The Effects Of Different Exercise Modalities On Adipokines In Patients With Type 2 Diabetes (original) (raw)
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Diabetes Research and Clinical Practice, 2019
Aims: To investigate the effect of exercise training on musculoskeletal pain in patients with type 2 diabetes. Methods: The intervention was exercise twice weekly for 12 weeks. The primary outcome was musculoskeletal pain assessed using a 0-10 Numeric Rating Scale (NRS) in 11 body sites. Secondary outcomes were use of analgesics, glycaemic control and body weight. Results: The participants (n=69) were 66±10 years old, 38 were men and 50 completed the intervention. Pain in the limbs was more frequently reported by the participants compared to a matched general population (80.9% vs 65.3%, p=0.007). The participants who had any pain at baseline (NRS>0) and severe pain (NRS>3) reported significantly decreased pain in the feet, calf muscles, knees, thighs, hips, lower back and arms after the training period. Use of analgesics was unchanged, HbA1c (mmol/mol) decreased from 60±15 to 54±11, p<0.001 and body weight (kg) decreased from 100.5±19.1 to 98.6±17.7, p=0.005. Conclusions: The participants with type 2 diabetes reported more frequent pain than a matched general population. The training intervention was associated with reduced musculoskeletal pain. Reduced pain may together with a positive impact on glycaemic control be an important motivational factor in patients with type 2 diabetes to perform exercise training.
Journal of Exercise Rehabilitation
Obesity and chronic pain are two major diseases of the 21th century. Our principal objective was to investigate the effects of a 4-week rehabilitation program on adiponectin and leptin concentrations, and insulin resistance, in patients with abdominal obesity and chronic pain syndrome. Our secondary objectives were to investigate the effects of this program on pain, body mass index (BMI), waist circumference and maximal oxygen consumption (VO2max) and to compare changes in VO2max between patients with or without insulin resistance. Among a consecutive sample of 128 patients with abdominal obesity hospitalized for rehabilitation for a chronic pain syndrome, 111 completed the protocol, which was a 4-week rehabilitation program including 6 hr of rehabilitation per day, 5 days per week, in a referral center of rehabilitation. This prospective cohort study compared clinical (BMI, waist circumference, VO2max, pain) and biological measures (concentrations of adiponectin, leptin and insulin, score of homeostasis model assessment of insulin resistance [HOMA]) before and after the program. Plasma leptin, adiponectin and insulin concentrations (P < 0.0001) and score of HOMA (P= 0.0002) had decreased significantly by the end of the 4 weeks. Pain, BMI and waist circumference decreased significantly, and VO2max improved significantly (P= 0.0001). Patients with insulin resistance had less improvement of their aerobic condition at the end of the 4 weeks (P< 0.002). The rehabilitation program decreases the concentration of leptin, and improves insulin sensitivity in patients with chronic pain and visceral obesity. Aerobic recovery was worse for patients with insulin resistance than other patients.
Obesity, pain, and exercise solutions
2015
Abstract: In obese persons, general and specific musculoskeletal pain is common. Emerging evidence suggests that obesity modulates pain via several mechanisms such as mechanical loading, inflammation, and psychological status. Read this review and sign up to receive Journal of Pain Research here: http://www.dovepress.com/chronic-pain-management-in-the-obese-patient-a-focused-review-of-key-c-peer-reviewed-article-JPR
Acta Diabetologica, 2014
Musculoskeletal disorders are common in subjects with type 2 diabetes mellitus (T2DM) and may represent a barrier to physical activity (PA). In the Italian Diabetes and Exercise Study, we assessed whether a strategy aimed at minimizing the risk of injury and worsening of musculoskeletal symptoms favors participation in exercise training and results in improvements in jointspecific functional scores, along with amelioration of metabolic profile. Sedentary patients with T2DM (n = 606) from 22 outpatient diabetes clinics were randomized to twice-a-week supervised aerobic and resistance training plus exercise counseling (EXE) versus counseling alone (CON) for 12 months. Musculoskeletal symptoms were evaluated at baseline in the entire cohort by the use of a self-reported questionnaire in order to design tailored exercise programs with exclusion of painful segments, and validated joint-specific scores were calculated at the end of study in a subgroup of CON (n = 65) and EXE subjects (n = 62). Musculoskeletal symptoms were present in more than of EXE and CON subjects. Yet, volumes of non-supervised PA were high, whereas dropout rates and adverse events were low in both groups. Moreover, in the EXE group, no difference was observed between patients with and without symptoms in session attendance and PA/exercise volume. Scores for symptoms and functional status of limbs and spine were significantly better in EXE than in CON subjects and correlated with PA/exercise volume and improvements in fitness parameters. Preliminary evaluation of musculoskeletal symptoms is useful in favoring compliance with supervised training programs and obtaining significant benefits to the functional status of the involved joints. Communicated by Massimo Federici. For the Italian Diabetes Exercise Study (IDES) Investigators. A complete list of the IDES Investigators can be found as online appendix. Trial Registration: ISRCTN-04252749, www.ISRCTN.org. Electronic supplementary material The online version of this article (
