The aim of this study was to investigate the effectiveness of a 12-week moderate intensity, water-based circuit-type training intervention on glucose and insulin responses in overweight women with normal or impaired glucose tolerance.
Methods:
Fifteen overweight women (body mass index [BMI] > 25 kg/m2) with normal glucose tolerance (NGT; n = 7) or impaired glucose tolerance (IGT; n = 8) were recruited for this study. All women completed a 12-week training intervention utilizing a combination of aerobic and resistance exercises in an aquatic environment, 3 days per week and 60 min per session at 70–75% mode-specific maximum heart rate. A standard 75-g oral glucose tolerance test (OGTT) was administered pre- and post-intervention, from which fasting and post-load plasma insulin and glucose levels were assessed.
Results:
Following the 12-week period, fasting insulin levels had decreased by 44% and 2-h glucose by 30.4% in the group with IGT. Waist circumference (WC) had decreased by 5.3% in this group at the end of the intervention. Only WC and waist-to-hip ratio (WHR) decreased (6.0% and 5.5%, respectively) following the intervention in the NGT group.
Conclusions:
Moderate intensity, water-based circuit-type exercises appear to be an effective exercise modality to improve glucose and insulin response to a glucose challenge in overweight women with IGT.
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References
1.
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care, 2008; 31:S55–S60.
2.
BaronAD. Impaired glucose tolerance as a disease. Am J Cardiol, 2001; 88:16H–9H.
3.
AbateN. Obesity and cardiovascular disease: pathogenetic role of the metabolic syndrome and therapeutic implications. J Diabetes Complications, 2000; 14:154–174.
4.
TripathyD, AlmgrenP, TuomiTet al.Contribution of insulin-stimulated glucose uptake and basal hepatic insulin sensitivity to surrogate measures of insulin sensitivity. Diabetes Care, 2004; 27:2204–2210.
5.
HillJO, WyattHR. Role of physical activity in preventing and treating obesity. J Appl Physiol, 2005; 99:765–770.
6.
IvyJL. Role of exercise training in the prevention and treatment of insulin resistance and non-insulin-dependent diabetes mellitus. Sports Med, 1997; 24:321–336.
7.
TuomilehtoJ, LindstromJ, ErikssonJGet al.Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med, 2001; 344:1343–1350.
8.
UusitupaMIJ, LindiV, LouherantaAet al.Long-term improvement in insulin sensitivity by changing lifestyles of people with impaired glucose tolerance. Diabetes, 2003; 52:2532–2538.
9.
YatesT, KhuntiK, BullFet al.The role of physical activity in the management of impaired glucose tolerance: a systematic review. Diabetologia, 2007; 50:1116–1126.
10.
BorodulinK, TuomilehtoJ, PeltonenMet al.Association of leisure time physical activity and abdominal obesity with fasting serum insulin and 2-h postchallenge plasma glucose levels. Diabet Med, 2006; 23:1025–1028.
11.
SigalRJ, KennyGP, BouleNGet al.Effects of aerobic training, resistance training, or both on glycemic control in Type 2 diabetes: a randomized trial. Ann Intern Med, 2007; 147:357–369.
12.
BalducciS, LeonettiF, Di MarioUet al.Is a long-term aerobic plus resistance training program feasible for and effective on metabolic profiles in type 2 diabetic patients?Diabetes Care, 2004; 27:841–842.
13.
ErikssonJ, TuominenJ, ValleTet al.Aerobic endurance exercise or circuit-type resistance training for individuals with impaired glucose tolerance?Horm Metab Res, 1998; 30:37–41.
14.
MaioranaA, O'DriscollG, GoodmanCet al.Combined aerobic and resistance exercise improves glycemic control and fitness in type 2 diabetes. Diabetes Res Clin Pract, 2002; 56:115–123.
15.
TakeshimaN, RogersME, WatanabeEet al.Water-based exercise improves health-related aspects of fitness in older women. Med Sci Sports Exerc, 2002; 34:544–551.
16.
ChuKS, EngJJ, DawsonASet al.Water-based exercise for cardiovascular fitness in people with chronic stroke: a randomised controlled trial. Arch Phys Med Rehabil, 2004; 85:870–874.
17.
MeyerK, BuckingJ. Exercise in heart failure: should aqua therapy and swimming be allowed?Med Sci Sports Exerc, 2004; 36:2017–2023.
18.
SideraviciuiteS, GailiunieneA, VisagurskieneKet al.The effect of long-term swimming program on glycemia control in 14–19-year aged healthy girls and girls with type 1 diabetes mellitus. Medicina (Kaunas), 2006; 42:513–518.
19.
TanakaH, BassettJDR, HowleyET. Effects of swim training on body weight, carbohydrate metabolism, lipid and lipoprotein profile. Clin Physiol, 1997; 17:347–359.
20.
HealyGN, DunstanDW, SalmonJet al.Objectively measured light-intensity physical activity is independently associated with 2-h plasma glucose. Diabetes Care, 2007; 30:1384–1389.
21.
O'DonovanG, KearneyE, NevillAet al.The effects of 24 weeks of moderate- or high-intensity exercise on insulin resistance. Eur J Appl Physiol, 2005; 95:522–528.
