Effects of an intensive lifestyle intervention on the underlying mechanisms of improved glycaemic control in individuals with type 2 diabetes: a secondary analysis of a randomised clinical trial

Mette Y. Johansen*, Kristian Karstoft, Christopher S. MacDonald, Katrine B. Hansen, Helga Ellingsgaard, Bolette Hartmann, Nicolai J. Wewer Albrechtsen, Allan A. Vaag, Jens J. Holst, Bente K. Pedersen, Mathias Ried-Larsen

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

18 Citations (Scopus)

Abstract

Aims/hypothesis The aim was to investigate whether an intensive lifestyle intervention, with high volumes of exercise, improves beta cell function and to explore the role of low-grade inflammation and body weight.

Methods This was a randomised, assessor-blinded, controlled trial. Ninety-eight individuals with type 2 diabetes (duration

Results At baseline, individuals were 54.8 years (SD 8.9), 47% women, type 2 diabetes duration 5 years (IQR 3-8) and HbA(1c)was 49.3 mmol/mol (SD 9.2); 6.7% (SD 0.8). The intensive lifestyle group showed 40% greater improvement in the disposition index compared with the standard care group (ratio of geometric mean change [RGM] 1.40 [95% CI 1.01, 1.94]) from baseline to 12 months' follow-up. Plasma concentration of IL-1 receptor antagonist (IL-1ra) decreased 30% more in the intensive lifestyle group compared with the standard care group (RGM 0.70 [95% CI 0.58, 0.85]). Statistical single mediation analysis estimated that the intervention effect on the change in IL-1ra and the change in body weight explained to a similar extent (59%) the variance in the intervention effect on the disposition index.

Conclusions/interpretation Our findings show that incorporating an intensive lifestyle intervention, with high volumes of exercise, in individuals with type 2 diabetes has the potential to improve beta cell function, associated with a decrease in low-grade inflammation and/or body weight.

Original languageEnglish
JournalDiabetologia
Volume63
Pages (from-to)2410-2422
Number of pages13
ISSN0012-186X
DOIs
Publication statusPublished - 2020

Keywords

  • Beta cell function
  • Exercise
  • Glycaemic control
  • Insulin secretion
  • Insulin sensitivity
  • Low-grade inflammation
  • Type 2 diabetes
  • BETA-CELL FUNCTION
  • ORAL GLUCOSE-TOLERANCE
  • INSULIN SENSITIVITY
  • WEIGHT-LOSS
  • EXERCISE
  • RESISTANCE
  • MELLITUS
  • MUSCLE

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