Resistance Exercise for Type 1 Diabetes

Overseen By Jane Yardley, PhD

Age: 18+

Sex: Female

Trial Phase: Academic

Sponsor: University of Alberta

Must not be taking: Atypical antipsychotics, Corticosteroids

Disqualifiers: Cardiovascular disease, Severe neuropathy, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 5

16 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines how different types of weight lifting affect blood sugar levels in post-menopausal women with type 1 diabetes. Researchers compare two exercise routines: one with lighter weights and more repetitions (High repetition, HI) and another with heavier weights and fewer repetitions (Moderate repetition, MOD). The goal is to determine which routine more significantly impacts blood sugar during and after exercise. Women with type 1 diabetes who have not had a menstrual period for at least a year and can perform resistance exercises may be suitable for this study. Participants should reside near Edmonton, Alberta, to attend sessions at the University of Alberta. As an unphased trial, this study offers a unique opportunity to contribute to understanding how exercise can manage diabetes.

Will I have to stop taking my current medications?

The trial requires that participants do not take medications other than insulin that affect glucose metabolism, such as atypical antipsychotics or corticosteroids.

What prior data suggests that resistance exercise is safe for post-menopausal women with type 1 diabetes?

Research has shown that both high repetition and moderate repetition resistance exercises are generally safe for people with type 1 diabetes. Studies indicate that high-intensity interval exercise, similar to high repetition workouts, is safe for adults with diabetes and helps maintain normal blood sugar levels during and immediately after exercise.

For moderate repetition exercises, research supports that resistance training is safe and can improve heart health, benefiting individuals with and without heart-related conditions. Both exercise types safely lower blood sugar levels after exercising.

In summary, high repetition and moderate repetition exercises are well-tolerated and safe for individuals with type 1 diabetes, offering benefits without major safety concerns. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores how different resistance exercise protocols can benefit people with Type 1 Diabetes. Unlike traditional management options, which often focus on insulin therapy and dietary modifications, this study looks at how physical exercise, particularly high repetition, low resistance, and moderate repetition, moderate intensity workouts, can impact blood sugar control. The unique focus here is on understanding how different exercise intensities and repetitions might improve insulin sensitivity and overall metabolic health, potentially offering a non-pharmaceutical approach to managing the condition.

What evidence suggests that resistance exercise is effective for managing blood glucose levels in post-menopausal women with type 1 diabetes?

Research shows that strength training can help people with type 1 diabetes manage their blood sugar levels. In this trial, participants will undergo two separate interventions: a high repetition, low resistance protocol, and a moderate repetition, moderate intensity protocol. Studies indicate that many repetitions with lighter weights often cause a bigger drop in blood sugar during the workout. In contrast, a moderate number of repetitions with moderate weights may help keep blood sugar levels more stable immediately after exercising. Both types of strength training are linked to better long-term blood sugar control, which is crucial for managing type 1 diabetes. Thus, both high and moderate repetition exercises can be beneficial, each offering its own advantages. ^{6 7 8 9 10}

Are You a Good Fit for This Trial?

This trial is for post-menopausal women with Type 1 Diabetes living near Edmonton, Alberta. They should have been diagnosed at least a year ago and not had a menstrual period in the last 12 months. Participants must be able to do resistance exercise but can't join if they have high blood pressure, cardiovascular disease history, are on certain medications, or have conditions affecting exercise ability.

Inclusion Criteria

Your HbA1c level is less than 10%.

Residing near Edmonton, Alberta or able to attend laboratory based sessions at the University of Alberta

I am a woman diagnosed with type 1 diabetes for over a year.

Exclusion Criteria

You have a body mass index higher than 30, which means you are very overweight.

I have a history of heart disease.

You are a smoker.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

1 visit (in-person)

Pre-test Measures

Participants undergo pre-test measures including questions related to menopause, physical activity levels, medication, blood pressure, heart rate, anthropometric characteristics, and blood sample for HbA1c.

1 week

1 visit (in-person)

Testing Sessions

Participants perform resistance exercises in two sessions with different protocols, and blood samples are drawn at various times.

2 weeks

2 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after exercise sessions, including CGM data collection and focus group participation.

1-2 weeks

1 visit (in-person or virtual)

What Are the Treatments Tested in This Trial?

Interventions

• High repetition (HI)
• Moderate repetition (MOD)

Trial Overview

The study tests how different resistance exercises affect blood sugar levels in participants. One group will do low resistance but high repetition weight lifting (3 sets of 15-20 reps), while another does moderate resistance and repetitions (3 sets of 8-10 reps). The goal is to see which method impacts blood glucose during and after exercise.

How Is the Trial Designed?

Group I: All participants Experimental Treatment 2 Interventions

All participants will be in a single arm that undergoes two separate interventions. These interventions will include a high repetition, low resistance protocol, and a moderate repetition, moderate intensity protocol.

Who Is Running the Clinical Trial?

