Exercise and Prediabetes after Renal Transplantation (EXPRED): Protocol Description

Nephron ◽  
2020 ◽  
Vol 145 (1) ◽  
pp. 55-62
Author(s):  
Raúl Morales Febles ◽  
Natalia Negrín Mena ◽  
Ana Elena Rodríguez-Rodríguez ◽  
Laura Díaz Martín ◽  
Federico González Rinne ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Exercise Training ◽  
Aerobic Exercise ◽  
Fasting Glucose ◽  
Anaerobic Exercise ◽  
Aerobic Exercise Training ◽  
Oral Glucose ◽  
Glucose Levels ◽  
Glucose Tolerance Tests ◽  
Reversible Condition

<b><i>Background:</i></b> Post-transplant diabetes mellitus (PTDM) is a frequent and severe complication after renal transplantation. In fact, PTDM is a risk factor for both infection and cardiovascular diseases. The prevalence and incidence of PTDM have a bimodal evolution: early (up to 3 months) and late PTDM (beyond 12 months). The majority of late PTDM occurs in subjects with prediabetes after transplantation. So, treating patients with prediabetes, a potentially reversible condition, might help preventing PTDM. In the general population, exercise prevents the evolution from prediabetes to diabetes. However, in renal transplantation, not enough evidence is available in this field. <b><i>Objectives:</i></b> We designed an exploratory analysis to evaluate the feasibility of exercise to reverse prediabetes as a first step in the design of a trial to prevent PTDM. <b><i>Methods:</i></b> Only patients with prediabetes beyond 12 months after transplantation with capacity to perform exercise will be included. Prediabetes will be diagnosed based on fasting glucose levels and oral glucose tolerance tests (OGTTs). Patients will be treated with a stepped training intervention, starting with aerobic exercise training (brisk walking, swimming, and cycling) 5 times per week and 30 min/day. Aerobic exercise training will be gradually increased to 60 min/day or eventually combined with anaerobic exercise training in case of persistent prediabetes. The reversibility/persistence of prediabetes will be measured with fasting glucose and OGTTs every 3 months. This study will last for 12 months.

Comparison Of Changes In Fasting Glucose Levels After Aerobic Exercise Training In Pre- And Post-menopausal African American Women

2011 ◽  
Vol 43 (Suppl 1) ◽  
pp. 353
Author(s):  
Charmie G. Vin ◽  
Keith M. Diaz ◽  
Deborah L. Feairheller ◽  
Kathleen M. Sturgeon ◽  
Praveen Veerabhadrappa ◽  
...  
Keyword(s):  
African American ◽  
Exercise Training ◽  
Aerobic Exercise ◽  
African American Women ◽  
Fasting Glucose ◽  
Aerobic Exercise Training ◽  
American Women ◽  
Glucose Levels ◽  
Post Menopausal

Abstract P137: Aerobic, Resistance or Combination Exercise Training does not Reduce C-Reactive Protein Levels in Individuals with Type 2 Diabetes

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Damon L Swift ◽  
Neil M Johannsen ◽  
Conrad P Earnest ◽  
Steven N Blair ◽  
Timothy S Church
Keyword(s):  
Type 2 Diabetes ◽  
Exercise Training ◽  
Aerobic Exercise ◽  
Fat Mass ◽  
Fasting Glucose ◽  
Aerobic Exercise Training ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein

Introduction: Type 2 diabetes is associated with elevated C-reactive protein levels (CRP), which is an independent risk factor for cardiovascular disease. Aerobic exercise training especially with weight/adiposity reduction has been shown to improve CRP, however few studies have evaluated the effect of other exercise training modalities (aerobic, resistance or combination training) on CRP in individuals with type 2 diabetes. Hypothesis: We hypothesize that combination training will improve CRP to a greater extent than other modalities of exercise training, and change in CRP levels will be associated with changes in weight and adiposity. Methods: The present study is a secondary analysis of the Health Benefits of Aerobic and Resistance Training in Individuals with Type 2 Diabetes (HART-D) study. Participants (n=204) were randomized to aerobic exercise (aerobic), resistance exercise (resistance) or a combination of both (combination) for nine months. Results: Baseline CRP was correlated with fat mass, waist circumference, BMI, and inversely correlated with VO2 peak (p<0.05). CRP was not reduced in the aerobic (0.16 mg•L-1, 95% CI: -1.0, 1.3), resistance (-0.03 mg•L-1, 95% CI: -1.1, 1.0) or combination (-0.49 mg•L-1, 95% CI: -1.5 to 0.6) groups compared to control (0.35 mg•L-1, 95% CI: -1.0, 1.7). Change in CRP was associated with change in fasting glucose (r=0.20, p= 0.009), glycated hemoglobin (HbA1C) (r=0.21 p=0.005), and fat mass (r=0.19, p=0.016), but not change in fitness or weight (p > 0.05). Conclusions: In conclusion, aerobic, resistance or a combination of both did not reduce CRP levels in individuals with type 2 diabetes. However, exercise related improvements in HbA1C, fasting glucose, and fat mass were associated with reductions in CRP.