22.
LindMSE, Joens-MatreRR, EkkekakisP. What intensity of physical activity do previously sedentary middle-aged women select? Evidence of a coherent pattern from physio-logical, perceptual, and affective markers. Prev Med, 2005; 40:407–419.
23.
TaylorHL, BuskirkE, HenschelA. Maximal oxygen uptake as an objective measure of cardio-respiratory performance. J Appl Physiol, 1955; 8:73–80.
24.
DayJR, RossiterHB, CoatsEMet al.The maximally attainable VO2 during exercise in humans: the peak vs. maximum issue. J Appl Physiol, 2003; 95:1901–1907.
25.
WilmoreJH, FreundBJ, JoynerMJet al.Acute responses to submaximal and maximal exercise consequent to beta-adrenergic blockade: implications for the prescription of exercise. Am J Cardiol, 1985; 55:135D–141D.
26.
MercerJA, JensenRL. Reliability and validity of a deep water running graded exercise test. Meas Phys Educ Exerc Sci, 1997; 1:213–222.
27.
PhillipsVK, LeggeM, JonesLM. Maximal physiological responses between aquatic and land exercise in overweight women. Med Sci Sports Exerc, 2008; 40:959–964.
28.
BorgGAV.Psychophysical basis of perceived exertion. Med Sci Sports Exerc, 1982; 14:377–381.
PerreaultL, BergmanBC, PlaydonMCet al.Impaired fasting glucose with or without impaired glucose tolerance: progressive or parallel states of prediabetes?Am J Physiol, 2008; 295:E428–E435.
31.
UnwinN, ZimmetP, AlbertiK. Impaired glucose tolerance and impaired fasting glycaemia: the current status on definition and intervention. Diabet Med, 2002; 19:708–723.
32.
DelaF, PlougT, HandbergAet al.Physical training increases muscle GLUT4 protein and mRNA in patients with NIDDM. Diabetes, 1994; 43:862–865.
33.
LilliojaS, YoungAA, CutlerCLet al.Skeletal muscle capillary density and fiber type are possible determinants of in vivo insulin resistance in man. J Clin Invest, 1987; 80:415–424.
34.
UtriainenT, HolmangA, BjorntorpPet al.Physical fitness, muscle morphology, and insulin-stimulated limb blood flow in normal subjects. Am J Physiol, 1996; 270:E905–E911.
35.
TurcotteLP, FisherJS. Skeletal muscle insulin resistance: roles of fatty acid metabolism and exercise. Phys Ther, 2008; 88:1279–1296.
36.
SimoneauJ-A, ColbergSR, ThaeteFLet al.Skeletal muscle glycolytic and oxidative enzyme capacities are determinants of insulin sensitivity and muscle composition in obese women. FASEB J, 1995; 9:273–278.
37.
BruceCR, ThrushAB, MertzVAet al.Endurance training in obese humans improves glucose tolerance and mitochondrial fatty acid oxidation and alters muscle lipid content. Am J Physiol, 2006; 291:E99–E107.
38.
SimoneauJ-A, KelleyDE. Altered glycolytic and oxidative capacities of skeletal muscle contribute to insulin resistance in NIDDM. J Appl Physiol, 1997; 83:166–171.
39.
HeJ, GoodpasterBH, KelleyDE. Effects of weight loss and physical activity on muscle lipid content and droplet size. Obes Res, 2004; 12:761–769.
40.
HoumardJA, WeidnerML, GaviganKEet al.Fiber type and citrate synthase activity in the human gastrocnemius and vastus lateralis with aging. J Appl Physiol, 1998; 85:1337–1341.
41.
PoehlmanET, DvorakRV, DeNinoWFet al.Effects of resistance training and endurance training on insulin sensitivity in nonobese, young women: a controlled randomized trial. J Clin Endocrinol Metab, 2000; 85:2463–2468.
42.
PoyhonenT, SipilaS, KeskinenKIet al.Effects of aquatic resistance training on neuromuscular performance in healthy women. Med Sci Sports Exerci, 2002; 34:2103–2109.
43.
RossR, JanssenI, DawsonJet al.Exercise-induced reduction in obesity and insulin resistance in women: a randomized controlled trial. Obes Res, 2004; 12:789–798.
44.
JaniszewskiPM, JanssenI, RossR. Does waist circumference predict diabetes and cardiovascular disease beyond commonly evaluated cardiometabolic risk factors?Diabetes Care, 2007; 30:3105–3109.
45.
LeeS, KukJL, KatzmarzykPTet al.Cardiorespiratory fitness attenuates metabolic risk independent of abdominal subcutaneous and visceral fat in men. Diabetes Care, 2005; 28:895–901.
46.
EkelundU, FranksPW, SharpSet al.Increase in physical activity energy expenditure is associated with reduced metabolic risk independent of change in fatness and fitness. Diabetes Care, 2007; 30:2101–2106.
47.
WassermanK, HansenJE, SueDYet al.Principles of exercise testing and interpretation, 4th. Philadelphia: Lippincott, Williams & Wilkins, 2005.
48.
BouchardC, RankinenT. Individual differences in response to regular physical activity. Med Sci Sports Exerc, 2001; 33:S446–S451.
