@2024 Afarand., IRAN
ISSN: 2252-0805 The Horizon of Medical Sciences 2016;22(1):57-64
ISSN: 2252-0805 The Horizon of Medical Sciences 2016;22(1):57-64
Effect of Aerobic Training and Diet on Insulin Resistance and Quality of Life in Type II Diabetic Patients
ARTICLE INFO
Article Type
Original ResearchAuthors
Mohammad Rahimi Gh.R. (1)Attarzadeh Hosseini S.R. (*)
(*) Sport Physiology Department, Physical Education & Sports Sciences Faculty, Ferdowsi University of Mashhad, Mashhad, Iran
(1) Sport Physiology Department, Physical Education & Sports Sciences Faculty, Ferdowsi University of Mashhad, Mashhad, Iran
Correspondence
Address: Sport Physiology Department, Physical Education & Sports Sciences Faculty, Pardis of Ferdowsi University, Azadi Square, Mashhad, Iran. Postal Code: 48979-91779Phone: +985138833910
Fax: +985138829580
attarzadeh@um.ac.ir
Article History
Received: October 25, 2015Accepted: July 1, 2015
ePublished: December 15, 2015
ABSTRACT
Aims
Self-controling and non-drug intervention methods such as aerobic activities and diet programs have a significant impact on insulin resistance and quality of life in type II diabetic patients. The purpose of this research was to investigate the effect of 12 weeks of aerobic training with diet on insulin resistance and quality of life in type II diabetic patients.
Materials & Methods In this quasi-experimental research in 2013-14, obese female with type II diabetes in Taybad City, Iran, were selected by achievable sampling method and were divided into aerobic training (n=12) and aerobic training with diet (n=11) groups. Aerobic training in both groups was performed in 36 sessions of exercise training; 3 sessions per week with an intensity of 50-70% heart rate reserve. In addition to aerobic training, the second group participated in diet that included 500kcal of energy less than the estimated daily energy requirement. Data were analyzed with SPSS 16 software by paired and independent T tests.
Findings The levels of blood glucose, insulin and insulin resistance reduced significantly just in aerobic training with diet group (p<0.05) just the fasting blood sugar difference was significant between 2 groups (p=0.035). Also, there were significant differences between groups in subscales of role limitations due to physical health problems (p=0.001), role limitations due to emotional problems (p=0.002), social functioning (p=0.002), pain (p=0.001) and general health (p=0.002).
Conclusion 12 weeks of aerobic training with diet lead to improvement in blood sugar, fasting insulin, insulin resistance and some subscales of quality of life in type II diabetic patients.
Materials & Methods In this quasi-experimental research in 2013-14, obese female with type II diabetes in Taybad City, Iran, were selected by achievable sampling method and were divided into aerobic training (n=12) and aerobic training with diet (n=11) groups. Aerobic training in both groups was performed in 36 sessions of exercise training; 3 sessions per week with an intensity of 50-70% heart rate reserve. In addition to aerobic training, the second group participated in diet that included 500kcal of energy less than the estimated daily energy requirement. Data were analyzed with SPSS 16 software by paired and independent T tests.
Findings The levels of blood glucose, insulin and insulin resistance reduced significantly just in aerobic training with diet group (p<0.05) just the fasting blood sugar difference was significant between 2 groups (p=0.035). Also, there were significant differences between groups in subscales of role limitations due to physical health problems (p=0.001), role limitations due to emotional problems (p=0.002), social functioning (p=0.002), pain (p=0.001) and general health (p=0.002).
Conclusion 12 weeks of aerobic training with diet lead to improvement in blood sugar, fasting insulin, insulin resistance and some subscales of quality of life in type II diabetic patients.
CITATION LINKS
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[2]DeFronzo RA. Pathogenesis of type 2 diabetes mellitus. Med Clin North Am. 2004;88(4):787-835.
[3]Misra A, Alappan NK, Vikram NK, Goel K, Gupta N, Mittal K, et al. Effect of supervised progressive resistance-exercise training protocol on insulin sensitivity, glycemia, lipids, and body composition in Asian Indians with type 2 diabetes. Diabetes Care. 2008;31(7):1282-7.
