The Effect of Resistance and Aerobic Training with and Without Blood Flow Restriction and Detraining Period on Insulin Resistance in Men with Type 2 Diabetes: A Pilot Study
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Abstract
Objectives: This study sought to examine the impact of resistance and aerobic exercise, with and without Blood Flow Restriction (BFR), on insulin resistance (IR) in males diagnosed with type 2 diabetes (T2D). Furthermore, we aimed to comprehend the ramifications of a detraining period on these outcomes.
Methods: We randomly assigned a total of 30 men with T2D to four groups: resistance training with blood flow restriction (RT-BFR), resistance training without blood flow restriction (RT), aerobic training with blood flow restriction (AT-BFR), and aerobic training without blood flow restriction (AT). Training sessions occurred thrice weekly for a duration of 12 weeks, succeeded by a 6-week detraining interval.
Results: The findings of our investigation indicated that insulin levels fluctuate with physical activity. The average insulin level in RT fell, and similarly, the average insulin level in AT-BFR also decreased. The comparison of the average weight and BMI of subjects within the groups indicates that, in all groups, the average weight dropped following AT and RT. This would enhance the BMI's accuracy and appropriateness.
Conclusion: The findings from this research contribute valuable evidence to the ongoing discourse surrounding exercise and diabetes management. The study reinforces the notion that both resistance and aerobic training are effective in combating IR, particularly when complemented by BFR techniques. This study emphasizes the significance of integrating customized exercise programs, including the possibility of blood flow restriction techniques, to enhance metabolic health in persons with T2D.
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3. Pignanelli C, Christiansen D, Burr JF. Blood flow restriction training and the high-performance athlete: science to application. J Appl Physiol. 2021;130(4):1163-70. https://doi.org/japplphysiol.00982.2020
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9. Marcotte-Chénard A, Little JP. Towards optimizing exercise prescription for type 2 diabetes: modulating exercise parameters to strategically improve glucose control. Transl Exerc Biomed. 2024;1(1):71-88. https://doi.org/10.1515/teb-2024-2007
10. Yasuda T, Ogasawara R, Sakamaki M, Ozaki H, Sato Y, Abe T. Combined effects of low-intensity blood flow restriction training and high-intensity resistance training on muscle strength and size. Eur J Appl Physiol. 2011;111:2525-33. https://doi.org/10.1007/s00421-011-1873-8
11. May AK, Russell AP, Della Gatta PA, Warmington SA. Muscle adaptations to heavy-load and blood flow restriction resistance training methods. Front Physiol. 2022;13:837697. https://doi.org/10.3389/fphys.2022.837697
12. Saatmann N, Zaharia O-P, Loenneke JP, Roden M, Pesta DH. Effects of blood flow restriction exercise and possible applications in type 2 diabetes. Trends Endocrinol Metab. 2021;32(2):106-17. https://doi.org/10.1016/j.tem.2020.11.010
13. Ratel S, Gryson C, Rance M, Penando S, Bonhomme C, Le Ruyet P, et al. Detraining-induced alterations in metabolic and fitness markers after a multicomponent exercise-training program in older men. Appl Physiol Nutr Metab. 2012;37(1):72-9. https://doi.org/10.1139/h11-130
14. Sellami M, Bragazzi N, Prince MS, Denham J, Elrayess M. Regular, intense exercise training as a healthy aging lifestyle strategy: preventing DNA damage, telomere shortening and adverse DNA methylation changes over a lifetime. Front Genet. 2021;12:652497. https://doi.org/10.3389/fgene.2021.652497
15. Cauza E, Hanusch-Enserer U, Strasser B, Ludvik B, Metz-Schimmerl S, Pacini G, et al. The relative benefits of endurance and strength training on the metabolic factors and muscle function of people with type 2 diabetes mellitus. Arch Phys Med Rehabil. 2005;86(8):1527-33. https://doi.org/10.1016/j.apmr.2005.01.007
16. Knapik JJ, Staab JS, Harman EA. Validity of an anthropometric estimate of thigh muscle cross-sectional area. Med Sci Sports Exerc. 1996;28(12):1523-30. https://doi.org/10.1097/00005768-199612000-00013
