Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

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

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Impact of high glucose levels and glucose lowering on risk of ischaemic stroke: a Mendelian randomisation study and meta-analysis

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. The interaction between metformin and physical activity on postprandial glucose and glucose kinetics: a randomised, clinical trial

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Gut microbiota profile and selected plasma metabolites in type 1 diabetes without and with stratification by albuminuria

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Metabolic effects of 1-week binge drinking and fast food intake during Roskilde Festival in young healthy male adults

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Distinct signaling by insulin and IGF-1 receptors and their extra- and intracellular domains

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Differential effects of bile acids on the postprandial secretion of gut hormones: a randomized crossover study

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Evidence for glucagon secretion and function within the human gut

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

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 <10 years), BMI of 25–40 kg/m 2, no use of insulin and taking fewer than three glucose-lowering medications were randomised (2:1) to either the standard care plus intensive lifestyle group or the standard care alone group. Standard care consisted of individual guidance on disease management, lifestyle advice and blinded regulation of medication following a pre-specified algorithm. The intensive lifestyle intervention consisted of aerobic exercise sessions that took place 5–6 times per week, combined with resistance exercise sessions 2–3 times per week, with a concomitant dietary intervention aiming for a BMI of 25 kg/m 2. In this secondary analysis beta cell function was assessed from the 2 h OGTT-derived disposition index, which is defined as the product of the Matsuda and the insulinogenic indices. 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. Trial registration: ClinicalTrials.gov NCT02417012 [Figure not available: see fulltext.].

Original languageEnglish
JournalDiabetologia
Volume63
Issue number11
Pages (from-to)2410-2422
Number of pages13
ISSN0012-186X
DOIs
Publication statusPublished - Nov 2020

    Research areas

  • Beta cell function, Exercise, Glycaemic control, Insulin secretion, Insulin sensitivity, Low-grade inflammation, Type 2 diabetes

ID: 61273641