High Intensity Body-weight Circuit Training Feasibility and Efficacy for Improving Metabolic Profile, Body Composition, and Health-Related Fitness in Middle Aged Persons with Type 2 Diabetes

II型糖尿病（T2 DM）是一种进行性疾病，在工业化国家被认为是健康流行病。未经治疗，这种疾病与几种不良状况有关（例如，心血管、神经、肾脏等）随着年龄的增长和身体活动的缺乏而恶化。迫切需要实用的、具有成本效益的对策来治疗T2 DM并减缓其进展。运动是一种这样的干预措施，已被证明是治疗T2 DM患者的成功方法;然而，通常规定的运动计划（例如有氧活动）无法结合全身，或者被视为过于耗时（例如每周150分钟），导致依从性较低。各种高强度的健身计划方法成功地动员以前久坐不动的人在一个时间效率的方式，但仍然未能纳入更大数量的骨骼肌。我们利用在家高强度体重循环训练（HIBC）计划的初步数据表明，1）T2 DM患者可以安全地进行每周累积40分钟的训练，持续16周，2）该计划有益于空腹血糖、HbA 1c、胆固醇、葡萄糖耐量和瘦体重。HIBC是一种基于家庭的干预，包括在分配的时间内完成尽可能多轮的改良蹲下（10次重复）、改良行（5次重复）、仰卧起坐（10次）和改良俯卧撑（5次）的循环（例如，5- 10分钟）。我们的长期目标是为T2 DM患者提供更省时、更有效的运动干预，并扩展当前的运动指南和建议。为了实现这些目标，我们将追求以下两个具体目标：目标1）确定新的HIBC训练计划对代谢生物标志物，身体成分和整体健康的影响。目的2）比较和对比HIBC干预与传统运动干预（TEI）的结果指标。拟开展的研究将通过招募82名近期诊断为T2 DM的中年成年人来实现这些目标，并将其分为两个治疗组：HIBC（n=41）和TEI（n=41），获得基线代谢、身体成分和健身指标，然后进行16周的在家训练，然后获得术后指标。在完成拟议的研究后，我们的预期结果是确定HIBC干预对代谢特征，身体成分和健身标志物的可行性和有效性。此外，我们还预计HIBC将产生类似的，如果不是比TEI更大的改进。本研究的结果可能为T2 DM成人患者的心脏代谢疾病管理提供有效和有吸引力的运动干预，并具有重要的临床和公共卫生应用。

Type II diabetes (T2DM) is a progressive disease that is considered a health pandemic in industrialized nations. Untreated, this disease is associated with several untoward conditions (e.g., cardiovascular, neural, renal, etc.) that worsen with both age and physical inactivity. Pragmatic, cost effective, countermeasures to treat T2DM and slow its progression are urgently needed. Exercise is one such intervention that has been proven to be a successful in treating persons with T2DM; however, commonly prescribed exercise programs (e.g. aerobic activity) fail to incorporate the whole body, or are viewed as too time-consuming (e.g.150-minutes per week) resulting in lower adherence. A variety of high-intensity fitness programs approaches successfully mobilize previously sedentary individuals in a time-efficient fashion; however still fail to incorporate greater quantities of skeletal muscle. Our preliminary data utilizing an at home high intensity bodyweight circuit training (HIBC) program indicate that 1) an accumulated 40-minutes per week of over a 16-week period can be safely undertaken by those with T2DM, and 2) the program benefits fasting glucose, HbA1c, cholesterol, glucose tolerance and lean mass. The HIBC is a home-based intervention that consists of completing as many rounds of the circuit of modified squats (10 repetitions), modified rows (5 repetitions), crunches (10), and modified push- ups (5) over the allotted time (e.g., 5-10minutes). Our long-term goal is to provide a more time- efficient, and effective exercise intervention for persons with T2DM and expand upon the current exercise guidelines and recommendations. In order to achieve these objectives, we will pursue the following two specific aims: Aim 1) Identify the influence of a novel HIBC training program on metabolic biomarkers, body composition, and overall fitness. Aim 2) To compare and contrast the outcome measures of the HIBC intervention to that of a traditional exercise intervention (TEI). The proposed research study will approach these aims by recruiting 82 recently diagnosed middle aged adults with T2DM and divide them into two treatment groups: HIBC (n=41) and TEI (n=41), obtain baseline metabolic, body composition, and fitness measures, then undergo 16-weeks of at home training, then obtain post measures. Upon completion of the proposed research, our expected outcomes are to have determined the feasibility and effectiveness of the HIBC intervention on the metabolic profile, body composition, and fitness markers. Additionally, we also expect HIBC to result in similar, if not greater improvements than those of TEI. Results of this study may provide an effective and appealing exercise intervention for cardiometabolic disease management in adults with T2DM, and have significant clinical and public health applications.