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Exercise individualized by TRIMPi method reduces arterial stiffness in early onset type 2 diabetic patients: a randomized controlled trial with aerobic interval training
Bellia A, Iellamo F, de Carli E, Andreadi A, Padua E, Lombardo M, Annino G, Campoli F, Tartaglione S, d'Ottavio S, Della-Morte D, Lauro D
International Journal of Cardiology 2017 Dec 1;248:314-319
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Arterial stiffness (AS) and baroreflex sensitivity (BRS) are subclinical markers of vascular diseases in type 2 diabetes (T2D). We evaluated the effects of aerobic interval training (AIT), with loads prescribed according to individual heart rate and lactate profiling obtained during a baseline treadmill test (TRIMPi method), on AS and BRS in patients with early-onset T2D without cardiovascular complications. POPULATION STUDY AND METHODS: Twenty-two sedentary overweight T2D patients (aged 57 +/- 7 years) were randomized to 12-weeks open-label of supervised AIT by TRIMPi (n = 8) or unsupervised physical activity as per usual care (SOC) (n = 11). Following parameters were evaluated (pre- and post-): anthropometrics; six-minute walking test (6MWT); fasting glucose, insulin, HbA1c; pulse wave velocity (PWV) and augmentation index (AIxHR75) using radial approach (SphigmoCor System); BRS using Finapress method. RESULTS: Both interventions significantly improved distance walked during 6MWT (AIT 52 +/- 21m; SOC 39 +/- 24m, p < 0.001 for both). PWV significantly improved with AIT (p < 0.001) whereas did not vary with SOC (p = 0.47). Similar trend was observed for AIxHR75. Resulting percent changes from baseline were significantly better for AIT versus SOC, in both PWV (-15.8 +/- 2.1 versus +1.50 +/- 3.4%, p < 0.001) and AIxHR75 (-28.9 +/- 3.2% versus +12.7 +/- 2.4%, p < 0.001). BRS similarly improved in both groups (p < 0.001 for both), as well as body weight, HbA1c and blood pressure. CONCLUSION: In sedentary T2D patients, 12-weeks AIT individualized by TRIMPi method improved AS to a greater extent than usual recommendation on physical activity, whilst exerting comparable effects on exercise capacity, glycemic control and body weight. Further researches are needed to ascertain durability of these effects.

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