Effectiveness of resistance exercise compared to aerobic exercise without insulin therapy in patients with type 2 diabetes mellitus: a meta-analysis.

BACKGROUND: Physical exercise has been used to mitigate the metabolic effects of diabetes mellitus. OBJECTIVE: To evaluate the effect of resistance exercise when compared to aerobic exercise without insulin therapy on metabolic and clinical outcomes in patients with type 2 diabetes mellitus. METHODS: Papers were searched on the databases MEDLINE/PubMed, CINAHL, SPORTDiscus, LILACS, and SCIELO, without language or date of publication limits. Clinical trials that compared resistance exercise to aerobic exercise in adults with type 2 diabetes mellitus who did not use insulin therapy were included. The quality of evidence and risk of bias were assessed using the GRADE system and the Cochrane Risk of Bias tool, respectively. Meta-analysis was also used, whenever possible. Two reviewers extracted the data independently. Eight eligible articles were included in this study, with a total of 336 individuals, with a mean age of 48-58 years. The protocols of aerobic and resistance exercise varied in duration from eight to 22 weeks, 30-60min/day, three to five times/week. RESULTS: Overall the available evidence came from a very low quality of evidence and there was an increase in Maximal oxygen consumption (mean difference: -2.86; 95% CI: -3.90 to -1.81; random effect) for the resistance exercise and no difference was found in Glycated hemoglobin, Body mass index, High-density lipoprotein cholesterol, Low-density lipoprotein cholesterol, triglycerides, and total cholesterol. CONCLUSIONS: Resistance exercise appears to be more effective in promoting an increase in Maximal oxygen consumption in protocols longer than 12 weeks and there is no difference in the control of glycemic and lipid levels between the two types of exercise.

Previous physical exercise slows down the complications from experimental diabetes in the calcaneal tendon.

BACKGROUND: the complications caused by diabetes increase fragility in the muscle-tendon system, resulting in degeneration and easier rupture. To avoid this issue, therapies that increase the metabolism of glucose by the body, with physical activity, have been used after the confirmation of diabetes. We evaluate the biomechanical behavior of the calcaneal tendon and the metabolic parameters in rats induced to experimental diabetes and submitted to pre- and post-induction exercise. METHODS: 54-male-Wistar rats were randomly divided into four groups: Control Group (CG), Swimming Group (SG), Diabetic Group (DG), and Diabetic Swimming Group (DSG). The trained groups were submitted to swimming exercise, while unexercised groups remained restricted to the cages. Metabolic and biomechanical parameters were assessed. RESULTS: the clinical parameters of DSG showed no change due to exercise protocol. The tendon analysis of the DSG showed increased values for the elastic modulus (p<0.01) and maximum tension (p<0.001) and lowest value for transverse area (p<0.001) when compared to the SG, however it showed no difference when compared to DG. CONCLUSION: the homogeneous values presented by the tendons of the DG and DSG show that physical exercise applied in the pre- and post-induction wasn't enough to promote a protective effect against the tendinopathy process, but prevent the progress of degeneration.

Medidas murinométricas e eficiência alimentar em ratos provenientes de ninhadas reduzidas na lactação e submetidos ou não ao exercício de natação / Murinometric evaluations and feed efficiency in rats from reduced litter during lactation and submitted or not to swimming exercise

INTRODUÇÃO: Excesso de alimentação no início da vida pode modificar persistentemente consumo e peso corporal. Adoção de exercício físico é uma estratégia útil para evitar excessivo ganho de peso. OBJETIVO: Avaliar o crescimento corporal e a eficiência alimentar em ratos provenientes de ninhada reduzida no aleitamento. MÉTODOS: Ao terceiro dia de vida, ninhadas foram formadas com quatro (GN4) ou 10 animais (GN10), (n = 25). Ao desmame, ratos machos Wistar permaneceram em gaiolas individuais, e, aos 60 (± 2) dias foram subdivididos em sedentários (SED) e exercitados (NAT), formando quatro grupos: GN4SED, GN10SED, GN4-NAT e GN10NAT. Avaliou-se o peso, ganho de peso e taxa específica de ganho de peso, gordura epididimal, índices de massa corporal e Lee, consumo e eficiência alimentar, glicemia e lactemia. RESULTADOS: Aos 21 dias, o GN4 apresentava peso corporal 52 por cento acima do GN10 (P = 0,001). Contudo, aos 30 e 60 dias os pesos não diferiram. Ao final do período, GN10NAT demonstrou menor peso (356,82 ± 23,04) que GN10SED (409,28 ± 17,30). Mas GN4NAT possuía maior peso (417,85 ± 37,91) que GN4SED (413,69 ± 57,45) e GN10NAT. O GN4 exibiu elevada taxa de ganho de peso na lactação, mas, redução da mesma pós-desmame. Independente do tamanho da ninhada, a taxa de ganho de peso reduz com o aumento da idade. Ao final do período, glicemia, gordura epididimal total e relativa, e os índices de Lee e IMC não diferiram entre os grupos. Os valores de lactato antes e após o exercício condizem com esforço de intensidade moderada. Na periadolescência, GN4 apresentou menor ingestão de alimentos, mas sem diferenças na vida adulta. CONCLUSÃO: A redução da ninhada no aleitamento não alterou o peso corporal ou ingestão alimentar persistentemente. Entretanto, o protocolo de natação foi eficaz em reduzir o ganho de peso em animais controles, mas não naqueles de ninhada reduzida.

INTRODUCTION: Overfeeding in early life can persistently modify consumption and body weight. Adoption of exercise is one useful strategy to prevent excessive weight gain. OBJECTIVE: to assess body growth and feed efficiency in rats from reduced litters during lactation. METHODS: On day 3 of life, litters were formed with 4 (GN4) or 10 animals (GN10) (n = 25). When weaned, Wistar male rats were kept in individual cages and at day 60 (± 2) they were divided into sedentary (SED) and exercised (NAT), forming thus four groups: GN4SED; GN10SED; GN4NAT and GN10NAT. Assessment consisted of weight, weight gain and specific rate of weight gain, epididymal fat, Body Mass and Lee Indices, consumption and feed efficiency, blood glucose and lactemia. RESULTS: At day 21, GN4 had body weight 52 percent above GN10 (P = 0.001). However, at days 30 and 60, their weight was not different. At the end of the period, GN10NAT showed lower weight (356.82 ± 23.04) that GN10SED (409.28 ± 17.30), but GN4NAT was heavier (417.85 ± 37.91) than GN4SED (413.69 ± 57.45) and GN10NAT. GN4 presented higher rate of weight gain during lactation, but slower after weaning. Regardless of litter size, rate of weight gain reduces as age progresses. At the end of this period, blood glucose, total and relative epididymal fat, and Lee and BMI indices did not differ between groups. Pre and post-exercise lactate values are consistent with moderate effort. In periadolescence, GN4 showed lower food intake, but with no differences in adulthood. CONCLUSION: Reduced litter during lactation did not affect body weight or food intake persistently. However, the swimming protocol was effective in reducing weight gain in control animals, but not in animals from reduced litters.