Effects of supervised structured aerobic exercise training program on fasting blood glucose level, plasma insulin level, glycemic control, and insulin resistance in type 2 diabetes mellitus

Objective: To determine the effects of supervised structured aerobic exercise training (SSAET) program on fasting blood glucose level (FBGL), plasma insulin level (PIL), glycemic control (GC), and insulin resistance (IR) in type 2 diabetes mellitus (T2DM). Methods: Riphah Rehabilitation and Research Centre (RRRC) was the clinical setting for this randomized controlled trial, located at Pakistan Railways General Hospital (PRGH), Rawalpindi, Pakistan. Study duration was 18 months from January 1, 2015 to June 30, 2016. Patients of both genders ranging 40-70 years of age with at least one year of history of T2DM were considered eligible according to WHO criteria, while patients with other chronic diseases, history of smoking, regular exercise and diet plan were excluded. Cohorts of 195 patients were screened out of whom 120 fulfilled the inclusion criteria. Amongst them 102 agreed to participate and were assigned to experimental (n=51) and control (n=51) groups. Experimental group underwent SSAET program, routine medication and dietary plan, whereas the control group received routine medication and dietary plan, while both group received treatment for 25 weeks. The blood samples were taken at baseline and on the completion of 25 weeks. The investigation of fasting blood glucose level, plasma insulin level, and glycemic control was conducted to calculate IR. Results: Patients with T2DM in experimental group (n=51) treated with SSAET program, routine medication and dietary plan significantly improved FBGL (pre-mean= 276.41 +/- 25.31, post-mean=250.07 +/- 28.23), PIL (pre-mean=13.66 +/- 5.31, post-mean=8.91 +/- 3.83), GC (pre-mean=8.31 +/- 1.79, post -mean 7.28 +/- 1.43), and IR (pre-mean=64.95 +/- 27.26, post -mean 37.97 +/- 15.58), as compared with patients in control group treated with routine medication and dietary plan in whom deteriorations were noted in FBGL (premean=268.19 +/- 22.48, post-mean=281.41 +/- 31.30), PIL(pre-mean=14.14 +/- 5.48, post-mean=14.85 +/- 5.27) GC (pre-mean=8.15 +/- 1.74, post-mean=8.20 +/- 1.44, and IR (pre-mean=64.49 +/- 23.63. -post-mean=70.79 +/- 23.30). Statistically at the baseline the results were not significant (p>0.05), but at the completion of 25 weeks intervention all the variable showed significant results (p<0.05). Conclusion: It is concluded that a 25 weeks SSAET program along with routine medical management is more effective treatment in the management of fasting blood glucose level, glycemic control, plasma insulin level and insulin resistance as compared with routine medical management and dietary plan in the management of T2DM.