LOSS OF ABDOMINAL FAT AND IMPROVEMENT OF THE CARDIOVASCULAR RISK PROFILE BY REGULAR MODERATE EXERCISE TRAINING IN PATIENTS WITH NIDDM

Non-insulin-dependent diabetes mellitus (NIDDM) is associated with an increased cardiovascular risk. Glycaemic control alone is often insuff icient to control diabetic dyslipidaemia and other cardiovascular risk factors associated with NIDDM. The present trial was designed to eval uate the effects of physical activity as an adjunct to standard diabet es therapy on the lipid profile, blood pressure, glycaemic control, we ight and body fat. Sixteen well-controlled (HbA(1c) 7.5 %) patients wi th NIDDM participated in a regular aerobic exercise training programme at 50-70 % maximal effort over 3 months. Thirteen age- and sex-matche d patients with NIDDM served as a control group. The 3-month intervent ion with an increase in physical activity from 92 (mean +/- SD)+/-79 t o 246 +/- 112 min per week (p < 0.001) by means of a structured activi ty programme resulted in significant improvement of plasma lipids with a 20 % decrease in triglycerides (p < 0.05), unchanged total choleste rol and increases in high-density lipoprotein and high-density lipopro tein-3 subfraction of 23 % (p < 0.001) and 26 % (p < 0.001), respectiv ely. Systolic and diastolic blood pressure decreased significantly fro m 138 +/- 16 to 130 +/- 17 mm Hg (p < 0.05) and 88 +/- 10 to 80 +/- 10 mm Hg (p < 0.001), respectively. Resting heart rate decreased from 81 +/- 13 to 74 +/- 14 beats per minute (p < 0.001), waist-hip circumfer ence ratio decreased from 0.96 +/- 0.11 to 0.92 +/- 0.10 ( p < 0.001) and body fat decreased from 35.3 +/- 7.2 to 33.0 +/- 8.0 % (p < 0.001) . These effects occurred independently of changes in body weight and g lycaemic control, which did not change during the study. This study sh ows that improvement in physical fitness by introducing regular physic al exercise as part of the treatment programme in patients with NIDDM results in a significant amelioration of their cardiovascular risk pro file.