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A 12-week prospective randomized controlled trial to investigate the effects of aerobic training on type 2 diabetes patientsThis study was undertaken to investigate the effects of a 12-week aerobic exercise program in the management of patients with type 2 diabetes. A prospective randomized controlled trial with repeated measures was conducted. Thirty-six Hong Kong Chinese patients with type 2 diabetes (mean age, 58.1 yr) were randomized into Group 1 (exercise, n = 24) and Group 2 (controls, n = 16). Assessments at baseline and at three months included anthropometry, body fat measurement, biochemistry, six-minute walking distance (6MWD) assessment, exercise capacity, and SF-36® quality of life assessment (QualityMetric Inc., Lincoln, RI). Blood glucose was monitored before and after each exercise session. The immediate response to one hour of moderate aerobic exercise was a significant decrease in blood glucose (10.4 ± 3.5 mmol/L to 7.1 ± 2.7 mmol/L, p < 0.05). After 12 weeks, significant differences were noted between the groups in 6MWD (498 ± 128 m versus 299 ± 75 m, p = 0.000), exercise capacity in terms of metabolic equivalent units (5.1 ± 1.0 METs versus 2.8 ± 0.8 METs, p = 0.001), and insulin sensitivity (1.7 ± 1.0 S1 versus 4.3 ± 2.5 S1, p = 0.048). Group 1 also demonstrated an increase in HDL (1.16 ± 0.30 mmol/L to 1.27 ± 0.33 mmol/L, p = 0.002), lower body weight (67.3 ± 12.8 kg to 66.9 ± 12.8 kg, p = 0.045), lower body mass (26.5 ± 4.6 BMI to 26.3 ± 4.6 BMI), reduced glycosylated hemoglobin HbA1c) (8.1 ± 1.3 percent to 7.7 ± 1.0 percent), and improved quality of life. In contrast, participants in Group 2 showed a significant decrease in the SF-36 social functioning domain (p = 0.035), lowered scores in all eight quality of life domains, and no changes in other variables. We conclude that moderate aerobic exercise should be advocated in the management of patients with type 2 diabetes.
Folate supplementation reduces serum Hsp70 levels in patients with type 2 diabetesType 2 diabetes patients are subject to oxidative stress as a result of hyperglycemia. The aim of this study was to determine whether administration of the antioxidant folic acid, previously shown to reduce homocysteine levels, would reduce circulating levels of Hsp70 while improving the condition of type 2 diabetes patients with microalbuminuria. Plasma homocysteine fell from pretreatment values of 12.9 to 10.3 μM (P < 0.0001). The urine albumin-creatinine ratio fell from 12.4 to 10.4 mg/mM (P = 0.38). Pretreatment Hsp70 levels were higher in patients not taking insulin (5.32 ng/mL) compared with those on insulin (2.44 ng/mL) (P = 0.012). Folic acid supplementation resulted in a significant fall in Hsp70 (5.32 to 2.05 ng/mL) (P = 0.004). There was no change in Hsp70 in those receiving insulin. Folic acid supplementation in non–insulin-treated type 2 diabetes patients, therefore, resulted in a fall in Hsp70, reflecting an improvement in oxidative stress. The data shows that improvement in homocysteine status can lead to a reduction in Hsp70, indicating the possibility of its use as a marker for severity of disease.