scholarly journals Effect of Aging and Exercise Training on Plasma Insulin Concentration

2013 ◽  
Vol 20 (3) ◽  
pp. 339-342
Author(s):  
Rucsandra Dănciulescu Miulescu ◽  
Denisa Margină ◽  
Roxana Corina Sfetea ◽  
Diana Păun ◽  
Cătălina Poiană
Keyword(s):  
Exercise Training ◽  
Aerobic Exercise ◽  
Plasma Insulin ◽  
Serum Insulin ◽  
Tolerance Test ◽  
Aerobic Exercise Training ◽  
Oral Glucose ◽  
Older Individuals ◽  
Plasma Insulin Concentration ◽  
Insulin Levels

Abstract Background and Aims. Previous studies have shown that aging is an important risk factor for insulin resistance and type 2 diabetes. The beneficial effects of exercise on glucose metabolism are well known. Our goal was to examine whether physical activity improves insulin levels in older individuals. Material and Methods. Plasma glucose and insulin were measured in fasting state and 2 h after a 75-g oral glucose tolerance test in young lean, sedentary, non-diabetic subjects (n=34, age 25±2 years, body mass index- BMI 24.4±0.7 kg/m2) and older, lean, sedentary, non-diabetic subjects (n=36, age 75±3 years, BMI 24.8±0.4 kg/m2), before and after 8 weeks of aerobic exercise. Training consisted of exercise (such as cycling or fast walking) 5 days/week for approximately 30 min/day. Results. Fasting plasma insulin and 2-h serum insulin levels at baseline were significantly higher in older than young subjects (11.6 μU/ml vs 10.0 μU/ml, p=0.0001, 46.3 μU/ml vs 34.0 μU/ml, p=0.0001). Fasting and 2h plasma insulin levels were reduced after 8 weeks of aerobic exercise in older subjects, with no change in body weight. Conclusion. In our study the hyperinsulinemia associated with aging can be blunted significantly by aerobic exercise in older individuals independent of any changes in body composition

Influence of the interleukin-6 −174 G/C gene polymorphism on exercise training-induced changes in glucose tolerance indexes

2004 ◽  
Vol 97 (4) ◽  
pp. 1338-1342 ◽  
Author(s):  
Jennifer A. McKenzie ◽  
Edward P. Weiss ◽  
Ioana A. Ghiu ◽  
Onanong Kulaputana ◽  
Dana A. Phares ◽  
...  
Keyword(s):  
Exercise Training ◽  
Glucose Tolerance ◽  
Glucose Tolerance Test ◽  
Fasting Glucose ◽  
Area Under The Curve ◽  
Tolerance Test ◽  
Aerobic Exercise Training ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Induced Changes

A polymorphism in the IL-6 gene, a G-to-C substitution 176 bp upstream of the ATG translation initiation site, has been associated with diabetes prevalence and insulin resistance. Interventions including exercise training are frequently used to modify cardiovascular disease risk factors. Consequently, this project examined associations between the IL-6 −174 genotype and oral glucose tolerance test outcomes in 50- to 75-yr-old sedentary men and postmenopausal women before and after aerobic exercise training. Among the 87 individuals who started the study, 56 were retested after 6 mo of aerobic exercise training. Subject characteristics at baseline did not differ between the IL-6 genotype groups with the exception of fasting glucose, which was higher ( P = 0.02, covariates age, gender, and ethnicity) in the CC genotype group. The training-induced change in glucose area under the curve during the oral glucose tolerance test varied between the IL-6 −174 genotype groups ( P = 0.05, covariates age, gender, ethnicity, baseline glucose area under the curve, and percent body fat change) with a significant decrease occurring only in the GG genotype group. Insulin outcomes did not differ among the groups at baseline or after training. Training-induced changes in weight, percent body fat, maximal oxygen consumption, fasting glucose, and an insulin sensitivity index also changed similarly among the genotype groups. In conclusion, fasting glucose and the extent to which glucose tolerance changes with exercise training may be influenced by the IL-6 −174 gene polymorphism.

