AIM: The effects of exercise intervention and to assess its long-term efficacy in preventing subsequent cardiovascular events in patients with type 2 diabetes were little known on randomized controlled trial. METHODS: Thirty-eight type 2 diabetic patients (21 men and 17 women) were assigned to either the exercise group (n = 21) or the control group without exercise training (n = 17) by simple randomization. The exercise training group was scheduled for aerobic and resistance exercise programs for 3 months. After the 3-month, we investigated endothelial function, insulin resistance, adipocytokines and inflammatory markers. The endothelial function was evaluated by examining a flow-mediated endothelium-dependent vasodilatation (FMD). Furthermore, we followed the incidence of cardiovascular events for 24 months. RESULTS: After 3-month, HbA1C was decreased significantly in both groups. FMD was increased from 7.3 +/- 4.7% to 10.9 +/- 6.2% only in the exercise group (p < 0.05). Long-term follow-up data showed that the control group developed cardiovascular events more frequently than did the exercise group (p < 0.05). CONCLUSIONS: Exercise improves endothelial dysfunction independently of glycemic control and insulin sensitivity in patients with type 2 diabetes. The beneficial effects of 3-month exercise to reduce cardiovascular events persist for 24 months.

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