Exercise individualized by TRIMPi method reduces arterial stiffness in early onset type 2 diabetic patients: A randomized controlled trial with aerobic interval training

Background: Arterial stiffness (AS) and baroreflex sensitivity (BRS) are subclinical markers of vascular diseases in type 2 diabetes (T2D). Weevaluated the effects of aerobic interval training (AIT), with loads prescribed according to individual heart rate and lactate profiling obtained during a baseline treadmill test (TRIMPi method), on AS and BRS in patients with early-onset T2D without cardiovascular complications. Population study and methods: Twenty-two sedentary overweight T2D patients (aged 57 +/- 7 years) were randomized to 12-weeks open-label of supervised AIT by TRIMPi (n = 8) or unsupervised physical activity as per usual care (SOC) (n = 11). Following parameters were evaluated (pre-and post-): anthropometrics; six-minute walking test (6MWT); fasting glucose, insulin, HbA1c; Pulse Wave Velocity (PWV) and Augmentation Index (AIxHR75) using radial approach (SphigmoCor System); BRS using Finapress method. Results: Both interventions significantly improved distance walked during 6MWT (AIT 52 +/- 21 m; SOC 39 +/- 24 m, p < 0.001 for both). PWV significantly improved with AIT (p < 0.001) whereas did not vary with SOC (p = 0.47). Similar trend was observed for AIxHR75. Resulting percent changes from baseline were significantly better for AIT vs SOC, in both PWV (-15.8 +/- 2.1 vs + 1.50 +/- 3.4%, p < 0.001) and AIxHR75 (-28.9 +/- 3.2% vs + 12.7 +/- 2.4%, p < 0.001). BRS similarly improved in both groups (p < 0.001 for both), as well as body weight, HbA1c and blood pressure. Conclusion: In sedentary T2D patients, 12-weeks AIT individualized by TRIMPi method improved AS to a greater extent than usual recommendation on physical activity, whilst exerting comparable effects on exercise capacity, glycemic control and body weight. Further researches are needed to ascertain durability of these effects. (C) 2017 Elsevier B.V. All rights reserved.