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| Effects of physical training and diet therapy on carbohydrate metabolism in patients with glucose intolerance and non-insulin-dependent diabetes mellitus | 
| Bogardus C, Ravussin E, Robbins DC, Wolfe RR, Horton ES, Sims EA | 
| Diabetes 1984 Apr;33(4):311-318 | 
| clinical trial | 
| 5/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; 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* | 
| The effects of 12 wk of physical training in addition to hypocaloric diet (DPT group, N = 10) on body composition, carbohydrate (CHO) tolerance, and insulin secretion and action were compared with the effects of diet therapy alone (D group, N = 8) in CHO-intolerant and non-insulin-dependent diabetic subjects. Fat mass, fat-free mass (FFM), mean fasting plasma glucose, serum C-peptide, and insulin concentrations decreased similarly in both groups. The mean plasma glucose response to a mixed meal decreased approximately 20% in both treatment groups, and, after IV glucose, decreased 12% in the D group (p < 0.05), but did not change in the DPT group (NS between groups). The acute serum insulin response (0 to 6 min) after IG increased significantly in the DPT group only (NS between groups). The mean basal endogenous glucose production (BEGP) decreased 17% (p < 0.025) in the DPT group and by 31% (p < 0.01) in the D group (NS between groups). Hepatic sensitivity to insulin, estimated by BEGP suppression during the euglycemic clamp, increased significantly by 25% in both groups. Total glucose disposal during the euglycemic clamp increased from 3.51 +/- 0.04 milligrams of glucose per kilogram of fat-free mass per minute (mg/kg-FFM/min) to 4.45 +/- 0.54 mg/kg-FFM/min (p < 0.05) in the DPT group, but no change occurred in the D group (NS between groups).  
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