University of Alberta

Lead Sponsor

Trials

957

Recruited

437,000+

Published Research Related to This Trial

In a study involving 12 individuals with type 1 diabetes, performing resistance exercise before aerobic exercise led to better glycemic stability during the workout, with lower blood glucose levels compared to doing aerobic exercise first.

The order of exercise also influenced post-exercise hypoglycemia, with resistance-aerobic (RA) resulting in a shorter duration and less severe hypoglycemia compared to aerobic-resistance (AR), although these differences were not statistically significant.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of performing resistance exercise before versus after aerobic exercise on glycemia in type 1 diabetes. Yardley, JE., Kenny, GP., Perkins, BA., et al.[2021]

In a study involving 12 individuals with type 1 diabetes, resistance exercise led to a smaller initial drop in blood glucose during the activity compared to aerobic exercise, but resulted in more sustained reductions in blood glucose levels afterward.

The findings suggest that resistance exercise may be more effective than aerobic exercise for managing post-exercise glycemia, which could help explain the observed reductions in HbA(1c) levels associated with resistance training in type 1 diabetes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Resistance versus aerobic exercise: acute effects on glycemia in type 1 diabetes. Yardley, JE., Kenny, GP., Perkins, BA., et al.[2022]

The READI trial involved 131 physically active adults with type 1 diabetes and aimed to determine if adding a 6-month resistance training program would improve glycemic control compared to aerobic exercise alone.

This study is significant as it is the first to assess the additional health benefits of resistance training in individuals with type 1 diabetes who are already engaged in aerobic exercise, potentially influencing future exercise recommendations for this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Resistance Exercise in Already-Active Diabetic Individuals (READI): study rationale, design and methods for a randomized controlled trial of resistance and aerobic exercise in type 1 diabetes. Yardley, JE., Kenny, GP., Perkins, BA., et al.[2022]

Intermittent high-intensity exercise (IHE) resulted in a smaller decline in blood glucose levels compared to moderate-intensity exercise (MOD) in individuals with type 1 diabetes, with a decrease of -2.9 mmol/l for IHE versus -4.4 mmol/l for MOD.

During recovery, blood glucose levels remained more stable after IHE, likely due to elevated lactate and hormone levels, indicating that IHE may help in better managing blood glucose levels post-exercise.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The decline in blood glucose levels is less with intermittent high-intensity compared with moderate exercise in individuals with type 1 diabetes. Guelfi, KJ., Jones, TW., Fournier, PA.[2022]

In a study involving 14 physically active individuals with type 1 diabetes, a single session of strenuous resistance exercise did not significantly change insulin sensitivity compared to a non-exercise control group.

Insulin sensitivity was measured using a precise technique before exercise and at 12 and 36 hours after, showing no significant differences over time or between the groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Insulin-sensitivity response to a single bout of resistive exercise in type 1 diabetes mellitus. Jimenez, C., Santiago, M., Sitler, M., et al.[2019]

Exercise training, particularly a combination of strength exercises and high-intensity interval training, may help reduce the risk of hypoglycemia in individuals with Type 1 diabetes mellitus (T1DM) compared to continuous aerobic exercise.

This proposed training regimen, performed three times a week, aims to improve long-term health markers and reduce the risk of complications associated with T1DM by enhancing glycemic control and overall physical fitness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise for type 1 diabetes mellitus management: General considerations and new directions. Farinha, JB., Krause, M., Rodrigues-Krause, J., et al.[2022]

In a study involving 131 aerobically active individuals with type 1 diabetes, adding resistance training did not significantly change glycated hemoglobin A1c (HbA1c) levels compared to those who only performed aerobic exercise.

However, participants who engaged in resistance training experienced greater increases in muscular strength and a more significant reduction in waist circumference over 22 weeks, indicating benefits in body composition and fitness without affecting glycemic control.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Resistance Exercise in Already Active Diabetic Individuals (READI) Randomized Clinical Trial. Sigal, RJ., Yardley, JE., Perkins, BA., et al.[2023]

A 3-month resistance training program significantly increased maximal muscle strength in 11 male patients with long-term type 1 diabetes, indicating that they can adapt well to physical training.

Despite the improvement in muscle strength, there were no significant changes in serum irisin levels or metabolic control parameters like HbA1c, suggesting that while strength can improve, other metabolic factors may remain unchanged.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The influence of resistance training on muscle strength, irisin concentration, and metabolic parameters in type 1 diabetic patients. Wróbel, M., Gołaś, A., Rokicka, D., et al.[2022]

Resistance training significantly reduces glycated hemoglobin (HbA1c) levels in individuals with Type 1 Diabetes (T1D), indicating improved glycemic control, based on a review of five studies.

Longer resistance training interventions, particularly in children and adolescents, not only lowered HbA1c but also increased strength and improved lipid profiles, suggesting additional health benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of resistance training on the glycemic control of people with type 1 diabetes: a systematic review and meta-analysis. de Abreu de Lima, V., de Menezes, FJ., da Rocha Celli, L., et al.[2023]

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