Can home-based training sustain glycemic control in older adults with type 2 diabetes?

Type 2 diabetes is a prevalent metabolic disorder affecting older individuals, necessitating effective strategies to manage glycemic control. In 2005 study conducted by David W Dunstan et al., delved into the potential of home-based resistance training to uphold the gains achieved through supervised training. The research aimed to determine if the beneficial effects on glycemic control and body composition, achieved via a structured high-intensity progressive resistance training regimen, could be sustained with an additional six months of home-based exercise.

The investigation employed a comprehensive 12-month randomized controlled trial, encompassing 36 sedentary, overweight men and women aged 60-80 years, all diagnosed with type 2 diabetes. Participants were randomly assigned to two groups: the moderate weight loss plus high-intensity progressive resistance training (RT&WL group) or the moderate weight loss plus a control program (WL group). The initial six months involved supervised gymnasium-based training, succeeded by an ensuing six months of home-based training. The research evaluated various parameters including glycemic control (measured by HbA1c levels), body composition, muscle strength, and metabolic syndrome markers at specified intervals over the course of the study.

Throughout the trial, the RT&WL group exhibited a significant reduction in HbA1c levels compared to the WL group during the initial six months of supervised gymnasium-based training, indicating promising improvements in glycemic control. However, this favorable effect could not be sustained during the subsequent six months of home-based training. Conversely, the initial superior gains in lean body mass (LBM) observed in the RT&WL group post gymnasium-based training were moderately sustained after home-based training. Muscle strength gains in the upper and lower body, achieved through gymnasium-based training, were consistently maintained over the entire year.

The study’s findings underscore the complexity of maintaining improved glycemic control through home-based resistance training in older adults with type 2 diabetes. While the maintenance of increased muscle strength and LBM through home-based training demonstrates promise, the regression in glycemic control could be attributed to multiple factors. Reductions in exercise adherence, training volume, and intensity during home-based training likely contribute to the diminished efficacy in sustaining glycemic improvements.

In conclusion, the study provides valuable insights into the challenges faced when endeavoring to maintain improved glycemic control among older adults with type 2 diabetes through home-based resistance training. While home-based training appears effective in preserving gains in muscle strength and lean body mass, the struggle to maintain glycemic control highlights the need for further research into enhancing adherence and maintaining exercise intensity during home-based regimens. These findings emphasize the complexity of long-term diabetes management strategies and the importance of tailored exercise interventions to achieve holistic health outcomes.

Reference: Dunstan, D. W., Daly, R. M., Owen, N., Jolley, D., Vulikh, E., Shaw, J., & Zimmet, P. (2005). Home-based resistance training is not sufficient to maintain improved glycemic control following supervised training in older individuals with type 2 diabetes. Diabetes care28(1), 3-9.

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