Resistance Exercise for Type 1 Diabetes
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Female
Travel: May be covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of Alberta
No Placebo Group
Trial Summary
What is the purpose of this trial?Regular physical activity has substantial health benefits in people with type 1 diabetes. The fear of hypoglycemia, both during and after exercise, is a major barrier to exercise in this population. A major obstacle to providing specific physical activity and exercise advice is that there are still significant gaps in the fundamental understanding of the impact of physical activity and exercise on blood glucose levels in type 1 diabetes.
Women with type 1 diabetes have a substantial increase in cardiovascular risk once they have passed menopause. They may lose both bone quality and muscle mass at a faster rate with aging than those without diabetes. Overall, these changes greatly increase the risk of both cardiovascular and frailty related complications. Despite the many potential benefits of resistance exercise for post-menopausal women with type 1 diabetes, there are currently no published studies examining the effects of resistance exercise in this population. Before being able to design a clinical trial of resistance exercise, an examination of the acute effects of resistance exercise on blood glucose levels in post-menopausal women with type 1 diabetes is required.
The present study will compare the glycemic effects of a low resistance, high repetition (3 sets of 15 to 20 repetitions) weight lifting program to the effects of a moderate resistance, moderate repetition (3 sets of 8 to 10 repetitions). The investigators hypothesize that the high repetition program will be associated with a bigger decline in blood glucose during exercise, but that the moderate resistance program will be associated with a higher risk of post-exercise hypoglycemia.
Do I have to stop taking my current medications for the trial?The trial does not specify if you need to stop taking your current medications. However, if you are taking medications other than insulin that affect glucose metabolism, you cannot participate in the trial.
Is the treatment 'High repetition (HI), Moderate repetition (MOD)' a promising treatment for type 1 diabetes?Yes, resistance exercise, like high and moderate repetition weight lifting, is promising for people with type 1 diabetes. It can help lower blood sugar levels, improve muscle strength, and enhance overall health. Studies show it can reduce HbA1c, a marker of long-term blood sugar control, and improve body composition and heart health.24579
What safety data exists for resistance exercise in type 1 diabetes?The available research indicates that resistance exercise, including weight lifting, may reduce HbA1c levels in individuals with type 1 diabetes. The READI trial specifically examined the effects of a 6-month resistance training program on glycemic control and other health markers in already active individuals with type 1 diabetes. It recorded data on hypoglycemia frequency, body composition, and other health indicators. Additionally, resistance exercise may reduce the risk of hypoglycemia compared to continuous aerobic exercise. However, more studies are needed to fully understand the chronic effects and safety of resistance exercise in this population.12456
What data supports the idea that Resistance Exercise for Type 1 Diabetes is an effective treatment?The available research shows that resistance exercise can help people with Type 1 Diabetes manage their blood sugar levels better. For example, the READI trial found that adding resistance training to aerobic exercise improved blood sugar control in people with Type 1 Diabetes. Another study showed that resistance exercise reduced a key blood sugar marker, HbA1c, which indicates better long-term blood sugar management. Compared to just doing aerobic exercise, resistance training can offer additional benefits like increased strength and improved cholesterol levels. This suggests that resistance exercise is an effective treatment for managing Type 1 Diabetes.23458
Eligibility Criteria
This trial is for post-menopausal women with Type 1 Diabetes living near Edmonton, Alberta. They should have been diagnosed at least a year ago and not had a menstrual period in the last 12 months. Participants must be able to do resistance exercise but can't join if they have high blood pressure, cardiovascular disease history, are on certain medications, or have conditions affecting exercise ability.Inclusion Criteria
I am a woman diagnosed with type 1 diabetes for over a year.
It has been over a year since my last menstrual period.
Exclusion Criteria
I am taking medication that affects my blood sugar levels, excluding insulin.
I have a history of heart disease.
I have changed my insulin management in the last two months.
I often have sudden low blood sugar levels.
I have injuries that prevent me from doing strength training exercises.
I have severe nerve pain or numbness in my hands or feet.
Participant Groups
The study tests how different resistance exercises affect blood sugar levels in participants. One group will do low resistance but high repetition weight lifting (3 sets of 15-20 reps), while another does moderate resistance and repetitions (3 sets of 8-10 reps). The goal is to see which method impacts blood glucose during and after exercise.
1Treatment groups
Experimental Treatment
Group I: All participantsExperimental Treatment2 Interventions
All participants will be in a single arm that undergoes two separate interventions. These interventions will include a high repetition, low resistance protocol, and a moderate repetition, moderate intensity protocol.
Find A Clinic Near You
Research locations nearbySelect from list below to view details:
Alberta Diabetes InstituteEdmonton, Canada
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Who is running the clinical trial?
University of AlbertaLead Sponsor
References
The decline in blood glucose levels is less with intermittent high-intensity compared with moderate exercise in individuals with type 1 diabetes. [2022]To compare the response of blood glucose levels to intermittent high-intensity exercise (IHE) and moderate-intensity exercise (MOD) in individuals with type 1 diabetes.
Insulin-sensitivity response to a single bout of resistive exercise in type 1 diabetes mellitus. [2019]Little is known about the acute effects of resistance exercise on insulin sensitivity in people with type 1 diabetes.
Effects of performing resistance exercise before versus after aerobic exercise on glycemia in type 1 diabetes. [2021]To determine the effects of exercise order on acute glycemic responses in individuals with type 1 diabetes performing both aerobic and resistance exercise in the same session.
