IMPACT OF TWO TYPES OF PHYSICAL EXERCISE PROGRAMS AND NUTRITIONAL COUNSELLING ON CARDIOVASCULAR RISK IN TYPE 2 DIABETES MELLITUS

Resumen

INTRODUCTION: The prevalence of type 2 diabetes mellitus (T2DM) and obesity are increasing rapidly worldwide and increasing the risk of cardiovascular diseases (1). Nutritional education and exercise programs are used to improve cardiovascular health (2). The aim is to study the effect of the type of exercise training and nutritional counselling on cardiovascular risk and the management of T2DM. METHODS: The study is a controlled clinical trial of 12 weeks of intervention. This is the first batch of 62 adults with T2DM and obesity (37 men; 55.90±7.28 years old ) randomized into 6 groups according to the nutritional counselling (Diet vs. NoDiet groups) and the physical exercise program which consisted of high-intensity interval training (HIIT) or moderateintensity continuous training (MICT) or maintaining their inactive levels (INACT) as controls. Thus, participants were allocated into Diet+HIIT, Diet+MICT, Diet+INACT, NoDiet+HIIT, NoDiet+MICT, and NoDiet+INACT. Weight, body mass index, fatpercentage, visceral fat, waist circumference (Wc), blood pressure, glycosylated haemoglobin (GhA1c), cholesterol and triglycerides were measured. Delta was calculated as differences between post and pre intervention. ANOVA test and DMS were applied with statistical significance set at p<0.05. RESULTS: The cardiovascular risk significantly differed after the intervention program in the fat percentage (p=0.008), visceral fat (p=0.002), Wc (p=0.009) and GhA1c (p=0.049). There was a difference in the fat percentage between Diet+MICT and NoDiet+INACT (-2.153±0.779;p=0.008), Diet+MICT and MICT (-1.744±0.779;p=0.029), HIIT and Diet+INACT (2.167±0.934;p=0.024), Diet+INACT and INACT (-2.562±0.779;p=0.002). Visceral fat was statistical significant in Diet+MICT and NoDiet+INACT (-0.992±0.447;p=0.031), HIIT and Diet+INACT(1.417±0.536;p=0.011), MICT and CONTROL+EDU (1.644±0.447;p=0.001), Diet+INACT and NoDiet+INACT (-1,826±0.448;p=0.000). The Wc difference between Diet+HIIT and NoDiet+INACT (-4.768±2.156;p=0.031), Diet+MICT and NoDiet+INACT (-4.369±2.059; p=0.038), MICT and Diet+INACT (6,388±2.059;p=0.003), HIIT and NoDiet+INACT (- 5.32±2.503; p=0.038). Data showed differences in the GhA1c between Diet+HIIT and MICT (-0.838±0.336;p=0.016), Diet+HIIT and NoDiet+INACT (-0.787±0.319;p=0.017), MICT and Diet+INACT (0.778±0.328;p=0.022), Diet+INACT andNoDiet+INACT (-0.727±0.311;p=0.024). CONCLUSION: Both interventions of physical exercise and nutritional counselling improve cardiovascular markers of adiposity and GhA1c independent of each group. The nutritional intervention was more effective in the fat percentage and visceral fat decreases, even in the inactive groups. However, it is important that the GhA1c improves in the Diet+HIIT group with respect to other groups.