EFFECTS OF PHYSICAL-TRAINING ON METABOLIC CONTROL IN ELDERLY TYPE-2 DIABETES-MELLITUS PATIENTS

1. The specific role of physical activity in the treatment of type 2 d iabetes is still subject to discussion, A randomized prospective study was performed, investigating both the influence of physical training on metabolic control and the feasibility of physical training in the e lderly. 2. A total of 58 patients (mean age: 62 +/- 5 years; range: 55 -75 years) with type 2 diabetes were randomized to either a physical t raining or a control programme. The training programme consisted of th ree sessions a week, aiming at 60-80% of the maximal oxygen uptake (V- O2max). The 12 week supervised period was followed by a 14 week nonsup ervised one, The control group followed an educational programme. V-O2 max was assessed during exercise on a cycle ergometer, Glycosylated ha emoglobin (HbA(1)c) was used as a measure for glucose control, and an insulin tolerance test was performed to test insulin sensitivity, Mult ivariate analysis of variance, with repeated measures design, was used to test differences between groups. 3. Fifty-one patients completed t he study. V-O2max was higher in the training group than in the control group both after 6 weeks (P less than or equal to 0.01 between groups ) and after 26 weeks [training group: 1796 +/- 419 ml/min (prestudy), 1880 +/- 458 ml/min (6 weeks), 1786 +/- 591 ml/min (26 weeks); control group: 1859 +/- 455 ml/min (prestudy), 1742 +/- 467 ml/min (6 weeks), 1629 +/- 504 ml/min (26 weeks)]. Blood glucose control and insulin se nsitivity did not change during the study, Levels of total triacylglyc erols, very-low-density lipoprotein-triacylglycerols and apolipoprotei n B were significantly lower after 6 weeks (P less than or equal to 0. 01, P less than or equal to 0.05, P less than or equal to 0.05 between groups respectively), and so was the level of total cholesterol after 12 weeks of training (P less than or equal to 0.05 between groups). 4 . Physical training in obese type 2 diabetic patients over 55 years of age does not change glycaemic control or insulin sensitivity in the s hort-term. Regular physical activity may lower triacylglycerol and cho lesterol levels in this group of patients. 5. Finally, physical traini ng in motivated elderly type 2 diabetic patients without major cardiov ascular or musculoskeletal disorders is feasible, but only under super vision.