Studies for the outcomes of training on diabetes type 2

Medical Q&A [Moderated]
1

Hi guys!

Not sure this is entirely fitting here but I thought you guys might be able to help out.

My gf is currently writing her thesis on the outcomes of training (cardio, resistance and combined training) on diabetes type 2 (Hba1c). She‘s looking for a few more studies to include and discuss and it‘s kinda hard to find enough that can be used in the comparison and fit the requirements of being less than 10yo and following the „EMET“ fomat (which I hope I spelled out correctly).

Maybe you guys have some interesting studies stashed in a list or bookmarked somewhere? Thanks either way!

2

I don’t know what the “EMET” format is.

With that said, if she knows how to search PubMed, she should have no difficulty in findings studies less than 10 years old looking at training and diabetes outcomes. I just searched “Exercise diabetes” and restricted the search to the past 10 years and got over 14,000 results.

3

Thank you, Austin!

Yeah turns out I managed to both spell it incorrectly as well as probably use a German acronym for something I could have just left out anyway. She just told me it’s basically when they follow the Introduction, Methodology, Results, Discussion format, which I think every study follows anyway?

This is true, however most of the search results there just contain the terms exercise and diabetes somewhere in the text, metadata or wherever and are often not related at all to the outcomes of exercise on diabetes/Hba1c. Also most are just articles and not clinical trials.

Free full texts would be a huge bonus as well as it’s a bit cumbersome for her to receive paid ones and sometimes they might still not fit after reading through them. So as to find more relevant studies I have helped her develop more precise search queries, such as:

(“diabetes”[title/abstract] AND “type 2”[title/abstract] AND “resistance training”[title/abstract]) AND (“loattrfree full text”[sb] AND “2012/02/25”[PDAT] : “2019/02/25”[PDAT])

I have tried to make it as specific as needed but as general as possible and it “successfully” reduces the number of results to 32, which sounds like a good starting point. But while there are certainly some interesting studies, the second hit for instance is “A Randomized Controlled Trial of Short-term Toe Resistance Training to Improve Toe Pinch Force in Patients with Type 2 Diabetes.”. So who would have thought that it’s really not quite as easy to find relevant studies for this topic. :confused:

4

Also, mine the reference list of cited studies that you already have… look them up… look at the next reference list… rinse repeat you will have more studies than you can poke a stick at…

You might find yourself somewhere you didn’t mean to go, then you go back to the last most credible paper and start again. Or to your lecture notes or a text book.

Good of luck on your journey through the literature! You might find something interesting that has been forgotten!

5

As an addendum she also told me that many of the studies look good at first glance but once you look through them in more detail you realize that they are of low quality and for instance only state the post-intervention Hba1c values without the initial measurements, while others for example only state the relative improvements without the absolute values or where there are only diagrams from where you could “guesstimate” the values rather than them being listed properly somewhere. This makes them fairly tough to compare and once you filter all those studies out, there just aren’t that many left.

6

Correct, there is no perfect search string - you actually have to sift through the results to find what’s applicable. If you can find a good review of the literature, that can often be a great starting point for finding further references. You can also restrict your search to clinical trials only on PubMed as well.

See if you have access to an Inter-Library loan service or if all else fails … Sci-Hub exists.

Yes, this is a good idea, though you’ll probably have to continue playing with the search terms / filters / limits to find what you’re looking for.

See if these help.

Brooks N, Layne JE, Gordon PL, et al. Strength training improves muscle quality and insulin sensitivity in Hispanic older adults with type 2 diabetes. Int J Med Sci 2006; 4:19.

Strasser B, Siebert U, Schobersberger W. Resistance training in the treatment of the metabolic syndrome: a systematic review and meta-analysis of the effect of resistance training on metabolic clustering in patients with abnormal glucose metabolism. Sports Med 2010; 40:397.

Colberg SR, Sigal RJ, Yardley JE, et al. Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care 2016; 39:2065.

Borghouts LB, Wagenmakers AJ, Goyens PL, Keizer HA. Substrate utilization in non-obese Type II diabetic patients at rest and during exercise. Clin Sci (Lond) 2002; 103:559.

Boon H, Blaak EE, Saris WH, et al. Substrate source utilisation in long-term diagnosed type 2 diabetes patients at rest, and during exercise and subsequent recovery. Diabetologia 2007; 50:103.

Vianna JM, Lima JP, Saavedra FJ, Reis VM. Aerobic and Anaerobic Energy During Resistance Exercise at 80% 1RM. J Hum Kinet 2011; 29A:69.

Holten MK, Zacho M, Gaster M, et al. Strength training increases insulin-mediated glucose uptake, GLUT4 content, and insulin signaling in skeletal muscle in patients with type 2 diabetes. Diabetes 2004; 53:294.

Kennedy JW, Hirshman MF, Gervino EV, et al. Acute exercise induces GLUT4 translocation in skeletal muscle of normal human subjects and subjects with type 2 diabetes. Diabetes 1999; 48:1192.

Braun B, Sharoff C, Chipkin SR, Beaudoin F. Effects of insulin resistance on substrate utilization during exercise in overweight women. J Appl Physiol (1985) 2004; 97:991.

Lee J, Kim D, Kim C. Resistance Training for Glycemic Control, Muscular Strength, and Lean Body Mass in Old Type 2 Diabetic Patients: A Meta-Analysis. Diabetes Ther 2017; 8:459.

Wang Y, Simar D, Fiatarone Singh MA. Adaptations to exercise training within skeletal muscle in adults with type 2 diabetes or impaired glucose tolerance: a systematic review. Diabetes Metab Res Rev 2009; 25:13.

Burgomaster KA, Howarth KR, Phillips SM, et al. Similar metabolic adaptations during exercise after low volume sprint interval and traditional endurance training in humans. J Physiol 2008; 586:151.

Cuff DJ, Meneilly GS, Martin A, et al. Effective exercise modality to reduce insulin resistance in women with type 2 diabetes. Diabetes Care 2003; 26:2977.

Ishiguro H, Kodama S, Horikawa C, et al. In Search of the Ideal Resistance Training Program to Improve Glycemic Control and its Indication for Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. Sports Med 2016; 46:67.

Strasser B, Pesta D. Resistance training for diabetes prevention and therapy: experimental findings and molecular mechanisms. Biomed Res Int 2013; 2013:805217.

Bweir S, Al-Jarrah M, Almalty AM, et al. Resistance exercise training lowers HbA1c more than aerobic training in adults with type 2 diabetes. Diabetol Metab Syndr 2009; 1:27.

Grøntved A, Rimm EB, Willett WC, et al. A prospective study of weight training and risk of type 2 diabetes mellitus in men. Arch Intern Med 2012; 172:1306.

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Thanks! Yeah it’s really quite the process finding enough high-quality studies, even with a topic where you would expect boatloads of them.

I’ve sent her that - many many thanks, Austin! She laughed when she saw some studies she’s already using in there but she should definitely be able to complete her selection with these.