[4]Kelley DE, Goodpaster BH. Effects of exercise on glucose homeostasis in Type 2 diabetes mellitus. Med Sci Sports Exerc. 2001;33(Suppl 6):S495-501.
[5]Alavi NM, Ghofranipour F, Ahmadi F, Emami A. Developing a culturally valid and reliable quality of life questionnaire for diabetes mellitus. East Mediterr Health J. 2007;13(1):177-85.
[6]Sadegh Ahari S, Arshi S, Iranparvar Alamdari M, Amani F, Siahpoush H. The effect of complications of diabetes type II on the quality of life in diabetic patients. J Ardebil Univ Med Sci. 2009;8(4):394-402. [Persian]
[7]Chaput JP, Klingenberg L, Rosenkilde M, Gilbert JA, Tremblay A, SjödinA. Physical activity plays an important role in body weight regulation. J Obes. 2011;2011:360257.
[8]Gram B, Christensen R, Christiansen C, Gram J. Effects of nordic walking and exercise in type 2 diabetes mellitus: A randomized controlled trial. Clin J Sport Med. 2010;20(5):355-61.
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[10]Snel M, Sleddering MA, Vd Peijl ID, Romijn JA, Pijl H, Meinders AE, et al. Quality of life in type 2 diabetes mellitus after a very low calorie diet and exercise. Eur J Intern Med. 2012;23(2):143-9.
[11]Wycherley TP, Marshall Clifton P, Noakes M, Brinkworth GD. Weight loss on a structured hypocaloric diet with or without exercise improves emotional distress and quality of life in overweight and obese patients with type 2 diabetes. J Diabetes Investig. 2014;5(1)94-8.
[12]Holton DR, Colberg SR, Nunnold T, Parson HK, Vinik AI. The effect of an aerobic exercise training program on quality of life in type 2 diabetes. Diabetes Educ. 2003;29(5):837-46.
[13]Paschalides C, Wearden AJ, Dunkerley R, Bundy C, Davies R, Dickens CM. The associations of anxiety, depression and personal illness representations with glycaemic control and health-related quality of life in patients with type 2 diabetes mellitus. J Psychosom Res. 2004;57(6):557-64.
[14]Undén AL, Elofsson S, Andréasson A, Hillered E, Eriksson I, Brismar K. Gender differences in self-rated health, quality of life, quality of care, and metabolic control in patients with diabetes. Gend Medi. 2008;5(2):162-80.
[15]Chagh R, Manoudi F, Benhima I, Asri F, Tazi I. Association between diabetes and depression. Eur Psychiatry. 2008;23(Suppl 2):S245.
[16]Egede LE, Ellis C. Diabetes and depression: Global perspectives. Diabetes Res Clin Pract. 2010;87(3):302-12.
[17]Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998;15(7):539-53.
[18]Siri WE. Body composition from fluid spaces and density: analysis of methods 1961. Nutrition. 1993;9(5):480-91.
[19]Jackson AS, Pollock ML, Ward A. Generalized equations for predicting body density of women. Med Sci Sports Exerc. 1980;12(3):175-81.
[20]Shidfar F, Rezaei Kh, Hosseini Esfahani Sh, Heydari I. The effects of vitamin E on insulin resistance and cardiovascular diseases risk factors in metabolic syndrome. Iran J Endo Metab. 2009;10(5):445-54. [Persian]
[21]Skrha J, Haas T, Sindelka G, Prázný M, Widimský J, Cibula D, et al. Comparison of the insulin action parameters from hyperinsulinemic clamps with homeostasis model assessment and QUICKI indexes in subjects with different endocrine disorders. J Clin Endocrinol Metab. 2004;89(1):135-41.
[22]Ryan MC, Abbasi F, Lamendola C, Carter S, McLaughlin TL. Serum alanine aminotransferase levels decrease further with carbohydrate than fat restriction in insulin-resistant adults. Diabetes Care. 2007;30(5):1075-80.
[23]Pollock M, Gaesser GA, Butcher JD, Després JP, Dishman RK, Franklin BA, et al. American College of Sports Medicine Position Stand, The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc. 1998;30(6):975-91.
[24]Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473-83.