The association of physical activity with novel adipokines in patients with type 2 diabetes
European Journal of Internal Medicine
Background: Adipose-tissue derivatives, known as adipokines, have been involved in the inflammatorymediated metabolic and cardiovascular disorders of type 2 diabetes mellitus (T2DM). This study examined the association between novel adipokines and self-reported physical activity, a potential anti-inflammatory mediator. Methods: We enrolled 247 men and women with T2DM, free from overt cardiovascular disease. Based on a physical activity questionnaire, patients were classified into groups: A) sedentary, who did not report any physical activity or reported light activities b 2 h/week and B) active, referring to low or moderate-intensity physical activities > 2 h/week. Among them, 88 patients were randomly selected to perform a cardiorespiratory ergocycle testing. Clinical parameters, glycemic and lipid profiles, HOMA-IR, and serum levels of visfatin, apelin, vaspin, ghrelin and adiponectin were assessed. Results: With the exception of fat-mass, our groups did not differ in anthropometric parameters and pharmaceutical regimen. Active patients showed ameliorated glucose regulation, HOMA-IR, hsCRP and exercise capacity compared to sedentary counterparts (p b 0.01). Active rather than sedentary patients showed lower visfatin (10.16 ± 5.53 ng/ml vs 14.77 ± 8.48 ng/ml, p = 0.013), higher apelin (1.39 ± 0.65 ng/ml vs 1.04 ± 0.35 ng/ml, p = 0.018) and adiponectin (11.82 ± 3.06 μg/ml vs 7.81 ± 2.11 μg/ml, p = 0.033) levels. There were non-significant differences in the rest of parameters between groups. After adjusting for age, sex and BMI, physical activity along with hsCRP and ghrelin remained independent determinants of visfatin levels (R 2 = 0.328, p = 0.032), while physical activity was independently associated with apelin (R 2 = 0.221, p = 0.022). Conclusions: Self-controlled physical activity of, even, moderate intensity ameliorates adipokines, such as visfatin, apelin and adiponectin, in patients with T2DM. Prospective interventional studies will confirm our results. The ClinicalTrials.gov identifier is: NCT00306176.
Pilot Study of Exercise Therapy on Painful Diabetic Peripheral Neuropathy
Pain medicine (Malden, Mass.), 2015
Painful diabetic peripheral neuropathy (DPN) is a common complication of diabetes. While the beneficial effect of exercise on diabetes is well established, its effect specifically on painful DPN has not been thoroughly explored. The objective of this pilot study was to examine the effect of aerobic exercise on pain in people with DPN. Fourteen sedentary individuals (mean age 57 ± 5.11 years) with painful DPN were enrolled in a 16-week, supervised aerobic exercise program. The Brief Pain Inventory-Diabetic Peripheral Neuropathy was used to assess pain intensity (worst, least, average, now) and pain interference with daily life (activity, mood, walk, normal work, relationship, sleep, enjoyment of life) pre intervention and postintervention. Body mass index (BMI), maximum oxygen uptake (VO2max ), hemoglobin A1c (HbA1c), and blood pressure were also measured preintervention and postintervention as secondary outcomes of interest. Significant reductions in pain interference were observed ...
Purpose : To investigate the effect of high intensity interval training on diabetic obese women with polyneuropathy. Methods : In rehabilitation clinics. A double blinded controlled randomized study including 40 type II diabetic women with polyneuropathy having class II central obesity, mean age 48.23±2.4 years. Patients were randomized equally into Group (A); (study), received high intensity interval training on cycle ergometer and group (B); (control) received moderate intensity aerobic training for (3 times/week) for 15 weeks. Assessment performed before and after treatment using Leeds Assessment of Neuropathic symptoms and signs Scale for pain assessment. Other measures, lower extremity functional scale, body weight, body mass index, waist circumference, and oral glucose tolerance test. Results : There were statistically significant improvement in favor of Group (A) compared to Group (B) in Leeds Assessment of Neuropathic symptoms and signs Scale results with a mean difference (-3.6±0.7 points), (P ≤ 0.0001); waist circumference mean difference (-1.13cm), (P ≤ 0.017). Oral glucose tolerance test had (P ≤ 0.0001): FBG (-6.5±2.9) (P ≤ 0.03), 60 min, 90 min and 120 min mean difference was (-42.75±6.2 mg/dl), (-32.5±4.5 mg/dl) and (-20.15±2.2 mg/dl) respectively. However, lower extremity functional scale, body weight and body mass index did not show a significant difference between both groups. Conclusion : high intensity interval training was effective in reducing pain outcome and glucose tolerance in diabetic obese women with polyneuropathy compared to moderate aerobic intensity training. Keywords : Polyneuropathy, neuropathic pain, high intensity interval traininfg, diabetes, women