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Finding the optimal volume and intensity of resistance training exercise for type 2 diabetes: the FORTE study, a randomized trial
Yang P, Swardfager W, Fernandes D, Laredo S, Tomlinson G, Oh PI, Thomas S
Diabetes Research and Clinical Practice 2017 Aug;130:98-107
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

AIM: To compare different volumes and intensities of resistance training (RT) combined with aerobic training (AT) for improvements in glycemic control and cardiovascular health for persons with type 2 diabetes (T2DM). METHODS: Participants with T2DM were stratified by HbA1c and randomized: "usual care" (RT1), which consisted of moderate intensity (50% 1-repetition maximum (1-RM)), low volumeRT (initiated half-way through program); higher intensity (75% 1-RM) and higher volume (initiated at program onset) RT (RT2); or moderate intensity but higher volume RT (RT3). RT sets and repetitions were adjusted to maintain similar work and volume between RT2 and RT3. Walking or cycling (60 to 80% aerobic capacity) was prescribed 5 times/week, and RT was prescribed 2 times/week. An ANCOVA, adjusted for baseline and gender, assessed changes post-6 months in glycemic control (HbA1c- primary outcome), aerobic capacity and anthropometrics. RESULTS: Sixty-two participants (52.3 +/- 1.2 years, 48% female) were randomized (RT1, n = 20; RT2, n = 20; RT3, n = 22). Only post-training fasting glucose, without significant HbA1c change, was different between groups (RT1 minus RT3 -1.7 mmol/L, p = 0.046). Pre-post differences were found in pooled HbA1c (7.4 +/- 0.2% (57 +/- 2.2 mmol/mol) versus 6.7 +/- 0.2% (50 +/- 2.2 mmol/mol), p < 0.001), aerobic capacity (21.5 +/- 0.8 versus 25.2 +/- 0.8 ml/kg/min, p < 0.001), body mass (84.0 +/- 2.7 versus 83.0 +/- 2.7 kg, p = 0.022 (DXA)), body mass index (30.8 +/- 0.9 versus 30.3 +/- 0.8 kg/m2, p = 0.02) and body fat (32.3 +/- 1.1 versus 31.3 +/- 1.2%, p < 0.001). The trial was discontinued early; no HbA1c advantage was found with either RT2 or RT3 over RT1. CONCLUSIONS: Combined AT+RT exercise improved glycemic control, cardiovascular risk factors and body composition after 6 months for participants with T2DM, but differential effects between the prescribed intensities and volumes of RT were not found to effect HbA1c.
With permission from Excerpta Medica Inc.

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