Exercise plus med improves diabetes control

People with type 2 diabetes respond markedly to exercise, and adding acarbose to an exercise regimen significantly improves blood glucose control, according to a Swedish study.

Dr. Henrik Wagner and colleagues at the Karolinska University in Stockholm, assigned subjects with type 2 diabetes to one of three treatment programs: group exercise for 50 minutes three times a week; the group exercise plus acarbose; or acarbose alone.

Acarbose (commonly known as Precose) is a standard anti-diabetes medication that improves the output of insulin from the pancreas and reduces the spike in blood glucose levels after meals.

All three treatment interventions lasted 12 weeks, and 48 participants completed the study, the investigators report in the journal Diabetes Care.

Insulin sensitivity, a measure of the body's response to insulin, improved by 92 percent in patients in the exercise-only group. Total body fat decreased significantly and blood pressure improved. Exercise had no effect on hemoglobin A1c levels, which reflect long-term regulation of blood sugar levels.

Adding acarbose to exercise had no further effect on body composition or insulin sensitivity, but it did result in a significant decrease in hemoglobin A1c and blood glucose levels.

Acarbose alone had no effect on insulin sensitivity or A1c level, but it did cause a fall in blood pressure and improvement in fasting insulin level.

More intensive exercise resulted in more pronounced improvements of diabetes control, but Wagner's team advises doctors to warn their diabetic patients - particularly those who are sedentary - against undertaking intensive exercise without a medical evaluation beforehand.

SOURCE: Diabetes Care, July 2006.