17. Wilson JM, Lowery RP, Joy JM, Loenneke JP, Naimo MA. Practical blood flow restriction training increases acute determinants of hypertrophy without increasing indices of muscle damage. J Strength Cond Res. 2013;27(11):3068-75. https://doi.org/10.1519/jsc.0b013e31828a1ffa
18. Moghetti P, Balducci S, Guidetti L, Mazzuca P, Rossi E, Schena F. Walking for subjects with type 2 diabetes: a systematic review and joint AMD/SID/SISMES evidence-based practical guideline. Nutr Metab Cardiovasc Dis. 2020;30(11):1882-98. https://doi.org/10.1016/j.numecd.2020.08.021
19. Zhang T, Wang X, Wang J. Effect of blood flow restriction combined with low-intensity training on the lower limbs muscle strength and function in older adults: A meta-analysis. Exp Gerontol. 2022;164:111827. https://doi.org/10.1016/j.exger.2022.111827
20. Patterson SD, Hughes L, Warmington S, Burr J, Scott BR, Owens J, et al. Blood flow restriction exercise: considerations of methodology, application, and safety. Front Physiol. 2019;10:533. https://doi.org/10.3389/fphys.2019.00533
21. Krisan AD, Collins DE, Crain AM, Kwong CC, Singh MK, Bernard JR, et al. Resistance training enhances components of the insulin signaling cascade in normal and high-fat-fed rodent skeletal muscle. J Appl Physiol. 2004;96(5):1691-700. https://doi.org/10.1152/japplphysiol.01054.2003
22. Zumbaugh MD, Johnson SE, Shi TH, Gerrard DE. Molecular and biochemical regulation of skeletal muscle metabolism. J Anim Sci 2022;100(8):skac035. https://doi.org/10.1093/jas/skac035
23. Li N, Shi H, Guo Q, Gan Y, Zhang Y, Jia J, et al. Aerobic exercise prevents chronic inflammation and insulin resistance in skeletal muscle of high-fat diet mice. Nutrients. 2022;14(18):3730. https://doi.org/10.3390/nu14183730
24. Rodrigo-Mallorca D, Loaiza-Betancur AF, Monteagudo P, Blasco-Lafarga C, Chulvi-Medrano I. Resistance training with blood flow restriction compared to traditional resistance training on strength and muscle mass in non-active older adults: A systematic review and meta-analysis. Int J Environ Res Public Health. 2021;18(21):11441. https://doi.org/10.3390/ijerph182111441
25. Patterson S. Low load resistance training with blood flow restriction: adaptations and mechanisms in young and old people: © Stephen D Patterson; 2011.
2. Suh S, Jeong I-K, Kim MY, Kim YS, Shin S, Kim SS, et al. Effects of resistance training and aerobic exercise on insulin sensitivity in overweight korean adolescents: a controlled randomized trial. Diabetes Metab J. 2011;35(4):418-26. https://doi.org/10.4093/dmj.2011.35.4.418
3. Pignanelli C, Christiansen D, Burr JF. Blood flow restriction training and the high-performance athlete: science to application. J Appl Physiol. 2021;130(4):1163-70. https://doi.org/japplphysiol.00982.2020
4. Sargazi S, Heidari Nia M, Mirani Sargazi F, Sheervalilou R, Saravani R, Bahrami S, et al. Functional miR143/145 cluster variants and haplotypes are associated with chronic kidney disease: a preliminary case-control study and computational analyses. Appl Biochem Biotechnol. 2021;193:1532-44. https://doi.org/10.1007/s12010-021-03489-w
5. Liu J, Wang H, Zeng D, Xiong J, Luo J, Chen X, et al. The novel importance of miR-143 in obesity regulation. Int J Obes. 2023;47(2):100-8. https://doi.org/10.1038/s41366-022-01245-6
6. AbouAssi H, Slentz CA, Mikus CR, Tanner CJ, Bateman LA, Willis LH, et al. The effects of aerobic, resistance, and combination training on insulin sensitivity and secretion in overweight adults from STRRIDE AT/RT: a randomized trial. J Appl Physiol. 2015;118(12):1474-82. https://doi.org/10.1152/japplphysiol.00509.2014
7. Holten MK, Zacho M, Gaster M, Juel C, Wojtaszewski JF, Dela F. Strength training increases insulin-mediated glucose uptake, GLUT4 content, and insulin signaling in skeletal muscle in patients with type 2 diabetes. Diabetes. 2004;53(2):294-305. https://doi.org/10.2337/diabetes.53.2.294
8. Syeda UA, Battillo D, Visaria A, Malin SK. The importance of exercise for glycemic control in type 2 diabetes. Am J Med Open. 2023;9:100031. https://doi.org/10.1016/j.ajmo.2023.100031
9. Marcotte-Chénard A, Little JP. Towards optimizing exercise prescription for type 2 diabetes: modulating exercise parameters to strategically improve glucose control. Transl Exerc Biomed. 2024;1(1):71-88. https://doi.org/10.1515/teb-2024-2007
10. Yasuda T, Ogasawara R, Sakamaki M, Ozaki H, Sato Y, Abe T. Combined effects of low-intensity blood flow restriction training and high-intensity resistance training on muscle strength and size. Eur J Appl Physiol. 2011;111:2525-33. https://doi.org/10.1007/s00421-011-1873-8
