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A randomized controlled trial of resistance exercise training to improve glycemic control in older adults with type 2 diabetes

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Castaneda, Carmen, Layne, Jennifer E., Munoz-Orians, Leda, Gordon, Patricia L., Walsmith, Joseph, Foldvari, Mona, Roubenoff, Ronenn, Tucker, Katherine L. +1 more·2002·Diabetes Care
DOI 10.2337/diacare.25.12.2335
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Abstract

OBJECTIVE—To determine the efficacy of high-intensity progressive resistance training (PRT) on glycemic control in older adults with type 2 diabetes. RESEARCH DESIGN AND METHODS—We performed a 16-week randomized controlled trial in 62 Latino older adults (40 women and 22 men; mean ± SE age 66 ± 8 years) with type 2 diabetes randomly assigned to supervised PRT or a control group. Glycemic control, metabolic syndrome abnormalities, body composition, and muscle glycogen stores were determined before and after the intervention. RESULTS—Sixteen weeks of PRT (three times per week) resulted in reduced plasma glycosylated hemoglobin levels (from 8.7 ± 0.3 to 7.6 ± 0.2%), increased muscle glycogen stores (from 60.3 ± 3.9 to 79.1 ± 5.0 mmol glucose/kg muscle), and reduced the dose of prescribed diabetes medication in 72% of exercisers compared with the control group, P = 0.004–0.05. Control subjects showed no change in glycosylated hemoglobin, a reduction in muscle glycogen (from 61.4 ± 7.7 to 47.2 ± 6.7 mmol glucose/kg muscle), and a 42% increase in diabetes medications. PRT subjects versus control subjects also increased lean mass (+1.2 ± 0.2 vs. −0.1 ± 0.1 kg), reduced systolic blood pressure (–9.7 ± 1.6 vs. +7.7 ± 1.9 mmHg), and decreased trunk fat mass (−0.7 ± 0.1 vs. +0.8 ± 0.1 kg; P = 0.01–0.05). CONCLUSIONS—PRT as an adjunct to standard of care is feasible and effective in improving glycemic control and some of the abnormalities associated with the metabolic syndrome among high-risk older adults with type 2 diabetes.

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  • An increase in muscle mass from resistance training may contribute to blood glucose uptake from a mass effect, and heavy weight training in particular may reverse or prevent further loss of skeletal muscle due to disuse and aging.

    “An increase in muscle mass from resistance training may contribute to BG uptake from a mass effect, and heavy weight training in particular may reverse or prevent further loss of skeletal muscle due to disuse and aging ( 34 , 276 ).”

    From Exercise and Type 2 Diabetes (2010) · cites this paper as [34]

    The discussion (indexed as Dietary intake; page unavailable) links increased lean mass and strength with improved glycemic control and suggests glucose uptake in skeletal muscle as a mechanism. Table 3 in the same indexed section shows that whole-body lean tissue mass increased with training. The paper does not establish that heavy weight training reverses or prevents skeletal-muscle loss specifically due to disuse and aging. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Exercise intervention studies showing the greatest effect on blood glucose control have all involved supervision of exercise sessions by qualified exercise trainers.

    “Exercise intervention studies showing the greatest effect on BG control have all involved supervision of exercise sessions by qualified exercise trainers ( 34 , 65 , 196 , 238 ).”

    From Exercise and Type 2 Diabetes (2010) · cites this paper as [34]

    The Study population section describes supervised exercise sessions three times a week, and the discussion reports a 1.2% mean reduction in glycosylated hemoglobin—twice that reported in earlier moderate-intensity resistance-training studies. The copy does not identify the supervisors as qualified exercise trainers or establish that all studies with the greatest effects used such trainers. Page numbers are unavailable in the indexed passages. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Reductions in trunk fat correlate with improved glycemic control in T2D.

    “Reductions in trunk fat correlate with improved glycemic control in T2D [316,317].”

    From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [317]

  • Reduced visceral fat improves glucose tolerance and insulin sensitivity in individuals with and without diabetes.

    “Reduced visceral fat has been shown to improve glucose tolerance and insulin sensitivity in individuals with and without diabetes.”

    From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [317]

  • Diet-induced weight loss improves insulin sensitivity and insulin secretion in older patients.

    “Diet-induced weight loss improves insulin sensitivity and insulin secretion in older patients (30), but data are conflicting about whether exercise can enhance insulin action and improve glucose tolerance, independent of weight loss (31).”

    From ]. The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes (2006) · cites this paper as [30]

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Research works printed but not linked: 1

  1. [5]5. Smedley BD, Stith AY, Nelson AR, Eds. Washing- ton, DC, National Academy Press, 2002

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Authors
Castaneda, C., Layne, J. E., Munoz-Orians, L., Gordon, P. L., Walsmith, J., Foldvari, M., Roubenoff, R., Tucker, K. L., & Nelson, M. E.
Affiliations
  • Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
  • Tufts University (US)
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2002-12-01
Volume
25
Issue
12
Pages
2335-2341
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/diacare.25.12.2335
OpenAlex
W2124826166
Cited by
844
References
41
Citations by year
2026: 15 · 2025: 33 · 2024: 32 · 2023: 36 · 2022: 26 · 2021: 31 · 2020: 25 · 2019: 32 · 2018: 30 · 2017: 41 · 2016: 40 · 2015: 44 · 2014: 55 · 2013: 47 · 2012: 57
FWCI
7.71
Type
journal article
Language
en
Open access
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • U.S. Department of Agriculture
  • Brookdale Foundation
  • Deutsches Krebsforschungszentrum
  • National Institute for Health and Care Research
  • NIH Clinical Center
Topics
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
progressive resistance training, type 2 diabetes, older adults, glycemic control, HbA1c, muscle glycogen, metabolic syndrome, body composition, Latino older adults, diabetes medication reduction, systolic blood pressure, trunk fat mass, lean body mass
MeSH terms
Aged, Blood Glucose, Body Weight, Diabetes Mellitus, Type 2, Educational Status, Ethnicity, Exercise Therapy, Female, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Lipids, Male, Middle Aged, Patient Compliance, Exercise

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