Objective: To explore the long-term effects of aerobic training (AT), resistance training (RT) and both (AT+RT) on prevention of incidence of type 2 diabetes(T2D) in patients with prediabetes.

Methods: Randomized control trial conducted in two Chinese medical centers between October, 2014 and November, 2016. Of 724 subjects, 122 declined, 430 were excluded, and 172 with prediabetes (fasting glucose ≥5.6mmol/L and <7.0mmol/L and/or 2-hour glucose ≥7.8mmol/L and <11.1mmol/L in the 75g oral glucose tolerance test) were included for randomization. Supervised exercise programs including AT, RT and AT+RT were completed for 60 minutes, three nonconsecutive times per week for 24 months respectively.

Primary outcome was incidence of T2D; secondary outcomes included hemoglobin (HbA1c), fasting plasma glucose (FPG), standard 2-hour oral glucose tolerance (2hPG), and lipid profile.

Results: 137 (80%) subjects, mean age 59 years, 45 men, 92 women, entered final analysis. After 24 months of intervention, the incidences of T2D adjusted by sex and age were significantly decreased by 74% (95% CI 0.38-0.89%), 65%(95% CI 0.21-0.85%) and 72% (95% CI 0.36-0.87%) with AT+RT, RT and AT, as compared with control group ((HRR 0.26(95% CI 0.11−0.62) in AT+RT 0.35(0.15-0.79)RT, and 0.28(95% CI 0.13-0.64)AT)), and the cumulative T2D incidences were significantly lower in AT+RT, RT, and AT group, compared to that of the control group(21%, 26% and 22% vs. 69%). Blood glucose and lipid profile in AT, RT and AT+RT improved more than in the control group, which had prevailed over time.

Conclusions: Resistance training and resistance training plus aerobic training were as effective as isolated aerobic training in preventing progression to T2D. Patients with prediabetes can choose aerobic training, resistance training or both to prevent T2D. This can have substantial impact on engaging patients with lifestyle change to prevent or delay T2D onset.


X. Yuan: None. Q. Lou: None.

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