BACKGROUND: We investigated the effects of exercise intensity on abdominal and mid-thigh adipose tissue, attenuation of skeletal muscle, and insulin sensitivity in overweight women with type 2 diabetes mellitus (T2DM). METHODS: Twenty-eight patients were randomly assigned to control (CG, n = 12), moderate intensity exercise (MEG, n = 8), or vigorous intensity exercise (VEG, n = 8) group. Subjects in both exercise groups completed a 12-week exercise program (MEG, 3.6 to 5.2 METs; VEG, >= 5.2 METs) that was monitored by accelerometers. We assessed body mass index (BMI), total fat area (TFA), visceral fat area (VFA), subcutaneous fat area (SFA), mid-thigh intramuscular adipose tissue (TIMAT), total skeletal muscle (TTM), low density skeletal muscle (TLDM), and normal density skeletal muscle (TNDM) using computed tomography, and measured insulin sensitivity with an insulin tolerance test (K-ITT), before and after the intervention. RESULTS: At baseline, the mean age was 53.8 +/- 7.9 years, duration of diabetes was 3.8 +/- 2.3 years, and BMI was 26.6 +/- 2.6 kg/m2. After 12 weeks, the percent change (%C) in BMI, TIMAT, and TLDM were not different among three groups. However, %C in TFA and VFA were significantly reduced in MEG compared to CG (p = 0.026 and p = 0.008, respectively). %C SFA was significantly reduced in VEG compared to CG (p = 0.038) and %C TTM, TNDM, and K-ITT were significantly increased in VEG compared to the CG (p = 0.044, p = 0.007, and p = 0.016, respectively). CONCLUSION: Although there was no difference in the change in BMI among groups, TFA and VFA were more reduced in MEG, and only VEG increased TTM, TNDM, and insulin sensitivity compared to CG.

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