Ejercicio físico en pacientes con diabetes e hipertensión: prevalencia de respondedores y no respondedores para mejorar factores de riesgo cardiometabólicos / Effects of a six weeks exercise training program for type 2 diabetes mellitus and hypertensive patients

Background: There is a wide interindividual variability in the response to a period of exercise training. The science have reported that a minimum of participants could be non-responders for improving different health-related outcomes after training. Aim: To compare the effects of a 6-weeks exercise program on body composition, cardiovascular and metabolic outcomes patients with type 2 diabetes and hypertension. Material and Methods: Data from 23 trained subjects were used in a secondary analysis of the response to exercise. Of these, 14 were considered adherent to training and nine as non-adherent. Body mass, height, waist circumference, four skinfolds and their sum, blood pressure and plasma triglyceride levels were assessed before and after the training period. Results: Among adherent participants, significant reductions were observed in the sum of four skinfolds (30 ± 7 to 27 ± 6 mm, p ≤ 0.05), systolic blood pressure (133 ± 18 to 127 ± 20 mmHg; p ≤ 0.05) and plasma triglycerides (125 ± 58 to 102 ± 34 mg/dL; p ≤ 0.05). No changes were observed in weight or diastolic blood pressure. Among non-adherent participants, no changes of measured parameters were observed. Among adherent participants, 57% were considered as non-responders for waist circumference, 7% for the sum of skinfold thickness, 50% for systolic blood pressure, 64% for diastolic blood pressure and 57% for plasma triglycerides. Conclusions: Participants with a good adherence to a 6-weeks exercise training program experienced overall improvement in body composition, blood pressure and plasma triglycerides. The prevalence of non-responders varied considerably among measured outcomes.

Ejercicio intermitente y consejería nutricional mejoran control glicémico y calidad de vida en pacientes con diabetes mellitus tipo 2 / Effects of high-intensity interval training and nutritional education in patients with type 2 diabetes

Background: High-intensity interval training (HIIT) improves cardiometabolic markers, but its effects on the quality of life of patients with type 2 diabetes (T2D) is not well known. Aim: To determine the effects of a 12-week HIIT exercise program on cardiometabolic and quality of life variables of T2D patients. Material and Methods: Nine T2D women were assigned to a HIIT + nutritional education (GE) and 10, to a nutritional education alone group (GC). At baseline and after each intervention, anthropometric and body composition parameters using bio-impedance were assessed, and a blood sample was obtained to measure serum lipid levels, blood glucose and glycated hemoglobin. Quality of life was assessed using the SF-12 questionnaire adapted for the Chilean population. Results: There were no significant changes on the lipid profile variables in the GE group, although HDL cholesterol was increased significantly (p < 0.05) in the GC group. Total fat mass was decreased in the GE group from 43.5 ± 1.5 to 41.9 ± 1.5%, p < 0.01. Fasting glucose and glycated hemoglobin decreased in the GE group. There was a significant correlation between the decrease in total fat mass and that of glycated hemoglobin. There were significant increases in quality of life parameters; physical function, physical role, pain, general health, vitality, emotional role, mental health, and social function in the GE but not in the GC group. Conclusions: A 12-week program of HIIT plus nutritional education improves cardiometabolic and quality of life parameters on type 2 diabetics.

Recuperación cardiovascular durante ejercicio intermitente en pacientes con hipertensión y diabetes tipo 2 altamente adherentes / Cardiovascular recovery during intermittent exercise in highly-adherent partic pants with hypertension and type 2 diabetes mellitus

Background: Despite the evidence supporting metabolic benefits of high intensity interval exercise (HIIT), there is little information about the cardiovascular response to this type of exercise in patients with type 2 diabetes (T2D) and hypertension (HTA). Aim: To analyze the changes in heart rate at rest, at the onset and at the end of each interval of training, after twelve weeks of a HIIT program in T2D and HTA patients. Material and Methods: Twenty-three participants with T2D and HTA (20 women) participated in a controlled HIIT program. Fourteen participants attended 90% of more session of exercise and were considered as adherent. Adherent and non-adherent participants had similar body mass index (BMI), and blood pressure. A “1x2x10” (work: rest-time: intervals) HIIT exercise protocol was used both as a test and as training method during twelve weeks. The initial and finishing heart rate (HR) of each of the ten intervals before and after the intervention were measured. Results: After twelve weeks of HIIT intervention, adherent participants had a significant reduction in the heart rate at the onset of exercise, and during intervals 4, 5, 8 and 10. A reduction in the final heart rate was observed during intervals 8 and 10. In the same participants the greatest magnitude of reduction, at the onset or end of exercise was approximately 10 beats/min. No significant changes in BMI, resting heart rate and blood pressure were observed. Conclusions: A HIIT program reduces the cardiovascular effort to a given work-load and improves cardiovascular recovery after exercise.

Interacción entre farmacoterapia hipotensiva y terapia con ejercicio físico requiere regulación farmacológica en pacientes hipertensos / Interaction between antihypertensive therapy and exercise training therapy requires drug regulation in hypertensive patients

Background: Exercise training could interact with the pharmacological therapy of hypertension, increasing the effects of these medications. Aim: To assess the effects of 12 weeks of physical training on blood pressure of hypertensive or diabetic patients, already receiving pharmacological therapy. Material and methods: Twelve participants with diabetes and hypertension, 16 participants with hypertension and 18 healthy participants were studied. During six weeks no intervention was carried out, except the treatment for their underlying conditions. During the ensuing six weeks, participants were subjected 12 sessions of physical training. Blood pressure was measured at baseline and after six and twelve weeks of intervention. Results: During the period without physical training, no changes in blood pressure were observed. After the physical training intervention systolic blood pressure decreased by 16, 17 and 20 mm Hg in participants with diabetes and hypertension, participants with hypertension and healthy participants, respectively. Diastolic blood pressure decreased by 9 and 6 mmHg in participants with diabetes and hypertension and hypertension alone, respectively. Conclusions: There is a decrease in blood pressure among hypertensive participants receiving pharmacological therapy, after a period of physical training.