1. |
- Glans, Forouzan, et al.
(author)
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Evaluation of the effects of exercise on insulin sensitivity in Arabian and Swedish women with type 2 diabetes.
- 2009
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In: Diabetes Research and Clinical Practice. - : Elsevier BV. - 1872-8227 .- 0168-8227. ; 85, s. 69-74
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Journal article (peer-reviewed)abstract
- AIMS: The purpose of this study was to evaluate the effects of exercise on cardio-respiratory fitness and insulin sensitivity in sedentary, overweight Arabian and Swedish women with type 2 diabetes. METHODS: Eighteen Arabian and 14 Swedish women participated in a supervised 6-month resistance training and aerobic program of moderate intensity. Insulin sensitivity and VO(2max) were measured at entry to the study and after 3 and 6 months training. RESULTS: After 6 months exercise, insulin sensitivity (M-value) increased (2.7+/-1.4mgkg(-1)min(-1) vs. 3.4+/-2mgkg(-1)min(-1), p<0.05) in all patients and accounted for by an increase in non-oxidative glucose metabolism (0.3+/-1.1mgkg(-1)min(-1) vs. 1.5+/-1.5mgkg(-1)min(-1), p<0.005) with no significant difference between the ethnic groups. Notably, significant improvement in HbA1c was only seen in the Swedish patients who achieved greater exercise intensity (73.3+/-4.8% vs. 63.3+/-5.2% of maximum heart rate, p<0.005). No changes were observed regarding VO(2max) or lipid profile in either group. CONCLUSIONS: Although a 6-month exercise intervention of moderate intensity in Arabian and Swedish patients with type 2 diabetes can improve insulin sensitivity it is hampered by the metabolic inflexibility of switching between oxidation of glucose or fat.
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2. |
- Glans, Forouzan, et al.
(author)
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Immigrants from the Middle-East have a different form of Type 2 diabetes compared with Swedish patients.
- 2008
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In: Diabetic Medicine: A journal of the British Diabetic Association. - : Wiley. - 1464-5491. ; 25:3, s. 303-307
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Journal article (peer-reviewed)abstract
- AIMS: To compare the clinical characteristics of Type 2 diabetes (T2DM) between immigrants from the Middle-East and Swedish patients. METHODS: The study group included 450 consecutive patients with T2DM, 379 Swedish-born aged 61 +/- 12 years and 71 patients originally from the Middle-East aged 50 +/- 11 years from the diabetes clinic of Malmo University Hospital. RESULTS: Onset of diabetes had occurred 12 years earlier in the Middle-East immigrants compared with the Swedish-born patients (43 +/- 10 vs. 55 +/- 12 years, P < 0.001). Immigrants had lower fasting serum C-peptide [0.7 (0.1-2.6) vs. 0.9 (0.1-4.0) nmol/l, P = 0.013], lower homeostasis model assessment (HOMA)-beta[1.7 (0.1-9.1) vs. 2.7 (0.1-59.0), P = 0.010], lower HOMA-IR [0.4 (0.02-1.19) vs. 0.4 (0.01-2.8), P = 0.005] than the Swedish group. A first-degree family history of diabetes was reported in 61% of immigrants, compared with 47% of Swedish-born (P = 0.022). CONCLUSIONS: Immigrants from the Middle-East have an earlier onset, stronger family history and more rapid decline of pancreatic B-cell function than Swedish patients, suggesting that they have a different form of T2DM compared with Swedish patients.