[25]Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The short form health survey (SF-36): Translation and validation study of the Iranian version. Qual Life Res. 2005;14(3):875-82.
[26]Shahrjerdi Sh, Shavandi N, Sheikh-Hoseini R, Shahrjerd Sh. The effect of strengthening and endurance training on metabolic factors, quality of life and mental health in women with type П diabetes. J Shahrekord Univ Med Sci. 2010;12(3):85-93. [Persian]
[27]Jorge ML, de Oliveira VN, Resende NM, Paraiso LF, Calixto A, Diniz AL, et al. The effects of aerobic, resistance, and combined exercise on metabolic control, inflammatory markers, adipocytokines, and muscle insulin signaling in patients with type 2 diabetes mellitus. Metabolism. 2011;60(9):1244-52.
[28]Eizadi M, Karimi M, Kohandel M, Doaly H. Effect of aerobic exercise on serum leptin response and insulin resistance of patients with type 2 diabetes . J Qazvin Univ Med Sci. 2013;16(4):33-9. [Persian]
[29]Cauza E, Hanusch-Enserer U, Strasser B, Ludvik B, Metz-Schimmerl S, Pacini G, et al. The relative benefits of endurance and strength training on the metabolic factors and muscle function of people with type 2 diabetes mellitus. Arch Phys Med Rehabil. 2005;86(8):1527-33.
[30]Smith DW, McFall SL. The relationship of diet and exercise for weight control and the quality of life gap associated with diabetes. J Psychosom Res. 2005;59(6):385-92.
[31]Brown GC, Brown MM, Sharma S, Brown H, Gozum M, Denton P. Quality of life associated with diabetes mellitus in an adult population. J Diabetes Complications. 2000;14(1):18-24.
[32]Shobhana R, Rama Rao P, Lavanya A, Padma C, Vijay V, Ramachandran A. Quality of life and diabetes integration among subjects with type 2 diabetes. J Assoc Physicians India. 2003;51:363-6.
[33]Khoshbin S, Ghosy A, Farahani A, Motlagh M. Guides to promote active lifestyles in old age. Tehran: Tandis Publications; 2007. [Persian]
[34]Schmidt D, Schoettler B. Sport the elders. Material for sports in North Rh ine Westphalia 46. Duesseldorf: MAGS; 1996.
[35]Hasan Pourdehkordy A, Masodi R, Naderi Poor A, Pourmirza Kalhori R. The effect of exercise on quality of life for the elderly in shahrekord. Salmand. 2008;6(2):437-44. [Persian]
[36]Chen YM, Li Y. Safety and efficacy of exercise training in elderly heart failure patients: A systematic review and meta-analysis. Int J Clin Pract. 2013;67(11):1192-8.
[37]Zhang X, Norris SL, Chowdhury FM, Gregg EW, Zhang P. The effects of interventions on health-related quality of life among persons with diabetes: a systematic review. Med Care. 2007;45(9):820-34.
[38]Rubin RR, Peyrot M. Quality of life and diabetes. Diabetes Metabo Res Rev. 1999;15(3):205-18.
[39]Lavie CJ, Thomas RJ, Squires RW, Allison TG, Milani RV. Exercise training and cardiac rehabilitation in primary and secondary prevention of coronary heart disease. Mayo Clin Proc. 2009;84(4);373-83.
[40]Ravasi AA, Aminian Razavi T, Gaeini A, Hamediniya M, Haghighi AH. Effects of endurance training on proinflammatory cytokines and insulin resistance in obese men. Harkat. 2005;28(2):31-49. [Persian]
[41]Dishman RK, Renner KJ, Youngstedt SD, Reigle TG, Bunnell BN, Burke KA, et al. Activity wheel running reduces escape latency and alters brain monoamine levels after footshock. Brain Res Bull. 1997;42(5):399-406.
[2]DeFronzo RA. Pathogenesis of type 2 diabetes mellitus. Med Clin North Am. 2004;88(4):787-835.
[3]Misra A, Alappan NK, Vikram NK, Goel K, Gupta N, Mittal K, et al. Effect of supervised progressive resistance-exercise training protocol on insulin sensitivity, glycemia, lipids, and body composition in Asian Indians with type 2 diabetes. Diabetes Care. 2008;31(7):1282-7.
