The American Association of Clinical Endocrinologists 21st Annual Scientific and Clinical Congress:

Exercise in Prediabetic Patients Improves Vascular Reactivity to Normal Levels

Regular aerobic exercise in patients with prediabetes can improve vascular reactivity to that of a non-diabetic patient, according to a pilot study conducted by Sabyasachi Sen, MD, MRCP, FACP, et al, from Baystate Medical Center in Springfield, Massachusetts1. The medical literature has established that patients with diabetes often exhibit endothelial cell dysfunction and poor vascular reactivity when compared to patients without diabetes, but a lack of data exists on vascular reactivity in prediabetic patients.

Investigators placed exercise-naïve patients who were at risk of developing diabetes into 2 groups (n = 10 per group) and were enrolled in a 6-week exercise program during which they would have their endothelial function evaluated after 150 minutes per week of aerobic exercise. The patient age range was 45 to 65 years, with a body mass index range of 25 to 34.9.1 During the 6-week program, half the group exercised while the other half did not. There was a 4-week washout period between the two groups, after which patients crossed over to exercise or no exercise.

Flow-mediated dilatation of the brachial arteries, which was used to measure vascular reactivity, improved from 5.7 to 11.2 with exercise. While no weight loss was recorded in either group, significant reductions were seen in leptin, interleukin-6, high-sensitivity C-reactive protein, tumor necrosis factor α, fasting triglycerides, low-density lipoproteins, and apolipoprotein B levels.

In patients who are at risk of developing diabetes, investigators concluded that the prediabetic state may be a period when regular aerobic exercise can serve as a non-pharmaceutical intervention and reverse poor vascular reactivity and biochemical inflammatory markers, which have been associated with heart disease, regardless of significant weight loss.

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