Walking is commonly employed as a non-pharmacological therapy for people with type 2 diabetes (T2DM) and has been shown to improve glycaemic control, lipid metabolism and insulin sensitivity (Di Loreto et al., 2005). However, other research has not shown these findings (Gray et al., 2009). The factors responsible for the differences in these studies are unclear hampered by ill-defined characteristics of the walking training programmes. This study examined changes in fasting glucose, insulin and non-esterified fatty acid (NEFA) concentrations following a 7-week heart rate prescribed, laboratory-supervised walking programme in individuals with T2DM. With ethics approval, twenty-eight people with complication free T2DM (age 60±10 years, mass 91.1±23.5 kg, HbA1c 7.0±1.4%, VO2peak 20.9±3.9 ml.kg-1.min-1) were randomly assigned to WALK or CONTROL groups. Participants attended the laboratory on two occasions in a fasted state having abstained from physical activity for the prior 24 h. Resting blood samples were obtained from an antecubital vein and were analysed for blood glucose (GEM Premier 3000, Instrumentation Laboratories), serum insulin (Roche Diagnostics Ltd) and non-esterified fatty acid (Roche Diagnostics Ltd) concentrations. WALK then completed a 7-week (4 sessions.wk-1, ~ 135 min weekly walking) heart rate intensity-prescribed, laboratory-supervised, walking training programme, while CONTROL continued normal daily activities. A Homeostasis Model Assessment (HOMA-IR) and revised Quantitative Insulin Sensitivity Check Index (QUICKI) were used to assess changes in insulin sensitivity. Data are presented as mean±SD and analysed using independent samples T-test’s with p<0.05. Training sessions over 7 weeks elicited a mean heart rate of 78±8 %HRpeak and an RPE of 11±1. Fasting insulin and glucose concentrations were not different between groups following training (Insulin: WALK Δ-1.4±10.9 vs. CONTROL Δ-5.2±19.7 µU.ml-1 & Glucose: WALK Δ-0.5±1.9 vs. CONTROL Δ0.9±3.0 mmol.L-1, NS). NEFA was similar between WALK and CONTROL following walking training (WALK Δ-0.3±0.3 vs. CONTROL Δ-0.2±0.3 mmol.L-1, NS). HOMA-IR (WALK Δ-1.2±3.6 vs. CONTROL Δ-0.5±6.3, NS) and QUICKI (WALK Δ 0.02±0.03 vs. CONTROL Δ 0.01±0.04, NS) index’s were not different between WALK and CONTROL following training. A 7-week heart rate prescribed, laboratory-supervised walking programme performed four times a week at 78±8 % of heart rate peak had no significant effect on fasted, resting glucose, insulin or non-esterified fatty acid concentrations. Insulin sensitivity was not improved following training when calculated using either HOMA-IR or QUICKI models. These findings demonstrate that the intensity of walking in this programme may not have been sufficient to alter resting metabolism or influence insulin sensitivity in individuals with T2DM.
King's College London (2009) Proc Physiol Soc 14, PC29
Poster Communications: Metabolic changes following a heart rate prescribed, laboratory-supervised walking training programme in individuals with Type 2 diabetes.
R. D. Morton1, D. J. West1, J. W. Stephens2, S. C. Bain2, R. M. Bracken1,2
1. Sports and Exercise Research Centre, Swansea University, Swansea, United Kingdom. 2. Diabetes Research Group, School of Medicine, Swansea University, Swansea, United Kingdom.
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Where applicable, experiments conform with Society ethical requirements.