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Eric Todd Jenna Kong Mike DeRosa

Eric Todd Jenna Kong Mike DeRosa. Article 1. Title of article: Moderate exercise improves leucocyte function and decreases inflammation in diabetes Author(s): M. F. Belotto , J. Magdalon , H. G. Rodrigues , M. A. R. Vinolo , R. Curi , T. C. Pithon-Curi , E. Hatanaka

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Eric Todd Jenna Kong Mike DeRosa

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  1. Eric ToddJenna KongMike DeRosa

  2. Article 1 Title of article: • Moderate exercise improves leucocyte function and decreases inflammation in diabetes Author(s): • M. F. Belotto, J. Magdalon, H. G. Rodrigues, M. A. R. Vinolo, R. Curi, T. C. Pithon-Curi, E. Hatanaka Journal title: • Clinical & Experimental Immunology Volume, date, pages: • 162, 7/12/10, 237-243

  3. Article 1 Cont. Purpose: • To prove that exercise helps to prevent and treat diabetes and other chronic diseases that cause inflammation. Methods: • The study was done on 40 male Wistar rats. The rats were divided into 4 groups of 10. The researchers induced the rats with type 1 diabetes through injection. They put the exercise rates on a 3 week moderate exercise regimen to study the inflammatory markers and leucocytefunctions in diabetic rats. • The exercise program consisted of running on a treadmill for 30 min a day at an intensity of up to approximately 60% VO2max, 6 days per week.

  4. Article 1 Cont. Results: • The exercise decreased serum levels in diabetic rats when compared with the sedentary diabetic rats and it also increased the responsiveness of leucocytes from diabetics when compared to control group rats and exercise had anti-inflammatory effects in diabetic rats. Discussion: • Accumulating evidence supports the recommendation of exercise for the prevention and treatment of diabetes and other chronic diseases. Conclusion: • Moderate physical exercise has marked anti-inflammatory effects on diabetic rats.

  5. Article 2 Title of article: • Women with type 2 diabetes perceive harder effort during exercise than non-diabetic women Author(s): • Amy G. Huebschmann, Erin N. Reis, Caroline Emsermann, L. Miriam Dickinson, Jane E.B. Reusch, Timothy A. Bauer, and Judith G. Regensteiner Journal title: Applied Physiology, Nutrition & Metabolism Volume, date, pages: • 34, 2009, 851-857

  6. Article 2 Cont. Purpose: • This study examined RPE (Borg scale, ordinal range 6–20) during submaximal exercise at identical absolute work rates to test the hypothesis that women with T2D demonstrate harder RPE during exercise than non-diabetic controls. Methods: • This study analyzed existing data to data obtained during steady-state bicycle exercise among 3 female study groups • Subjects performed three 7 min, constant-load exercise tests at 20 W and 30 W.

  7. Article 2 Cont. Results: • Subjects with T2D perceived harder effort during bicycling exercise than controls, as measured by RPE at 20 W and 30 W. Harder perceived effort during exercise may be a barrier to physical activity for those with T2D. Discussion: • This study demonstrated that sedentary subjects with T2D perceived harder effort during exercise at low identical work rates as compared with equivalently sedentary non-diabeticoverweight and normal-weight persons, as measured by RPE.

  8. Article 2 Cont. Conclusion: • Previous research identified difficulty taking part in exercise and tiredness as barriers to exercise in women with diabetes. • This study agrees with those observations in that harder effort was perceived in T2D subjects vs. controls at low-level resistances.

  9. Article 3 Title: • Impact of Physical Therapist-Directed Exercise Counseling Combined With Fitness Center-Based Exercise Training on Muscular Strength and Exercise Capacity in People with Type 2 Diabetes: A Randomized Clinical Trial Authors: • J. David Taylor, James P. Fletcher, JakesaTiarks Journal: • Physical Therapy Vol. 89 Sep 2009, p884-892

  10. Article 3 Cont. Purpose: • Assessing muscular strength (force-generating capacity) and exercise capacity in response to an intervention for people with type 2 diabetes -Testing physical therapist-directed exercise combined with fitness center based exercise compared to supervised exercise in a laboratory setting • The assessment is important for determining preventions of type 2 diabetes-related complications.

