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The metabolic effects of long term exercise in Type 2 Diabetes patients

Die metabolischen Effekte von Langzeittraining bei Patienten mit Diabetes mellitus 2

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Zusammenfassung

EINLEITUNG: Der Effekt von körperlichem Training in der Behandlung des Diabetes mellitus ist gut etabliert. Die Absicht dieser Untersuchung wares, die Langzeit Effekte von einer 8 monatigen Trainingstherapie auf den Glukose- und Fettstoffwechsel zu untersuchen und dies mit Patienten, die nach 4 Monaten ihr Training beendet hatten, zu vergleichen. METHODIK: Nach einer effektiven 4 monatigen Kraftoder Ausdauertrainingperiode wurden 10 Patienten (5 männlich und 5 weiblich, mittleres Alter ± SE:57,1 ± 1,6a) randomisiert um ein weiteres 4 monatiges kombiniertes Kraft- und Ausdauertraining zu absolvieren, während eine Kontrollgruppe von 10 Patienten (5 männlich und 5 weiblich, mittleres Alter ± SE:56,9 ± 1,6a) ihr Training beendeten. ERGEBNISSE: Langzeitzuckerkontrolle verbesserte sich und das HbA1C fiel von 6,9 ± 0,4 auf 6,2 ± 0,2 bei aktiven Patienten, während bei den Kontrollpatienten das HbA1C von 7,5 ± 0,4 auf 8,7 ± 0,6 anstieg (p = 0,002). Die Basiswerte des Gesamtcholesterins verminderten sich signifikant in der Trainingsgruppe (205,5 mg/dl ± 14,1 auf 177,5 ± 13,3) und stiegen in der Kontrollgruppe (185,9 ± 14,1 auf 220,2 ± 15,8) an [p = 0,004]. Zusätzlich kam es zu einer signifikanten Erniedrigung des LDL-Cholesterins und der Trigliceridwerte (beide p < 0,05) in der Trainingsgruppe verglichen zu den Kontrollpatienten. KONKLUSION: Die Studie zeigte, dass zusätzlich zu einer 4 monatigen Trainingsperiode die Fortführung von Training einen hohen Vorteil mit zusätzlicher Reduktion von Nüchtern Blutzuckerwert, HbA1C, Gesamtcholesterin, LDL-Cholesterin und Trigliceridwerte, sowie Erhöhung des HDL-Cholesterin bei Patienten mit Diabetes mellitus 2 bewirken kann. Dies führt zu einer Reduktion des atherogenen Lipid Profils. Im Gegensatz dazu, kam es bei den Kontrollpatienten, die Ihr Training beendet hatten, zu einer Verschlechterung des atherogenen Lipidprofils und des Zuckerstoffwechsels. Die Ergebnisse dieser Studie zeigten, dass Langzeittraining eine wichtige Rolle in der Behandlung des Diabetes mellitus 2 spielen kann und vielleicht vor der Entwicklung kardiovaskulärer Erkrankungen schützen kann.

Summary

INTRODUCTION: The effectiveness of physical exercise in the management of diabetes mellitus type 2 is well established. The purpose of this investigation was to evaluate the effect of long term exercise on glycemic and metabolic control measured after eight months in contrast to patients who had ceased their training after four months. METHODS: After an effective 4 months' strength training or endurance training period, ten patients (5 male and 5 female, mean age ± SE:57.1 ± 1.6 yr) were randomised to a further 4 months of combined endurance and strength training, while a control group of 10 patients (5 male and 5 female, mean age ± SE:56.9 ± 1.6 yr) ceased training. RESULTS: Long term glycemic control improved and HbA1C values fell from 6.9 ± 0.4 to 6.2 ± 0.2 in active patients and increased from 7.5 ± 0.4 to 8.7 ± 0.6 in control patients (p = 0.002). Baseline levels of total cholesterol significantly decreased in training group (205.5 mg/dl ± 14.1 to 177.5 ± 13.3) and increased in controls (185.9 ± 14.1 to 220.2 ± 15.8) [p = 004]. In addition, significant decreases in LDL-cholesterol and triglyceride levels (both p < 05) were observed in the training group compared to controls. CONCLUSION: This study showed that in addition to a 4 month training period, continuation of training proved highly beneficial with further reductions in fasting blood glucose, HbA1C, total cholesterol, LDL-cholesterol, triglyceride, and an elevation in HDL-cholesterol concentrations in diabetes mellitus type 2 patients, thus resulting in a reduced atherogenic lipid profile. In contrast, patients who ceased training after 4 months developed an atherogenic lipid profile and a worsened glycemic control. The results of this study indicate that long term exercise plays an important role in the treatment of diabetes mellitus type 2 and may protect against the development of cardiovascular diseases.

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Correspondence to Edmund Cauza.

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Cauza, E., Hanusch-Enserer, U., Strasser, B. et al. The metabolic effects of long term exercise in Type 2 Diabetes patients. Wien Med Wochenschr 156, 515–519 (2006). https://doi.org/10.1007/s10354-006-0337-y

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