A 12-month vigorous or moderate aerobic exercise program can yield long-term benefit Type 2 diabetes (T2D) prophylaxis in patients with Central obesityaccording to a 10-year follow-up of a randomized clinical trial.
Similar trials reported beneficial results of a lifestyle intervention to prevent diabetes, but these trials combined exercise and diet and included individual or group counseling. In contrast, the current trial conducted rigorous training in exercise programs during the 1-year intervention and all participants were instructed not to change their diet.
“With respect to the importance of obesity management in the prevention of T2D addressed in the latest American Diabetes Association guidelines, our findings support physical exercise as an effective obesity management scheme for delaying the progression of T2D, and that moderate and vigorous aerobic exercise programs can be implemented for the prevention of T2D in obese subjects. wrote corresponding author Xiaoying Li, MD, PhD, Laboratory of Metabolism and Molecular Medicine of the Ministry of Education, Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University.
Lifestyle interventions, including diet and exercise, play a major role in preventing T2D in high-risk individuals, but the isolated effects of vigorous and moderate exercise are uncertain. Lee and colleagues conducted a 10-year follow-up study based on their previous randomized controlled trials to assess the long-term effects of exercise on diabetes prevention between July 2021 and May 2022.
The trial consisted of vigorous aerobic exercise (n = 73), moderate aerobic exercise (n = 73), and non-athletic control groups (n = 74) in individuals with central obesity and non-alcoholic fatty liver disease. At the end of the 12-month intervention, all participants were encouraged to continue to lead a healthy lifestyle and to engage in moderate-intensity aerobic exercise.
They were then followed up with 2-year and 10-year visits to assess the incidence of T2D, changes in body weight, waist circumference, and metabolic risk factors. The study defined incident diabetes as fasting plasma glucose of 126 mg/dL or greater, hemoglobin A1c (HbA1c) levels of 6.5% or greater, and/or use of antidiabetic medication.
Of the 220 eligible participants in the original randomized controlled trial, 208 (94.5%) participants completed the 1-year exercise. At the 2-year and 10-year follow-up visits, 195 (88.6%) and 179 (81.4%) participants continued to have an assessment of incident diabetes, respectively.
Similar metabolic equivalencies for leisure-time physical activity were observed among the three groups at baseline but were found to be higher in the moderate and vigorous exercise groups than in the non-athletic group at the end of the 1-year intervention.
No significant differences were reported between the three groups at the 10-year follow-up, but there was a trend for higher levels of leisure-time physical activity in the exercise group than in the no-exercise group.
At a 10-year follow-up, the data show that the cumulative incidence rate of T2D was 2.1 per 100 person-years (PYs) in the active group, compared to 1.9 per 100 PYs in the moderate group, and 4.1 per 100 PYs in the non-exercise group. groups.
The risk of developing diabetes was reduced by 49% in the vigorous aerobic exercise group and by 53% in the moderate aerobic group compared to the no exercise group. Investigators reported similar results for moderate and vigorous aerobic exercise in those who completed the interventions for 12 months.
Results showed significant decreases in HbA1c and waist circumference in the vigorous and moderate exercise groups compared to the no exercise group. Meanwhile, fasting plasma glucose levels and weight regain were lower in the exercise groups, although there were no significant differences.
search message,”Effect of moderate and vigorous aerobic exercise on the incidence of diabetes in obese adults: a 10-year follow-up of a randomized clinical trial.“in JAMA Internal Medicine.