The effects of (a combined exercise programme aerobic and resistance) on blood glucose and incretin hormone that could control the diabetes in type 2 diabetes.

Abstract

Aim: An excessive number of calories consumed daily, in addition to a sedentary lifestyle, are the main causes of increasing Type 2 Diabetes (T2D) prevalence worldwide. Diabetes is usually accompanied by hypertension, lipid disorders, and obesity. The aim of this study is to show that the combination exercise is effective. It will compare T2D and Non-Diabetes (ND) volunteer doing combination exercise consisting of resistance and cycling. The interventions are minor and fairly short consisting of 12 episodes of exercise over 6 weeks, yet this was enough to produce measurable change and improvement. This included the re-categorization of two T2D volunteers to being ND, using normal metrics. A literature search was conducted by using electronic databases (Science direct, google scholar, Medline, Embase, Sports medicine, PubMed, CINAHL, Cochrane library, and Scopus) from April 2015 until January 2019. Results show that changes in primary and secondary outcomes are significant between the different groups. The primary outcome is HbA1c, and the secondary outcomes are weight, waist, BMI, lipid, BP, HR, lactate and body fitness. Moreover, this study focuses on the changes in incretin level in the T2D group for effects of exercise on the secretion of this hormone and compare within T2D who are using a different medication for diabetes Results: After just six weeks, there was a reduction in the HbA1c level for the T2D volunteers which is significant (P=0.000). Moreover, in ND the reduction was also significant (P=0.000). In the T2D group who are using (Metformin and SGT2-I group), their result shows elevation in GLP-1 in the assessment of the both acute and chronic effect of the programme. GLP-1 in this group was (3.9 ± 1.5) and increased to (8.4 ± 1.2), (P=0.345) after S1 and then increased more to (11.0 ± 0.8), (P=0.196) after 6 weeks of exercise. This was of interest because of the inference that incretins and exercise were linked. The crucial factor is metformin. Conclusion: In T2D and ND combination exercise has a beneficial effect on HbA1c, the improvement was higher in T2D. The anthropometric variables (weight, waist, BMI and lung capacity) improved significantly as well in T2D and ND. Exercise is also important to improve GLP-1 secretion. Despite the range of studies on incretin undertaken here, still, there is a need to compare the effect of exercise and different types of pharmacological therapy on GLP1. This study compared the effect of exercise on T2D plus medication in volunteers. It has been found that within the T2D group only Metformin and SGT2-I group was improved. Both SGLT2 inhibitors and metformin have been found to affect body weight and this may explain the improvement of GLP-1 level, suggesting an area for future investigation.