  11. Article 3 Cont. Methods: • Randomized clinical trial • Conducted on university campus using twenty-four people with type 2 diabetes -Randomly selected to group receiving physical therapist directed exercise (experimental group) -OR laboratory based, supervised exercise (comparison group) • Both groups received same exercise program -Consisted of chest press, back row and leg press (strength training) -Graded exercise test conducted at baseline and 2 months later (aerobic capacity)

  12. Article 3 Cont. Methods Cont: • Strength training was conducted on machines -4 sets of up to 8 reps at 80% of their 1 RM on two nonconsecutive days/week with 1-3 min rest in between -Once patients were able to do 4 sets of 8 reps, weight was increased by 5-10 pounds the following workout -And each workout thereafter once patient reached 4 sets of 8 reps • Aerobic activity consisted of walking or jogging on a treadmill -Intensity – RPE of 12 on the Borg scale -20 minute duration on the same days as strength training -Speed and grade increased in order to keep the patient at an RPE of 12 as they progressed

  13. Article 3 Cont. Results: • There were no significant differences in muscular strength or aerobic capacity between the experimental group who received physical therapist prescribed exercise in a fitness center or the supervised group in a lab setting. Discussion: • There were no differences between the physical therapist directed exercise and the laboratory setting because both groups were given the same exercise program -In the future a different exercise program for each group might help to differentiate which instruction of exercise is more beneficial -It would also help to have a larger sample size in future studies

  14. Article 3 Cont. Conclusion: • Physical therapist directed exercise in a fitness center did improve muscular strength in people with type 2 diabetes • But no significant differences were seen between them and the supervised group in a lab setting.

  15. Article 4 Title: • Prognostic Effect of Exercise Capacity on Mortality in Older Adults with Diabetes Mellitus Authors: • Eric S. Nylen, MD, Peter Kokkinos, PhD, Jonathan Myers, PhD, and Charles Faselis, MD Journal: • Journal of the American Geriatrics Society, Oct2010, Vol. 58, p1850-1854

  16. Article 4 Cont. Purpose: • To investigate the prognostic effect of exercise capacity in older individuals with diabetes mellitus. Methods: • Retrospective data review in a clinic-based cohort study -Took place over a 23 year period from 1986 to 2009 -At the Veterans Affairs Medical Centers in Washington, District of Columbia, and Palo Alto, California • 2,867 Caucasian and African American men aged 50 to 87 with type 2 diabetes mellitus. -The men were separated into two separate groups, those 50-65 years of age and 65 years of age or older.

  17. Article 4 Cont. Methods Cont: • Exercise capacity was tested using the Bruce Protocol in Washington DC, and an individualized ramp protocol for the patients in Palo Alto. -Exercise capacity was measured in MET’s. Results: • 324 men in the 50-65 year group died within the next 23 years • 464 men 65 or older died within the same time period • For every 1 MET increase in exercise capacity there was an 18% lower mortality rate for the entire group -23 % lower mortality rate for group 1 (50-65 years of age) -16% lower mortality rate for group 2 (65 and older) • For group as a whole, men who increased more than 4 METs saw a 30-80% decrease in mortality risk.

  18. Article 4 Cont. Discussion: • Awareness of healthcare providers to the importance of exercise capacity in individuals should be taken into consideration -Due to the correlation of a lower mortality risk in individuals with an increased fitness level regardless of age. Conclusion: • Results of a lower mortality risk due to increased exercise capacity were also found to be evident for men without diabetes mellitus -Regardless of age.

  19. Article 5 Title: • Physical Activity and Reduced Occurrence of Non-Insulin-Dependent Diabetes Mellitus Authors: • Susan P. Helmrich, PhD., David R. Ragland, PhD., M.P.H., Rita W. Leung, A.B., and Ralph S. Paffenbarger, Jr., M.D., DR.P.H. Journal: • The New England Journal of Medicine, July 1991, Vol. 325, No.3 p147-52.

  20. Article 5 Cont. Purpose: • To determine whether physical activity is effective in preventing Non-Insulin Dependent Diabetes. Methods: • Questionnaires were used to examine patterns of physical activity and other personal characteristics in relation to the development of Non-Insulin Dependent Diabetes. -5990 male alumni of the University of Pennsylvania. -Mail or phone questionnaires of the Physicians of the alumni

  21. Article 5 Cont. Results: • Leisure-time physical activity per week was inversely related to the development of  Non-Insulin Dependent Diabetes. -Walking, stair climbing, and sportswere types of activities used. • For each 500-kcal increment in energy expenditure, the age-adjusted risk of Non-Insulin Dependent Diabeteswas reduced by 6 percent. • The most active men had a risk of Non-Insulin Dependent Diabetes two thirds that of the least active men.

  22. Article 5 Cont. Discussion: • Physically trained middle-aged men have lower plasma insulin levels than healthy sedentary men. • Weight gain was a strong independent predictor of Non-Insulin Dependent Diabetes. -Adipose tissue is a major site for insulin insensitivity, and most obese persons have increased insulin resistance, some degree of glucose intolerance, or both. Conclusion: • Increased physical activity is effective in preventing Non-Insulin Dependent Diabetes.

  23. Summarization of Research Articles • Women with Type II Diabetes have higher RPE’s while exercising than Non-Diabetics. • Exercise has positive benefits on a person/ mouse with Diabetes. - Physical activity reduces the chances of developing Type II Diabetes (Vigorous more than Moderate) • Strength training improves muscular strength for a person with Type II Diabetes. • Moderate physical activity reduces inflammation (In mice). • Cardiovascular training decreases the risk of mortality.

  24. QUESTIONS?

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