Health benefits of Aerobic and Resistance Training in individuals with Diabetes

描述(申请人提供)：这项名为“有氧和阻力训练对2型糖尿病患者的健康益处”(HART-D)的拟议研究的目标是比较最初久坐不动的2型糖尿病(T2D)女性和男性在最初久坐不动的女性和男性中，单独进行阻力训练和阻力结合有氧训练对血红蛋白A1c(HbA1c)的影响。虽然人们普遍认为，定期锻炼对患有T2D的人有很大的健康益处，但具体的运动处方(有氧运动还是阻力运动，两者都有)仍然很大程度上仍未被探索，特别是关于HbA1c评估的每周一次的血糖控制。例如，很少有研究研究单独对糖尿病患者进行阻力训练的益处，也没有足够的动力或对照试验来检验阻力训练与有氧训练相结合的益处。这尤其有问题，因为国家组织对T2D患者运动处方的大多数建议/指南都建议结合有氧训练和阻力训练，以最大限度地提高健康效益。有必要进行更多的研究，以帮助更好地为T2D患者制定锻炼建议，并潜在地提供更多的锻炼选择，这一点非常重要，因为T2D患者定期参加锻炼的比例很小。研究组将是久坐不动的女性和患有T2D的男性，年龄在30到75岁之间。我们将随机将300人分为仅限有氧运动训练组(AT)、仅限阻力训练组(RT)或有氧加阻力训练组(AT RT)。AT患者将参加为期9个月的每周3至4次训练，总能量消耗达到12千卡/公斤/周(KKW)，这是符合目前公共卫生对T2D患者体力活动的建议的运动量。RT组每周参加3次训练(每次30-45分钟)，重点是大肌肉群。AT RT组的个人将接受12KKW的有氧训练和减少阻力的训练方案，每周2次，每次20分钟。这种组合养生法代表了美国运动医学院和美国糖尿病协会的确切运动建议。简单地说，我们希望检查RT在降低HbA1c方面是否具有与标准AT程序类似的好处，以及AT RT的混合计划是否在降低HbA1c方面优于单独的AT(&RT)。主要结果指标是糖化血红蛋白，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.