Effects of an intensive lifestyle intervention on the underlying mechanisms of improved glycaemic control in individuals with type 2 diabetes: a secondary analysis of a randomised clinical trial
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Aims/hypothesis The aim was to investigate whether an intensive lifestyle intervention, with high volumes of exercise, improves beta cell function and to explore the role of low-grade inflammation and body weight.
Methods This was a randomised, assessor-blinded, controlled trial. Ninety-eight individuals with type 2 diabetes (duration
Results At baseline, individuals were 54.8 years (SD 8.9), 47% women, type 2 diabetes duration 5 years (IQR 3-8) and HbA(1c)was 49.3 mmol/mol (SD 9.2); 6.7% (SD 0.8). The intensive lifestyle group showed 40% greater improvement in the disposition index compared with the standard care group (ratio of geometric mean change [RGM] 1.40 [95% CI 1.01, 1.94]) from baseline to 12 months' follow-up. Plasma concentration of IL-1 receptor antagonist (IL-1ra) decreased 30% more in the intensive lifestyle group compared with the standard care group (RGM 0.70 [95% CI 0.58, 0.85]). Statistical single mediation analysis estimated that the intervention effect on the change in IL-1ra and the change in body weight explained to a similar extent (59%) the variance in the intervention effect on the disposition index.
Conclusions/interpretation Our findings show that incorporating an intensive lifestyle intervention, with high volumes of exercise, in individuals with type 2 diabetes has the potential to improve beta cell function, associated with a decrease in low-grade inflammation and/or body weight.
|Number of pages||13|
|Publication status||E-pub ahead of print - 2020|
- Beta cell function, Exercise, Glycaemic control, Insulin secretion, Insulin sensitivity, Low-grade inflammation, Type 2 diabetes, BETA-CELL FUNCTION, ORAL GLUCOSE-TOLERANCE, INSULIN SENSITIVITY, WEIGHT-LOSS, EXERCISE, RESISTANCE, MELLITUS, MUSCLE