Effects of combined training with different intensities on vascular health in patients with type 2 diabetes

A 1-year randomized controlled trial

João P. Magalhães, Xavier Melo, Inês R. Correia, Rogério T. Ribeiro, João Raposo, Hélder Dores, Manuel Bicho, Luís B. Sardinha

Research output: Contribution to journalArticle

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Abstract

Background: Exercise, when performed on a regular basis, is a well-accepted strategy to improve vascular function in patients with type 2 diabetes. However, the exercise intensity that yields maximal adaptations on structural and functional indices in patients with type 2 diabetes remains uncertain. Our objective was to analyze the impact of a 1-year randomized controlled trial of combined high-intensity interval training (HIIT) with resistance training (RT) vs. a combined moderate continuous training (MCT) with RT on structural and functional arterial indices in patients with type 2 diabetes. Methods: Patients with type 2 diabetes (n = 80) were randomized into an exercise intervention with three groups: control, combined HIIT with RT and combined MCT with RT. The 1-year intervention had 3 weekly exercise sessions. High-resolution ultrasonography of the common carotid artery and central and peripheral applanation tonometry were used to assess the changes in structural and functional arterial indices. Generalized estimating equations were used to model the corresponding outcomes. Results: After adjusting the models for sex, baseline moderate-to-vigorous physical activity, and mean arterial pressure changes, while using the intention-to-treat analysis, a significant interaction was observed on the carotid intima-media thickness (cIMT) for both the MCT (β = - 4.25, p < 0.01) and HIIT group (β = - 3.61, p < 0.01). However, only the HIIT observed favorable changes from baseline to 1-year on peripheral arterial stiffness indices such as carotid radial arterial pulse wave velocity (β = - 0.10, p = 0.044), carotid to distal posterior tibial artery pulse wave velocity (β = - 0.14, p < 0.01), and on the distensibility coefficient (β = - 0.00, p < 0.01). No effect was found for hemodynamic variables after the intervention. Conclusions: Following a 1-year intervention in patients with type 2 diabetes, both the MCT and HIIT group reduced their cIMT, whereas only the HIIT group improved their peripheral arterial stiffness indices and distensibility coefficient. Taken together, HIIT may be a meaningful tool to improve long-term vascular complications in type 2 diabetes. Trial registration clinicaltrials.gov ID: NCT03144505

Original languageEnglish
Article number34
JournalCardiovascular Diabetology
Volume18
Issue number1
DOIs
Publication statusPublished - 18 Mar 2019

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Type 2 Diabetes Mellitus
Blood Vessels
Randomized Controlled Trials
Resistance Training
Health
Exercise
Carotid Intima-Media Thickness
Pulse Wave Analysis
Vascular Stiffness
Tibial Arteries
Intention to Treat Analysis
Common Carotid Artery
Manometry
High-Intensity Interval Training
Ultrasonography
Arterial Pressure
Hemodynamics
Control Groups

Keywords

  • Arterial stiffness
  • Distensibility coefficient
  • High-intensity interval training
  • Intima-media thickness
  • Moderate continuous training
  • Pulse wave velocity

Cite this

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title = "Effects of combined training with different intensities on vascular health in patients with type 2 diabetes: A 1-year randomized controlled trial",
abstract = "Background: Exercise, when performed on a regular basis, is a well-accepted strategy to improve vascular function in patients with type 2 diabetes. However, the exercise intensity that yields maximal adaptations on structural and functional indices in patients with type 2 diabetes remains uncertain. Our objective was to analyze the impact of a 1-year randomized controlled trial of combined high-intensity interval training (HIIT) with resistance training (RT) vs. a combined moderate continuous training (MCT) with RT on structural and functional arterial indices in patients with type 2 diabetes. Methods: Patients with type 2 diabetes (n = 80) were randomized into an exercise intervention with three groups: control, combined HIIT with RT and combined MCT with RT. The 1-year intervention had 3 weekly exercise sessions. High-resolution ultrasonography of the common carotid artery and central and peripheral applanation tonometry were used to assess the changes in structural and functional arterial indices. Generalized estimating equations were used to model the corresponding outcomes. Results: After adjusting the models for sex, baseline moderate-to-vigorous physical activity, and mean arterial pressure changes, while using the intention-to-treat analysis, a significant interaction was observed on the carotid intima-media thickness (cIMT) for both the MCT (β = - 4.25, p < 0.01) and HIIT group (β = - 3.61, p < 0.01). However, only the HIIT observed favorable changes from baseline to 1-year on peripheral arterial stiffness indices such as carotid radial arterial pulse wave velocity (β = - 0.10, p = 0.044), carotid to distal posterior tibial artery pulse wave velocity (β = - 0.14, p < 0.01), and on the distensibility coefficient (β = - 0.00, p < 0.01). No effect was found for hemodynamic variables after the intervention. Conclusions: Following a 1-year intervention in patients with type 2 diabetes, both the MCT and HIIT group reduced their cIMT, whereas only the HIIT group improved their peripheral arterial stiffness indices and distensibility coefficient. Taken together, HIIT may be a meaningful tool to improve long-term vascular complications in type 2 diabetes. Trial registration clinicaltrials.gov ID: NCT03144505",
keywords = "Arterial stiffness, Distensibility coefficient, High-intensity interval training, Intima-media thickness, Moderate continuous training, Pulse wave velocity",
author = "Magalh{\~a}es, {Jo{\~a}o P.} and Xavier Melo and Correia, {In{\^e}s R.} and Ribeiro, {Rog{\'e}rio T.} and Jo{\~a}o Raposo and H{\'e}lder Dores and Manuel Bicho and Sardinha, {Lu{\'i}s B.}",
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Effects of combined training with different intensities on vascular health in patients with type 2 diabetes : A 1-year randomized controlled trial. / Magalhães, João P.; Melo, Xavier; Correia, Inês R.; Ribeiro, Rogério T.; Raposo, João; Dores, Hélder; Bicho, Manuel; Sardinha, Luís B.