Distinct effects of aerobic exercise training and weight loss on glucose homeostasis in obese sedentary men

1996 ◽  
Vol 81 (1) ◽  
pp. 318-325 ◽  
Author(s):  
D. R. Dengel ◽  
R. E. Pratley ◽  
J. M. Hagberg ◽  
E. M. Rogus ◽  
A. P. Goldberg
Keyword(s):  
Weight Loss ◽  
Glucose Metabolism ◽  
Exercise Training ◽  
Glucose Tolerance ◽  
Aerobic Exercise ◽  
Glucose Homeostasis ◽  
Insulin Response ◽  
Older Men ◽  
Aerobic Exercise Training ◽  
Oral Glucose

The decline in glucose homeostasis with aging may be due to the physical deconditioning and obesity that often develop with aging. The independent and combined effects of aerobic exercise training (AEX) and weight loss (WL) on glucose metabolism were studied in 47 nondiabetic sedentary older men. There were 14 men in a weekly behavioral modification/WL program, 10 in a 3 times/wk AEX program, 14 in an AEX+WL program, and 9 in the control (Con) group. The 10-mo intervention increased maximal oxygen consumption (VO2max) in both the AEX and AEX+WL groups [0.33 +/- 0.05 and 0.37 +/- 0.09 (SE) l/min, respectively], but VO2max did not significantly change in the WL (0.01 +/- 0.06 l/min) and Con groups (-0.04 +/- 0.05 l/min; P > 0.05). The AEX+WL and WL groups had comparable reductions in body weight (-8.5 +/- 0.9 and -8.8 +/- 1.2 kg, respectively) and percent fat (-5.5 +/- 0.7 and -5.9 +/- 1.1%, respectively) that were significantly greater than those in the Con and AEX groups. Oral glucose tolerance tests showed significant reductions in insulin responses in the AEX, WL, and AEX+WL groups, but the decrease in insulin response in the AEX+WL group was significantly greater than that in the other three groups. The glucose area decreased significantly in the WL and AEX+WL groups but did not change in the Con or AEX groups. There were significant increases in insulin-mediated glucose disposal rates as measured by the hyperinsulinemic (600 pmol.m-2.min-1) euglycemic clamps in the AEX and AEX+WL groups [1.66 +/- 0.50 and 1.76 +/- 0.41 mg.kg fat-free mass (FFM)-1.min-1, respectively] that were significantly greater than those in the WL (0.13 +/- 0.31 mg.kg FFM-1.min-1) and Con groups (-0.05 +/- 0.51 mg.kg FFM-1.min-1; n = 5). These data suggest that AEX and WL improve glucose metabolism through different mechanisms and that the combined intervention of AEX+WL is necessary to improve both glucose tolerance and insulin sensitivity in older men.

scholarly journals PO-146 Effects of aerobic exercise training on GTT and ITT in apelin Knockout mice

2018 ◽  
Vol 1 (4) ◽  
Author(s):  
Shiyi He ◽  
Ying Zhang
Keyword(s):  
Blood Glucose ◽  
Glucose Metabolism ◽  
Exercise Training ◽  
Aerobic Exercise ◽  
Aerobic Exercise Training ◽  
Control Groups ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Insulin Tolerance ◽  
Glucose Clearance

Objective Aerobic exercise training is important to prevent and cure chronic diseases such as diabetes, cardiovascular diseases and so on. Apelin has been identified as a novel myokine in recent years, and the exogenous supplementation of apelin can promote the glucose absorption, the biosynthesis of mitochondria and the oxidation of fatty acids in skeletal muscle. Intraperitoneal glucose (GTT) and insulin tolerance tests (ITT) are useful in vivo assays that provide approximations of glucose metabolism and homeostasis. The bigger area under the curve (AUC) confirmed the decreased glucose clearance, which is evaluated by GTT. However, the mechanism of apelin mediating glucose metabolism during aerobic exercise training is not clear. Our study was to investigate the differences of GTT and ITT after four weeks training between wild-type (WT) mice (C57BL/6J) and apelin Knockout (KO) mice. Methods Two-month-old WT and KO were divided into trained and control groups (n=8-10/group) respectively. There are four groups: WT control (WC), apelin KO control (KC), WT trained (WT), and apelin KO trained (KT). The trained groups were trained on treadmills for four weeks (six days per week and one hour per day). In order to maintain the exercise intensity, the speed is at 70%-75% VO2max with an incline of 5 degrees. The control groups were kept at a sedentary condition. after four weeks of interventions, glucose was measured at 0, 15, 30, 45, 60, 90, 120min following GTT. Glucose was also measured at 0, 30, 60, 90, 120min following ITT. Results  (1) blood glucose levels and AUC of the KC were significantly bigger than those of WC. ITT showed that KC also had slower insulin-stimulated glucose clearance compared with the WC. (2) Following 4-week training, KT had lower blood glucose levels and AUC of the KT was significantly smaller than those of KC. KT had faster insulin-stimulated glucose clearance compared with KC. Conclusions Without apelin, glucose tolerance and insulin tolerance in mice will decrease. And aerobic exercise training improves them in apelin deficiency mice.

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