Health benefits of Aerobic and Resistance Training in individuals with Diabetes

描述（由申请人提供）：拟议研究的目标，有氧和阻力训练对2型糖尿病患者的健康益处（HART-D），是比较单独阻力训练和阻力训练结合有氧训练与单独有氧训练对2型糖尿病患者（T2D）血红蛋白A1c （HbA1c）的影响。虽然人们普遍认为有规律的运动对T2D患者的健康有益，但确切的运动处方（有氧运动vs抵抗运动，还是两者都有）在很大程度上仍未被探索，特别是根据HbA1c评估的每周血糖控制。例如，很少有研究检验单独进行抗阻训练对糖尿病患者的益处，也没有足够有力的对照试验检验将抗阻训练与有氧训练相结合的益处。考虑到大多数国家组织关于T2D患者运动处方的建议/指南都建议有氧和阻力训练相结合以获得最大的健康益处，这一点尤其成问题。有必要进行更多的研究，以帮助更好地为T2D患者制定运动建议，并可能提供更多的运动选择，考虑到定期参加运动的T2D患者比例很小，这一点非常重要。研究对象为年龄在30至75岁之间、患有糖尿病、久坐不动的女性和男性。我们将随机将300人平均分配到有氧运动训练组（AT），阻力训练组（RT）或有氧加阻力训练组合（AT+RT）。AT个体将在9个月内每周参加3或4次训练，达到总能量消耗为12千卡/公斤/周（KKW），这是与目前公共卫生建议的T2D个体体育活动相一致的运动剂量。RT组每周参加3次训练（每次30-45分钟），主要训练大肌肉群。AT+RT组的个体将接受12 KKW的有氧训练和每周2次，每次20分钟的减少阻力训练方案。这种联合疗法代表了美国运动医学学院和美国糖尿病协会的确切运动建议。简而言之，我们希望研究RT在降低HbA1c方面是否具有与标准AT方案相当的益处，以及AT +RT混合方案在降低HbA1c方面是否优于AT （& RT单独）。主要指标是HbA1c，这是过去8-12周血糖控制的综合指标。

DESCRIPTION (provided by applicant): The goal of the proposed study, Health benefits of Aerobic and Resistance Training in individuals with type 2 Diabetes (HART-D), is to compare the effect of resistance training alone, and resistance in combination with aerobic training to aerobic training alone on hemoglobin A1c (HbA1c), in initially sedentary women and men with type 2 diabetes (T2D). While it is generally accepted that regular exercise provides substantial health benefits to individuals with T2D, the exact exercise prescription in terms of type (aerobic versus resistance versus both) still remains largely unexplored, particularly in regard to week-to-week glucose control as assessed by HbA1c. For example, there has been very little research performed that examines the benefit of resistance training alone in individuals with diabetes, and there exists no adequately powered or controlled trials that have examined the benefits of combining resistance training with aerobic training. This is particularly problematic given that most recommendations/guidelines from national organizations for exercise prescription in individuals with T2D suggest a combination of aerobic and resistance training for maximal health benefits. There is a need for more research to help better formulate exercise recommendations for patients with T2D as well as potentially provide more exercise options, which is very important given the small percentage of individuals with T2D who regularly participate in exercise. The study group will be sedentary women and men with T2D, aged 30 to 75 years. We will randomly assign 300 individuals equally to an aerobic exercise training-only group (AT), a resistance training-only group (RT), or a combination of aerobic plus resistance training (AT+RT). The AT individuals will participate in 3 or 4 training sessions each week for 9 months, progressing to a total energy expenditure of 12 kcal/kg/week (KKW), which is an exercise dose consistent with the current public health recommendations for physical activity for individuals with T2D. The RT group will participate in 3 sessions per week (30-45 minutes each), which focus on large muscle groups. Individuals in the AT+RT group will receive both the 12 KKW of aerobic training and a reduced resistance-training regimen of 2 sessions per week at 20 minutes per session. This combination regimen represents the exact exercise recommendations of the American College of Sports Medicine and the American Diabetes Association. Simply stated, we wish to examine if a RT has comparable benefits in lowering HbA1c to a standard AT program, and if a hybrid program of AT +RT is superior to AT alone (& RT alone) in reducing HbA1c. The primary outcome measure is HbA1c, an integrated measure of blood glucose control over the past 8-12 weeks.