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3. |
- Glans, Forouzan
(author)
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The impact of ethnicity on type 2 diabetes
- 2009
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Doctoral thesis (other academic/artistic)abstract
- Abstract Type 2 diabetes mellitus is among the fastest growing diseases in the world. The reported prevalence of T2D appears to differ among various ethnic groups. Although ethnic-related differences in lifestyle factors may account for some of the predisposition to diabetes in various ethnic groups, genetic factors may play a more determinant role.High prevalence rates of T2D have been reported in Middle-Eastern populations and these rates are considerably higher than those reported in Scandinavians. The aims of this thesis were 1) to compare the clinical characteristics of T2D between immigrants from the Middle-East and Swedish subjects and to examine whether differences in the frequency of high risk genotypes in established T2D genes can explain differences in the clinical presentation of T2D between these 2 ethnic groups 2) to evaluate the effects of exercise on insulin sensitivity in sedentary, overweight Arabian and Swedish women with T2D. The key findings were 1) Middle-Eastern immigrants with T2D have an earlier onset and stronger family history than Swedish patients. This, in turn, was associated with a more severe reduction in B .- cell function. Middle-Eastern immigrants with T2D had higher frequency of the TCF7L2 and PPARG genes compared with Scandinavian patients, 2) Despite no measurable increase in VO2max, overweight, sedentary Arabian and Swedish women with T2D were able to increase insulin sensitivity after a 6-month exercise intervention period. Although this study provided some insight into the potential genetic factors explaining differences between Middle-Eastern and Swedish patients with T2D, larger studies are needed to explain whether unique patterns of T2D associated genes explain the high prevalence of T2D in Middle-East.
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4. |
- Tornberg, Åsa, et al.
(author)
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Assessment of exercise capacity in women with type 2 diabetes.
- 2008
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In: Clinical Physiology and Functional Imaging. - 1475-0961. ; 28, s. 294-298
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Journal article (peer-reviewed)abstract
- The primary aim of this study was to compare the maximal oxygen uptake as evaluated from a submaximal exercise test (EVO(2peak)) to direct measurements of VO(2peak) during a maximal exercise test as means of monitoring the aerobic endurance capacity in women with type 2 diabetes (T2D). Twenty-seven women with T2D participated in the study. The program consisted of combined group training 1 h twice a week during 12 weeks and walks 1 h per week. EVO(2 max) was estimated using a submaximal exercise test on a bicycle ergometer ad modumAstrand. VO(2peak) and maximal work rate were measured using an incremental maximal exercise test on an electrically braked bicycle ergometer at baseline and after 6 and 12 weeks. EVO(2peak)was higher than VO(2peak)at baseline and significantly higher at 12 weeks (EVO(2peak)1.92 +/- 0.54 l min(-1), VO(2peak) 1.41 +/- 0.36, P < 0.005). Maximal work rate increased significantly after 12 weeks (12 +/- 15, P < 0.005) compared to baseline. The main finding of this study was that EVO(2peak) assessed using a submaximal exercise test, systematically overestimated VO(2peak). The combined group training increased maximal work rate but not VO(2peak). This is likely to reflect peripheral adaptation to exercise and/or improved mechanical efficiency.
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5. |
- Tornberg, Åsa, et al.
(author)
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Impact of exercise intensity and duration on insulin sensitivity in women with T2D.
- 2010
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In: European Journal of Internal Medicine. - : Elsevier BV. - 1879-0828 .- 0953-6205. ; 21:5, s. 404-408
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Journal article (peer-reviewed)abstract
- BACKGROUND: Clinical guidelines seldom provide in depth information about the most suitable type and intensity of exercise to obtain optimal benefit in different subgroups of T2D individuals. The aim of this study was to examine the effect of group exercise training on exercise capacity, insulin sensitivity and HbA1c in women with diabetes. METHODS: Twenty-two women with T2D participated in a supervised group exercise program for six months. The program combined endurance and resistance exercise. The duration and intensity of exercise for each subject was recorded. The volume of exercise was calculated as the product of exercise duration and intensity. Exercise capacity, insulin sensitivity and HbA1c were measured at baseline and after six months of training. The subjects were dichotomized with respect to training volume in a high training volume group and a low training volume group. RESULTS: Exercise capacity did not change significantly during the training period. Insulin sensitivity increased significantly and HbA1c decreased significantly from baseline in the high volume group but not in the low volume group. The increase in insulin sensitivity was explained with the intensity of exercise by 30%. The reduction in HbA1c was explained with exercise by 25%. CONCLUSION: Improvement in insulin sensitivity after six months combined supervised group training in female diabetic subjects is related to exercise intensity, whereas the reduction in HbA1c is related mainly to training volume. Metabolic effects of training may be seen in the absence of improved exercise capacity.
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