11. May AK, Russell AP, Della Gatta PA, Warmington SA. Muscle adaptations to heavy-load and blood flow restriction resistance training methods. Front Physiol. 2022;13:837697. https://doi.org/10.3389/fphys.2022.837697
12. Saatmann N, Zaharia O-P, Loenneke JP, Roden M, Pesta DH. Effects of blood flow restriction exercise and possible applications in type 2 diabetes. Trends Endocrinol Metab. 2021;32(2):106-17. https://doi.org/10.1016/j.tem.2020.11.010
13. Ratel S, Gryson C, Rance M, Penando S, Bonhomme C, Le Ruyet P, et al. Detraining-induced alterations in metabolic and fitness markers after a multicomponent exercise-training program in older men. Appl Physiol Nutr Metab. 2012;37(1):72-9. https://doi.org/10.1139/h11-130
14. Sellami M, Bragazzi N, Prince MS, Denham J, Elrayess M. Regular, intense exercise training as a healthy aging lifestyle strategy: preventing DNA damage, telomere shortening and adverse DNA methylation changes over a lifetime. Front Genet. 2021;12:652497. https://doi.org/10.3389/fgene.2021.652497
15. Cauza E, Hanusch-Enserer U, Strasser B, Ludvik B, Metz-Schimmerl S, Pacini G, et al. The relative benefits of endurance and strength training on the metabolic factors and muscle function of people with type 2 diabetes mellitus. Arch Phys Med Rehabil. 2005;86(8):1527-33. https://doi.org/10.1016/j.apmr.2005.01.007
16. Knapik JJ, Staab JS, Harman EA. Validity of an anthropometric estimate of thigh muscle cross-sectional area. Med Sci Sports Exerc. 1996;28(12):1523-30. https://doi.org/10.1097/00005768-199612000-00013
17. Wilson JM, Lowery RP, Joy JM, Loenneke JP, Naimo MA. Practical blood flow restriction training increases acute determinants of hypertrophy without increasing indices of muscle damage. J Strength Cond Res. 2013;27(11):3068-75. https://doi.org/10.1519/jsc.0b013e31828a1ffa
18. Moghetti P, Balducci S, Guidetti L, Mazzuca P, Rossi E, Schena F. Walking for subjects with type 2 diabetes: a systematic review and joint AMD/SID/SISMES evidence-based practical guideline. Nutr Metab Cardiovasc Dis. 2020;30(11):1882-98. https://doi.org/10.1016/j.numecd.2020.08.021
19. Zhang T, Wang X, Wang J. Effect of blood flow restriction combined with low-intensity training on the lower limbs muscle strength and function in older adults: A meta-analysis. Exp Gerontol. 2022;164:111827. https://doi.org/10.1016/j.exger.2022.111827
20. Patterson SD, Hughes L, Warmington S, Burr J, Scott BR, Owens J, et al. Blood flow restriction exercise: considerations of methodology, application, and safety. Front Physiol. 2019;10:533. https://doi.org/10.3389/fphys.2019.00533
21. Krisan AD, Collins DE, Crain AM, Kwong CC, Singh MK, Bernard JR, et al. Resistance training enhances components of the insulin signaling cascade in normal and high-fat-fed rodent skeletal muscle. J Appl Physiol. 2004;96(5):1691-700. https://doi.org/10.1152/japplphysiol.01054.2003
22. Zumbaugh MD, Johnson SE, Shi TH, Gerrard DE. Molecular and biochemical regulation of skeletal muscle metabolism. J Anim Sci 2022;100(8):skac035. https://doi.org/10.1093/jas/skac035
23. Li N, Shi H, Guo Q, Gan Y, Zhang Y, Jia J, et al. Aerobic exercise prevents chronic inflammation and insulin resistance in skeletal muscle of high-fat diet mice. Nutrients. 2022;14(18):3730. https://doi.org/10.3390/nu14183730
24. Rodrigo-Mallorca D, Loaiza-Betancur AF, Monteagudo P, Blasco-Lafarga C, Chulvi-Medrano I. Resistance training with blood flow restriction compared to traditional resistance training on strength and muscle mass in non-active older adults: A systematic review and meta-analysis. Int J Environ Res Public Health. 2021;18(21):11441. https://doi.org/10.3390/ijerph182111441
25. Patterson S. Low load resistance training with blood flow restriction: adaptations and mechanisms in young and old people: © Stephen D Patterson; 2011.
| Files | ||
| Issue | Vol 3 No 1 (2025) | |
| Section | Original Articles | |
| Keywords | ||
| Type 2 diabetes (T2D), resistance training (RT), aerobic training (AT), Blood Flow Restriction (BFR) | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Moudi H, Feizolahi F, Rahimi A, Saravani R. The Effect of Resistance and Aerobic Training with and Without Blood Flow Restriction and Detraining Period on Insulin Resistance in Men with Type 2 Diabetes: A Pilot Study. ABI. 2025;3(1):55-61.
