The article is about preventing the disease called Diabetes by means of using exercise. Since Diabetes is caused by lifestyle, it is believed that having an exercise pattern strongly interconnected with lifestyle would be able to alleviate the problem of diabetes. To
the effect of
exercise on diabetes, 12 human samples who considered exercise
of their lifestyle and those individual who are healthy and age an average of 21 years were considered. The effect of
exercise on diabetes were examined by means of analysing the levels of glucose tolerance levels in the experimented individuals.
PowerPoint Presentation Introduction Low and High Intensity ‘Life-Style’ Based Exercise May Protect Against Type 2 Diabetes Results Discussion and Conclusion Method The rising prevalence of diabetes in society is rapidly becoming one of the biggest global epidemics and has prompted research into minimising risk factors1 Life-style is a traditional risk factor of Type 2 diabetes mellitus (T2DM) and thereby studying the effects of life-style based exercise training, will allow us to determine if there is any significant benefit on glucose tolerance (GT) Life-style based exercise is physical activity that can be easily incorporated into the participant's current day-to-day routine Current literature demonstrates that life-style alterations such as regular weekly exercise improves GT in individuals with metabolic disorders such as impaired glucose tolerance (IGT)2,3 Aim: To examine the effect of life-style based exercise of differing intensity, including low intensity walking and High Intensity Interval Exercise (HIIT) on GT in healthy untrained subjects. Hypothesis: HIIT is expected to result in a greater GT in comparison to low intensity exercise. 12 students (age ~21) participated in an exercise intervention for three weeks. Exercise interventions were performed three times a week, with a high intensity interval exercise (HIIT) group (eight minute interval running session at >80% max. HR) and a low-intensity exercise group (30 minutes walking at ~60% max. HR). Blood glucose levels were assessed at week 0, and weekly for three subsequent weeks with the oral glucose tolerance test (OGTT). Readings were taken at 0 min, 15 mins, 30 mins, 60 mins, 90 mins and 120 mins with a glucometer in measurements of millimolar (mM). Stratification of Participants: Subsequent stratification of subjects was performed to minimise confounding and ensure an even spread of subjects in each group. Stratification was based on baseline GT (measured in week 0), BMI, weekly exercise and sex. Statistical analysis: Data was analysed using a one-way ANOVA utilising a post-hoc Tukey test (Figure 1). Further analysis was conducted with area under the curve (AUC) (Figure 2). The results of the OGTT show that both groups experienced a slight, albeit insignificant increase in GT. The magnitude of effect was greater in the HIIT group, as shown in Figure 2. Previous studies focused on the benefits of exercise for those with metabolic diseases such as T2DM4,5. Current literature6 shows that exercise could prevent or attenuate T2DM. HIIT shows greater efficacy compared to lower intensity exercise, especially in regards to glycemic control7. With 1 in 6 individuals being pre-diabetic in Australia8, there is a possibility of such individuals existing in our cohort. Given that the results did not produce any outliers indicating diabetes, it can be assumed that all subjects were ‘metabolically healthy’. Future research in this area should involve a clinical diagnosis of metabolic health of subjects before commencing the intervention. Furthermore, the insignificant results of the cohort could be explained by the subjects, which mainly consisted of individuals who take an active interest in exercise. Thus these insignificant results are not necessarily reflective of the general, or metabolically abnormal population. Many studies have suggested that poor OGTT results are a predictive risk factor of T2DM. Therefore, pre-existing literature6 and this study provide a strong incentive for further research various improvements. Incorporating more stringent intervention control, a larger sample size and prolonged study period would perhaps contribute to fully confirming the role of lifestyle-based exercise in preventing T2DM. Figure 1. Blood glucose levels of HIIT and walking populations at baseline and 3 weeks post intervention, over two hours. An OGTT was conducted weekly for four weeks in both HIIT and walking intervention groups. Data points were presented as mean values. Additionally, SEM was calculated and was 0.57, 0.51, 0.70 and 0.80 respectively for baseline HIIT, week 3 HIIT, baseline walking and week 3 walking. HIIT group showed a slight, albeit statistically insignificant (p > 0.05) improvement in glucose tolerance over the four weeks, indicated above as it takes less time for glucose levels to decrease. Walking group shows a statistically insignificant decrease (p > 0.05) in glucose tolerance post-intervention as maximum plasma glucose levels in week 4 exceed that of week 1. However, glucose is cleared at a faster rate, so plasma glucose levels at 2 hours remain largely the same (6.85mmol and 6.75mmol respectively). Figure 2. Difference in area under the curve (AUC) for blood glucose levels for HIIT and walking populations at baseline and at week 3 over two hours. AUC indicates glucose tolerance with the larger the area under the curve, the lower the glucose tolerance. As shown above, there was a greater difference in AUC for the walking group, and a large AUC. This indicates that subjects in the HIIT group were overall more glucose-tolerant throughout the testing period. References: Zimmet PZ. Diabetes and its drivers: the largest epidemic in human history? Clinical Diabetes and Endocrinology. 2017;3(1):1. Mensink M, Feskens EJM, Saris WHM, de Bruin TWA, Blaak EE. Study on Lifestyle Intervention and Impaired Glucose Tolerance Maastricht (SLIM): preliminary results after one year. Int J Obes Relat Metab Disord. 0000;27(3):377-84. Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämäläinen H, Ilanne-Parikka P, et al. Prevention of Type 2 Diabetes Mellitus by Changes in Lifestyle among Subjects with Impaired Glucose Tolerance. New England Journal of Medicine. 2001;344(18):1343-50. Colberg SR, Sigal RJ. Prescribing Exercise for Individuals with Type 2 Diabetes: Recommendations and Precautions. The Physician and Sportsmedicine. 2011;39(2):13-26. So B, Kim H-J, Kim J, Song W. Exercise-induced myokines in health and metabolic diseases. Integrative Medicine Research. 2014;3(4):172-9. Jenkins DW, Jenks A. Exercise and Diabetes: A Narrative Review. The Journal of Foot and Ankle Surgery. 2017;56(5):968-74. Ross LM, Porter RR, Durstine JL. High-intensity interval training (HIIT) for patients with chronic diseases. Journal of Sport and Health Science. 2016;5(2):139-44. Australia D. Diabetes: the silent pandemic and its impact on Australia. In: Edited by Associate Professor Jonathan Shaw AD, Baker IDI Heart and Diabetes Institute and Stephanie Tanamas, Epidemiologist, Baker IDI Heart and Diabetes Institute, with input from Diabetes Australia and Juvenile Diabetes Research Foundation (JDRF). 2012. Acknowledgements to David Roberts (Project Contact) 1