Clinical study: exercise training
The effect of combined aerobic and resistance exercise training on vascular function in type 2 diabetes

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Abstract

OBJECTIVES

The purpose of this study was to examine whether exercise training stimulates a generalized improvement in vascular function in patients with type 2 diabetes mellitus.

BACKGROUND

Exercise is often recommended for patients with type 2 diabetes to improve physical conditioning and glycemic control. This study examined the effect of eight weeks of exercise training on conduit and resistance vessel function in patients with type 2 diabetes, using a randomized crossover design.

METHODS

Both resistance vessel endothelium-dependent and -independent functions were determined by forearm plethysmography and intrabrachial infusions of acetylcholine (ACh) and sodium nitroprusside (SNP), respectively, in 16 patients with type 2 diabetes. Conduit vessel endothelial function was assessed in 15 of these patients using high-resolution ultrasound and flow-mediated dilation of the brachial artery; glyceryl trinitrate (GTN) was used as an endothelium-independent dilator.

RESULTS

Flow-mediated dilation increased from 1.7 ± 0.5% to 5.0 ± 0.4% following training (p < 0.001). The forearm blood flow ratio to ACh was significantly improved (analysis of variance, p < 0.05). Responses to SNP and GTN were unchanged. Endothelium-dependent vasodilation was enhanced in both conduit and resistance vessels.

CONCLUSIONS

If endothelial dysfunction is an integral component of the pathogenesis of vascular disease, as currently believed, this study supports the value of an exercise program in the management of type 2 diabetes.

Abbreviations

ACE
angiotensin-converting enzyme
ACh
acetylcholine
ANOVA
analysis of variance
ECG
electrocardiogram
FBF
forearm blood flow
FMD
flow-mediated dilation
GTN
glyceryl trinitrate
HR
heart rate
L-NMMA
NG-monomethyl-l-arginine
MAP
mean arterial pressure
NO
nitric oxide
SNP
sodium nitroprusside

Cited by (0)

This study was supported by the National Heart Foundation of Australia and the Medical Research Fund of Western Australia (MEDWA).