[4]Kelley DE, Goodpaster BH. Effects of exercise on glucose homeostasis in Type 2 diabetes mellitus. Med Sci Sports Exerc. 2001;33(Suppl 6):S495-501.
[5]Alavi NM, Ghofranipour F, Ahmadi F, Emami A. Developing a culturally valid and reliable quality of life questionnaire for diabetes mellitus. East Mediterr Health J. 2007;13(1):177-85.
[6]Sadegh Ahari S, Arshi S, Iranparvar Alamdari M, Amani F, Siahpoush H. The effect of complications of diabetes type II on the quality of life in diabetic patients. J Ardebil Univ Med Sci. 2009;8(4):394-402. [Persian]
[7]Chaput JP, Klingenberg L, Rosenkilde M, Gilbert JA, Tremblay A, SjödinA. Physical activity plays an important role in body weight regulation. J Obes. 2011;2011:360257.
[8]Gram B, Christensen R, Christiansen C, Gram J. Effects of nordic walking and exercise in type 2 diabetes mellitus: A randomized controlled trial. Clin J Sport Med. 2010;20(5):355-61.
[9]Reid RD, Tulloch HE, Sigal RJ, Kenny GP, Fortier M, McDonnell L, et al. Effects of aerobic exercise, resistance exercise or both, on patient-reported health status and well-being in type 2 diabetes mellitus: A randomised trial. Diabetologia. 2010;53(4):632-40.
[10]Snel M, Sleddering MA, Vd Peijl ID, Romijn JA, Pijl H, Meinders AE, et al. Quality of life in type 2 diabetes mellitus after a very low calorie diet and exercise. Eur J Intern Med. 2012;23(2):143-9.
[11]Wycherley TP, Marshall Clifton P, Noakes M, Brinkworth GD. Weight loss on a structured hypocaloric diet with or without exercise improves emotional distress and quality of life in overweight and obese patients with type 2 diabetes. J Diabetes Investig. 2014;5(1)94-8.
[12]Holton DR, Colberg SR, Nunnold T, Parson HK, Vinik AI. The effect of an aerobic exercise training program on quality of life in type 2 diabetes. Diabetes Educ. 2003;29(5):837-46.
[13]Paschalides C, Wearden AJ, Dunkerley R, Bundy C, Davies R, Dickens CM. The associations of anxiety, depression and personal illness representations with glycaemic control and health-related quality of life in patients with type 2 diabetes mellitus. J Psychosom Res. 2004;57(6):557-64.
[14]Undén AL, Elofsson S, Andréasson A, Hillered E, Eriksson I, Brismar K. Gender differences in self-rated health, quality of life, quality of care, and metabolic control in patients with diabetes. Gend Medi. 2008;5(2):162-80.
[15]Chagh R, Manoudi F, Benhima I, Asri F, Tazi I. Association between diabetes and depression. Eur Psychiatry. 2008;23(Suppl 2):S245.
[16]Egede LE, Ellis C. Diabetes and depression: Global perspectives. Diabetes Res Clin Pract. 2010;87(3):302-12.
[17]Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998;15(7):539-53.
[18]Siri WE. Body composition from fluid spaces and density: analysis of methods 1961. Nutrition. 1993;9(5):480-91.
[19]Jackson AS, Pollock ML, Ward A. Generalized equations for predicting body density of women. Med Sci Sports Exerc. 1980;12(3):175-81.
[20]Shidfar F, Rezaei Kh, Hosseini Esfahani Sh, Heydari I. The effects of vitamin E on insulin resistance and cardiovascular diseases risk factors in metabolic syndrome. Iran J Endo Metab. 2009;10(5):445-54. [Persian]
[21]Skrha J, Haas T, Sindelka G, Prázný M, Widimský J, Cibula D, et al. Comparison of the insulin action parameters from hyperinsulinemic clamps with homeostasis model assessment and QUICKI indexes in subjects with different endocrine disorders. J Clin Endocrinol Metab. 2004;89(1):135-41.
