Type 2 Diabetes Mellitus Clinical Trial
Official title:
A Randomized Trial Evaluating the Effects of One-Year Caloric Restriction and 12-Week Exercise Training Intervention in Obese Adults With Type 2 Diabetes: Emphasis on Metabolic Control and Resting Metabolic Rate
Diabetic patients with uncontrolled disease are often characterized by increased energy expenditure and could thus present a high resting metabolic rate (RMR). Lifestyle interventions aimed at improving glucose control in these patients may lead to reductions of futile pathways, resulting in lower rates of energy expenditure, and paradoxically to making it more difficult to lose weight. However, only few studies investigated how exercise could influence patients' RMR and results are still not unanimous. In this study, we aim to investigate the effects on metabolic health of a combined dietary intervention and 12-week exercise training in obese adults with type 2 diabetes.
Although a number of exercise training interventions have been proposed to type 2 diabetes
patients, the current clinical practice demonstrates that most patients are still sedentary
and with excess body weight. A negative balance between energy intake and energy expenditure
is crucial to reduce excess body weight. However, diabetic patients with uncontrolled disease
are often characterized by increased energy expenditure and could thus present a high resting
metabolic rate (RMR). Lifestyle interventions aimed at improving glucose control in these
patients may lead to reductions of futile pathways, resulting in lower rates of energy
expenditure, and paradoxically to making it more difficult to lose weight. However, no robust
evidence has been collected on this issue, and the few studies that investigated how exercise
could influence patients' RMR have not shown unanimous results, especially concerning
combined dietary and physical activity interventions.
This open-label randomized trial in obese adults with type 2 diabetes aims to investigate the
effects of a 1-year caloric restriction and 12-week exercise training intervention on
metabolic health, RMR and VO2max.
In particular, eligible type 2 diabetes patients of our clinic will be invited to participate
in a short lifestyle intervention (LSI). LSI will consist of four weekly group-led lessons
lasting 60-90 minutes in which specialized professionals will educate patients on specific
dietary and physical activity recommendations for improving health and metabolic control.
After this month, patients will be randomly assigned either to: 1) 1-year caloric restriction
with an immediate start of 12-week supervised structured exercise training (SSET) (Early-SSET
intervention), followed by no exercise at health centers for 3 months; or: 2) 1-year caloric
restriction with no exercise at health centers for 3 months and then a 12-week SSET from
month 4 to month 6 (Late-SSET intervention). During the last 6 months participants' activity
will be unrestricted.
Type 2 diabetic and obese adult volunteers will be recruited and screened through medical
history, physical examination and biochemical analyses.
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