@2024 Afarand., IRAN

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ISSN: 2252-0805    The Horizon of Medical Sciences 2016;22(1):57-64

Background
Many patients with type II diabetes can control their blood glucose via a proper diet, regular sports, excess weight loss, self-care behaviors, and medication consumption [1]. … [2-10]
Previous Studies
There are few studies on the effects of diet with sport activities on the quality of life in obese persons with diabetes and some results contradict each other [8, 9, 11]. … [12-17]
Aim(s)
The aim of this study was to investigate the effects of 12-week aerobic exercises with diet on insulin resistance and quality of life in patients with type II diabetes.
Research type
This is a semi-experimental study with pretest-posttest stages.
Research society, place and time
Female obese patients with type II diabetes under the care of the health centers of Taibad Township (Iran) were studied in spring 2013.
Sampling method and number
23 women with at least 2years diabetes history were selected voluntarily through Achievable Sampling Method.
Used devices&materials
The subjects were divided into two groups including aerobic exercise (n=12) and aerobic exercise with diet (n=11). Through Fleiss Sample Size, the sample size was estimated 10 persons per group. Due absence, 2 persons of aerobic exercise group and 1 person of aerobic exercise with diet group were excluded. At the first day, heights and weights of the subjects were measured using a stadiometer and a scale (ADE; Germany). Body mass index was computed via dividing weight by the square of height in meter. In three successive times, subcutaneous fat thicknesses of arm triceps, upper iliac, and femoral regions were measured in millimeters, using a caliper (Yagami; Japan). To compute the density of the body, Jackson-Pollock equation and Body Fat Percentage Saturation formula were used [18, 19]. Before the beginning and after the end of the exercise and diet program, blood sampling was done from the forward-brachial vein (10 cc). Before the blood sampling, all the subjects were fasting for 12-hour and without any severe activities for 24 hours. Blood biochemical factors, including fasting blood glucose, were measured, through enzymatic method and using an auto-analyzer device and a kit (Pars-Azmoon; Iran). Fasting insulin was measured using Eliza kit (Noor Laboratory Network; Iran). Insulin resistance was measured via HOMA-IR method and after the measurement of glucose concentration and serum fasting insulin [20]. Reverse ratio of HOMA-IR was used to compute insulin sensitivity [21]. All the measurements were repeated at the beginning and at the end of the study (after a 12-week intervention) similarly and equally. Diet for each person was determined based on the basis metabolism and daily activity level [22]. Aerobic exercise program was designed based on the American College of Sport Medicine guidelines [23]. The program was performed by a stationary bike indoors and under the supervisions of the instructor and the researcher. The sport activity program included warming up (10-15min), aerobic exercise, and cooling down (10-12min) for 12 weeks, 3 sessions per week, and 30-60min a week. The first session exercise length was 10min. And there was 1min excess exercise length at each session, added gradually. The exercise length at the ninth, tenth, eleventh, and twelfth weeks was fixed (35min). Before and after the intervention, the quality of life was assessed, using 36-question Quality of Life Questionnaire (SF-36) [24]. The more the scores are, the better the situation is. Data was analyzed, using SPSS 16 software. Mean and standard deviation were computed, using Descriptive Statistics. Kolmogorov-Smirnov test was used to investigate normal data. Correlated T test was used to compare intragroup mean values. Independent T test was used to compare intergroup mean values. … [25]
Findings by Text
Mean ages of aerobic exercise group and diet with aerobic exercise group were 46.00±8.48years and 49.50±6.90years, respectively. Mean heights of aerobic exercise group and diet with aerobic exercise group were 154.80±5.02cm and 151.50±5.01cm, respectively. After 12-week intervention, there were significant reductions in mean blood sugar, fasting insulin, and insulin resistance indices in diet with aerobic exercises. However, the changes were not significant in aerobic group. Intergroup comparison showed a significant difference between the groups only in mean fasting blood sugar. There was no significant difference between the groups in fasting insulin and insulin resistance. In addition, there were significant reductions in mean weight, body mass index (BMI), and body fat percentage in both groups. There was a significant difference in mean BMI between the groups only (Table 1). There were significant changes in physical limited functioning, psychological limited functioning, vitality, social functioning, and general health due to 12-week aerobic exercises. There were significant changes in physical limited functioning, psychological limited functioning, vitality, social functioning, pain and general health due to 12-week aerobic exercises with diet. There were significant differences between the groups in mean physical limited functioning, psychological limited functioning, social functioning, pain, and general health (Table 2).
Main comparison to the similar studies
There were significant reductions in blood sugar, fasting insulin, and insulin resistance after the intervention in aerobic exercise with diet group only. There were no significant changes in blood sugar and fasting insulin in aerobic exercise group. Based on the intergroup comparison, there was a significant difference between the groups only in blood sugar changes. There was no significant difference in the changes of insulin resistance between the groups. There are significant reductions in fasting glucose and insulin resistance, due to aerobic exercises [26-28]. The results are consistent with the present results. There were reductions in fasting glucose, glycosylated hemoglobin, and serum insulin [26]. There are reductions in fasting glucose, lipid indices, fasting insulin, and C-reactive protein, due to aerobic, resistance, and combined exercises [27]. There are significant reductions in fasting glucose and insulin resistance in male patients with type II diabetes during aerobic exercise program [28]. The results are not consistent with another study [29]. … [30-32] Based on the intergroup mean comparisons, there was a significant difference in physical limited functioning between the groups. Body activities advantageously affect physical functioning of the diabetic patients [33]. The result is consistent with the present results. Based on the intergroup comparison, there was a significant difference in psychological limited functioning between the groups. There is a positive and significant correlation between physical activity level and self-esteem [34, 35]. There were significant differences in social functioning, body pain, and general health between the groups. 20-30min daily moderate sport activity might reduce function limitations and leads to play more roles, which results in better quality of life [36]. … [37-41]
Suggestions
In designing sport activities and diets, the physicians and sport instructors should consider optimal consumptions of micronutrients and proper diets.
Limitations
Lack of any control on life method and genetic, physiological, and hormonal characteristics were of the limitations for the present study.
Conclusions
12-week aerobic exercises with diet can improve sugar blood, fasting insulin, insulin resistance, and some sub-scales of the quality of life in patients with type II diabetes. Nevertheless, aerobic exercises, solely, do not affect the improvement of the factors.
Acknowledgments
All the participants are appreciated.
Conflict of interest
Non-declared
Ethical Permissions
Written informed consent forms were completed by the participants.
Funding Sources
The study was not funded.

TABLES and CHARTS

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