[22]Ryan MC, Abbasi F, Lamendola C, Carter S, McLaughlin TL. Serum alanine aminotransferase levels decrease further with carbohydrate than fat restriction in insulin-resistant adults. Diabetes Care. 2007;30(5):1075-80.
[23]Pollock M, Gaesser GA, Butcher JD, Després JP, Dishman RK, Franklin BA, et al. American College of Sports Medicine Position Stand, The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc. 1998;30(6):975-91.
[24]Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473-83.
[25]Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The short form health survey (SF-36): Translation and validation study of the Iranian version. Qual Life Res. 2005;14(3):875-82.
[26]Shahrjerdi Sh, Shavandi N, Sheikh-Hoseini R, Shahrjerd Sh. The effect of strengthening and endurance training on metabolic factors, quality of life and mental health in women with type П diabetes. J Shahrekord Univ Med Sci. 2010;12(3):85-93. [Persian]
[27]Jorge ML, de Oliveira VN, Resende NM, Paraiso LF, Calixto A, Diniz AL, et al. The effects of aerobic, resistance, and combined exercise on metabolic control, inflammatory markers, adipocytokines, and muscle insulin signaling in patients with type 2 diabetes mellitus. Metabolism. 2011;60(9):1244-52.
[28]Eizadi M, Karimi M, Kohandel M, Doaly H. Effect of aerobic exercise on serum leptin response and insulin resistance of patients with type 2 diabetes . J Qazvin Univ Med Sci. 2013;16(4):33-9. [Persian]
[29]Cauza E, Hanusch-Enserer U, Strasser B, Ludvik B, Metz-Schimmerl S, Pacini G, et al. The relative benefits of endurance and strength training on the metabolic factors and muscle function of people with type 2 diabetes mellitus. Arch Phys Med Rehabil. 2005;86(8):1527-33.
[30]Smith DW, McFall SL. The relationship of diet and exercise for weight control and the quality of life gap associated with diabetes. J Psychosom Res. 2005;59(6):385-92.
[31]Brown GC, Brown MM, Sharma S, Brown H, Gozum M, Denton P. Quality of life associated with diabetes mellitus in an adult population. J Diabetes Complications. 2000;14(1):18-24.
[32]Shobhana R, Rama Rao P, Lavanya A, Padma C, Vijay V, Ramachandran A. Quality of life and diabetes integration among subjects with type 2 diabetes. J Assoc Physicians India. 2003;51:363-6.
[33]Khoshbin S, Ghosy A, Farahani A, Motlagh M. Guides to promote active lifestyles in old age. Tehran: Tandis Publications; 2007. [Persian]
[34]Schmidt D, Schoettler B. Sport the elders. Material for sports in North Rh ine Westphalia 46. Duesseldorf: MAGS; 1996.
[35]Hasan Pourdehkordy A, Masodi R, Naderi Poor A, Pourmirza Kalhori R. The effect of exercise on quality of life for the elderly in shahrekord. Salmand. 2008;6(2):437-44. [Persian]
[36]Chen YM, Li Y. Safety and efficacy of exercise training in elderly heart failure patients: A systematic review and meta-analysis. Int J Clin Pract. 2013;67(11):1192-8.
[37]Zhang X, Norris SL, Chowdhury FM, Gregg EW, Zhang P. The effects of interventions on health-related quality of life among persons with diabetes: a systematic review. Med Care. 2007;45(9):820-34.
[38]Rubin RR, Peyrot M. Quality of life and diabetes. Diabetes Metabo Res Rev. 1999;15(3):205-18.
[39]Lavie CJ, Thomas RJ, Squires RW, Allison TG, Milani RV. Exercise training and cardiac rehabilitation in primary and secondary prevention of coronary heart disease. Mayo Clin Proc. 2009;84(4);373-83.
[40]Ravasi AA, Aminian Razavi T, Gaeini A, Hamediniya M, Haghighi AH. Effects of endurance training on proinflammatory cytokines and insulin resistance in obese men. Harkat. 2005;28(2):31-49. [Persian]
[41]Dishman RK, Renner KJ, Youngstedt SD, Reigle TG, Bunnell BN, Burke KA, et al. Activity wheel running reduces escape latency and alters brain monoamine levels after footshock. Brain Res Bull. 1997;42(5):399-406.