In: Cardiovascular Diabetology, Vol. 18, No. 1, 34, 18.03.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effects of combined training with different intensities on vascular health in patients with type 2 diabetes

T2 - A 1-year randomized controlled trial

AU - Magalhães, João P.

AU - Melo, Xavier

AU - Correia, Inês R.

AU - Ribeiro, Rogério T.

AU - Raposo, João

AU - Dores, Hélder

AU - Bicho, Manuel

AU - Sardinha, Luís B.

N1 - info:eu-repo/grantAgreement/FCT/SFRH/SFRH%2FBD%2F85742%2F2012/PT# The authors declare that the research was conducted in the absence of any commercial or fnancial relationships that could be construed as a potential competing interest. JM and RTR are supported by a scholarship from the Portuguese Foundation for Science and Technology (JM grant: SFRH/ BD/85742/2012, RTR grant: SFRH/BPD/110426/2015). This work is also fnanced by a national grant through the FCT—Fundação para a Ciência e Tecnologia within the unit I&D 472 (UID/DTP/00447/2019).

PY - 2019/3/18

Y1 - 2019/3/18

N2 - Background: Exercise, when performed on a regular basis, is a well-accepted strategy to improve vascular function in patients with type 2 diabetes. However, the exercise intensity that yields maximal adaptations on structural and functional indices in patients with type 2 diabetes remains uncertain. Our objective was to analyze the impact of a 1-year randomized controlled trial of combined high-intensity interval training (HIIT) with resistance training (RT) vs. a combined moderate continuous training (MCT) with RT on structural and functional arterial indices in patients with type 2 diabetes. Methods: Patients with type 2 diabetes (n = 80) were randomized into an exercise intervention with three groups: control, combined HIIT with RT and combined MCT with RT. The 1-year intervention had 3 weekly exercise sessions. High-resolution ultrasonography of the common carotid artery and central and peripheral applanation tonometry were used to assess the changes in structural and functional arterial indices. Generalized estimating equations were used to model the corresponding outcomes. Results: After adjusting the models for sex, baseline moderate-to-vigorous physical activity, and mean arterial pressure changes, while using the intention-to-treat analysis, a significant interaction was observed on the carotid intima-media thickness (cIMT) for both the MCT (β = - 4.25, p < 0.01) and HIIT group (β = - 3.61, p < 0.01). However, only the HIIT observed favorable changes from baseline to 1-year on peripheral arterial stiffness indices such as carotid radial arterial pulse wave velocity (β = - 0.10, p = 0.044), carotid to distal posterior tibial artery pulse wave velocity (β = - 0.14, p < 0.01), and on the distensibility coefficient (β = - 0.00, p < 0.01). No effect was found for hemodynamic variables after the intervention. Conclusions: Following a 1-year intervention in patients with type 2 diabetes, both the MCT and HIIT group reduced their cIMT, whereas only the HIIT group improved their peripheral arterial stiffness indices and distensibility coefficient. Taken together, HIIT may be a meaningful tool to improve long-term vascular complications in type 2 diabetes. Trial registration clinicaltrials.gov ID: NCT03144505

AB - Background: Exercise, when performed on a regular basis, is a well-accepted strategy to improve vascular function in patients with type 2 diabetes. However, the exercise intensity that yields maximal adaptations on structural and functional indices in patients with type 2 diabetes remains uncertain. Our objective was to analyze the impact of a 1-year randomized controlled trial of combined high-intensity interval training (HIIT) with resistance training (RT) vs. a combined moderate continuous training (MCT) with RT on structural and functional arterial indices in patients with type 2 diabetes. Methods: Patients with type 2 diabetes (n = 80) were randomized into an exercise intervention with three groups: control, combined HIIT with RT and combined MCT with RT. The 1-year intervention had 3 weekly exercise sessions. High-resolution ultrasonography of the common carotid artery and central and peripheral applanation tonometry were used to assess the changes in structural and functional arterial indices. Generalized estimating equations were used to model the corresponding outcomes. Results: After adjusting the models for sex, baseline moderate-to-vigorous physical activity, and mean arterial pressure changes, while using the intention-to-treat analysis, a significant interaction was observed on the carotid intima-media thickness (cIMT) for both the MCT (β = - 4.25, p < 0.01) and HIIT group (β = - 3.61, p < 0.01). However, only the HIIT observed favorable changes from baseline to 1-year on peripheral arterial stiffness indices such as carotid radial arterial pulse wave velocity (β = - 0.10, p = 0.044), carotid to distal posterior tibial artery pulse wave velocity (β = - 0.14, p < 0.01), and on the distensibility coefficient (β = - 0.00, p < 0.01). No effect was found for hemodynamic variables after the intervention. Conclusions: Following a 1-year intervention in patients with type 2 diabetes, both the MCT and HIIT group reduced their cIMT, whereas only the HIIT group improved their peripheral arterial stiffness indices and distensibility coefficient. Taken together, HIIT may be a meaningful tool to improve long-term vascular complications in type 2 diabetes. Trial registration clinicaltrials.gov ID: NCT03144505

KW - Arterial stiffness

KW - Distensibility coefficient

KW - High-intensity interval training

KW - Intima-media thickness

KW - Moderate continuous training

KW - Pulse wave velocity

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