MedicalResearch.com: What are the main findings of the study?
Answer: The main finding of this study is that reducing central adiposity and increasing fitness in men and women with Type 2 diabetes are key components for successfully improving glycemic control.
A secondary finding of the study is that improvement in both central adiposity (reduction) and fitness (increasing) simultaneously; increase the likelihood of reducing HbA1c, one of the most widely used indicators of glucose control, and/or Type 2 diabetes medications.
MedicalResearch.com: Were any of the findings unexpected?
Answer: The objective of the study was to identify the predictors of glycemic control improvement following a 9-month intervention with individuals who have Type 2 diabetes. We hypothesized that fitness and adiposity would be associated with an improvement in glycemic control. However it turns out that fitness and adiposity, especially central adiposity, were actually the main predictors of improvement in glycemic control. The most interesting unexpected results were the additive effect of these two components on glycemic control.
MedicalResearch.com: What should clinicians and patients take away from your report?
Answer: I think patients should retain is the importance of EXERCISE. In general, people simply do not, or do not exercise enough and there are strong data showing this. Exercise is beneficial for body weight management; however it is important to keep in mind that it is also vital for different spheres of health (metabolic, physiologic, mental, etc.). Therefore, it is imperative to exercise in order to reduce central adiposity and improve fitness, which, have a strong impact on glycemic control and enhance the management of Type 2 diabetes.
In an effort to make sure clinicians can draw significant information for practice, we used two clinical tools (waist circumference and estimated METs) that can be easily manipulated by clinicians. Consequently, in the field or within exercise facilities where research equipment is not always available, clinicians can now use estimated METs and waist circumference as a measuring tool for a successful program aimed at improving glucose control. The take home message is that clinicians should prescribe safe exercise that reduces central adiposity and improves glucose control, which may be optimized by a concomitant improvement in fitness.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Answer: I think that we need to move further with the identification of predictors of glucose control in individuals with Type 2 diabetes. For example, it would be interesting to investigate the impact this simultaneous decrease in waist circumference and increase in fitness has on other cardiovascular risk factors individuals with type 2 diabetes may have.
The mechanism behind why this concomitant reduction in central adiposity and increase in fitness generates greater improvement in glycemic control needs to be explored.
Changes in Body Fat Distribution and Fitness Are Associated With Changes in Hemoglobin A1c After 9 Months of Exercise Training
Sénéchal M, Swift DL, Johannsen NM, Blair SN, Earnest CP, Lavie CJ, Church TS.
Manitoba Institute of Child Health, Winnipeg, Manitoba, Canada.
Diabetes Care. 2013 May 13. [Epub ahead of print]