent in moderate to vigorous activity correlated directly with the degree …