Resistance versus aerobic exercise: acute effects on glycemia in type 1 diabetes. [2022]In type 1 diabetes, small studies have found that resistance exercise (weight lifting) reduces HbA(1c). In the current study, we examined the acute impacts of resistance exercise on glycemia during exercise and in the subsequent 24 h compared with aerobic exercise and no exercise.
Resistance Exercise in Already-Active Diabetic Individuals (READI): study rationale, design and methods for a randomized controlled trial of resistance and aerobic exercise in type 1 diabetes. [2022]The Resistance Exercise in Already Active Diabetic Individuals (READI) trial aimed to examine whether adding a 6-month resistance training program would improve glycemic control (as reflected in reduced HbA₁c) in individuals with type 1 diabetes who were already engaged in aerobic exercise compared to aerobic training alone. After a 5-week run-in period including optimization of diabetes care and low-intensity exercise, 131 physically active adults with type 1 diabetes were randomized to two groups for 22weeks: resistance training three times weekly, or waiting-list control. Both groups maintained the same volume, duration and intensity of aerobic exercise throughout the study as they did at baseline. HbA₁c, body composition, frequency of hypoglycemia, lipids, blood pressure, apolipoproteins B and A-1 (ApoB and ApoA1), the ApoB-ApoA1 ratio, urinary albumin excretion, serum C-reactive protein, free fatty acids, total daily insulin dose, health-related quality of life, cardiorespiratory fitness and musculoskeletal fitness were recorded at baseline, 3 (for some variables), and 6 months. To our knowledge, READI is the only trial to date assessing the incremental health-related impact of adding resistance training for individuals with type 1 diabetes who are already aerobically active. Few exercise trials have been completed in this population, and even fewer have assessed resistance exercise. With recent improvements in the quality of diabetes care, the READI study will provide conclusive evidence to support or refute a major clinically relevant effect of exercise type in the recommendations for physical activity in patients with type 1 diabetes.
Exercise for type 1 diabetes mellitus management: General considerations and new directions. [2022]Type 1 diabetes mellitus (T1DM) is characterized by the loss of insulin secreting cells due to a directed autoimmune process, which is linked to oxidative stress and inflammation. Exercise training is known to induce several benefits by reducing inflammation and improving antioxidant defenses. In this context, exercise training may be considered as an efficient and relatively inexpensive non-pharmacological tool for diabetes treatment, added to the usual insulin administration. Unfortunately, most people with T1DM do not reach the recommended levels of physical activity due to concerns with hypoglycemic episodes. Recent data have demonstrated that exercise sessions composed by strength exercises or high-intensity interval exercise reduce the risk of hypoglycemia during and after the physical effort, when compared with continuous aerobic exercise in insulin-dependent patients. However, no studies have tested the chronic effects of this combination of protocols on health-related markers yet. Herein, we suggest a combination of hypertrophic strength exercises (3 sets at 8-RM) with a high-intensity interval protocol (10×60-s bouts at ∼90% HRmax interspersed with 60s recovery) in the same exercise session, three times per week, for T1DM patients free of micro and macrovascular complications. Our hypothesis is that this training protocol may minimize the exercise-associated rapid drop of glucose levels in T1DM, due to glucoregulatory hormones and transient reduction of insulin-mediated glucose uptake. This training is also likely to cover long-term glycaemic, bioenergetic, neuromuscular and cardiorespiratory adaptations, implicating in improved health and decreased risk of micro and macro complications.
The influence of resistance training on muscle strength, irisin concentration, and metabolic parameters in type 1 diabetic patients. [2022]Resistance effort has a beneficial effect on muscle mass, body composition, bone density, and cardiac parameters. It is also a modulator of the inflammatory reaction. The aim of the study was to assess the impact of 3 months of resistance training on muscle strength, irisin levels, and metabolic parameters in patients with long-term type 1 diabetes.
Effects of resistance training on the glycemic control of people with type 1 diabetes: a systematic review and meta-analysis. [2023]Resistance training has shown the potential to contribute to better glycemic control in people with Type 1 Diabetes (T1D), however, there are contradictory results in this regard and a need to clarify the effects of isolated resistance training on glycemic control in T1D. The aim was to verify the effects of resistance training on the glycemic control of people with T1D. Original articles were selected, randomized and non-randomized clinical trials that aimed to verify chronic responses, through the concentrations of glycated hemoglobin (HbA1c), to a structured program of resistance exercise in the glycemia of patients with T1D. The following databases were searched; MEDLINE, PubMed, Web of Science, Scopus, ScienceDirect, LILACS, and SciELO. Five studies were included in the review. A reduction in HbA1c was observed (SMD = -0.568 ± 0.165 [95% CI = -0.891 to -0.246]; p = 0.001; I2 = 82%) in patients undergoing resistance training, when compared to the control group (SMD = 1.006 ± 0.181 [95% CI = 0.653 to 1.360]; p <0.001). Two studies, with children and adolescents and longer interventions, demonstrated a significant reduction in HbA1c, increased strength, and an improved lipid profile. Resistance training was efficient for assisting in glycemic control in people with T1D and should be incorporated in treatment plans.
The Resistance Exercise in Already Active Diabetic Individuals (READI) Randomized Clinical Trial. [2023]Resistance exercise training (strength training) and aerobic exercise training are both recommended for people with type 1 diabetes, but it is unknown whether adding resistance exercise provides incremental benefits in people with this condition who already perform aerobic exercise regularly.