پديد آورندگان :
طهان، پيمان داﻧﺸﮕﺎه آزاد اﺳﻼﻣﯽ واﺣﺪ ﺗﻬﺮان ﺷﻤﺎل , حيدرزادي، سهيلا داﻧﺸﮕﺎه آزاد اﺳﻼﻣﯽ واﺣﺪ ﺗﻬﺮان ﺷﻤﺎل , مالكي، الهام داﻧﺸﮕﺎه آزاد اﺳﻼﻣﯽ واﺣﺪ ﺗﻬﺮان ﺷﻤﺎل , قلاوند، اكبر داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﮑﯽ زاﺑﻞ - ﻣﺮﮐﺰ ﺗﺤﻘﯿﻘﺎت ﮔﻮارش و ﮐﺒﺪ ﮐﻮدﮐﺎن , دلارام نسب، مجتبي داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﮑﯽ زاﺑﻞ - دانشگده پرستاري
كليدواژه :
ديابت نوع 2 , تمرين تناوبي هوازي , مقاومت به انسولين , ذخاير آهن
چكيده لاتين :
Type 2 diabetes is a multifactorial chronic disease caused by the interaction between genetic and environmental factors. Genetic and environmental factors together are important factors influencing insulin resistance and pancreatic beta cell function. Although most research on type 2 diabetes focuses on macronutrients, but more recent research has shown that these patients also have disorders of micronutrient metabolism, such as vitamins and minerals. Iron is one of the most important micronutrients in the body that has a variety of biological roles in the body. However, the research has shown that high levels of iron in the body are associated with obesity and metabolic syndrome. Hyperferritinemia has also been found to have significant association between insulin resistance and high levels of glycosylated hemoglobin in patients with type 2 diabetes. Lifestyle intervention programs including physical activity and healthy diets are options for treating and managing type 2 diabetes, and the beneficial effects of exercise on the bodychr('39')s metabolism, especially insulin sensitivity, have long been recognized. One of the methods of aerobic training is interval training, which due to the possibility of rest and recovery of energy systems between training intervals, a person can perform a larger volume of training than continuous training and also due to the ability to perform higher-intensity interval training, workouts continuation of this type of training for people with lower physical fitness is recommended. Considering the role of iron in insulin resistance in patients with type 2 diabetes and as no specific research has been done to investigate the effect of aerobic interval training on iron metabolism in patients with type 2 diabetes, therefore, the present study was designed to determine the effect of aerobic interval training on iron stores and insulin resistance in men with type 2 diabetes.
Methods
In this quasi-experimental study, 20 men with type 2 diabetes were selected and divided randomly into two groups of interval aerobic training (age: 39.61±1.82; body mass index: 26.92±2.24 kg/m2) and control (age: 38.12±2.08; body mass index: 27.39±2.53 kg/m2). The training protocol consisted of aerobic interval training for twelve weeks, three days a week and each session 60-90 minutes that was performed with a 50-80% reserve heart rate with a 1: 1 rest-to-exercise ratio. Blood variables in the study protocol, 48 hours after the last training session was measured fasting. Insulin resistance was calculated using the Homeostasis model assessment: insulin resistance (HOMA-IR). Statistical analysis was performed using Paired sample t- test and independent t-test. Statistical analysis was performed at the significant level of (p≤ 0.05) by SPSS software version 22.
Results
The results of independent t-test showed that at the beginning of the study there was no significant difference in the baseline values of the measured variables between the exercise and control groups (p> 0.05). The results of paired sample t-test showed a significant decrease were founded in serum Fe (p= 0.002), hematocrit (p= 0.001), ferritin (p< 0.001) and insulin resistance (p< 0.001) in the exercise group compared to baseline values; But no significant difference was observed in hemoglobin level in the exercise group (p= 0.091). No significant difference was observed in any of the research variables in the control group (p> 0.05). The results of independent t-test showed that changes in serum Fe (p= 0.003), hematocrit (p<0.001), ferritin (p< 0.001) and insulin resistance (p< 0.001) in the aerobic interval training group was significant compare to the control group; But no significant difference was observed in hemoglobin changes (p< 0.05).
Conclusion
In the present study, after a period of aerobic interval training, a significant decrease was observed in insulin resistance compared to the control group without exercise. Exercise primarily controls blood glycemic in these patients by increasing glucose uptake into active muscles and preventing the production of hepatic glucose. Muscle glucose uptake is improved by dependent and independent insulin signaling pathways, and these benefits persist for several hours after exercise. Then the aerobic interval training led to significant decrease in levels of serum iron, ferritin, hematocrit and ferritin as indicators of iron compared to the control group. Due to the fact that the measured basal levels of iron-related indices in the present study were in the normal range, and after exercise, the changes in these indices were in the normal range. and since insulin resistance is associated with iron stores in type 2 diabetes, it can be said that the effectiveness of aerobic interval training on reducing insulin resistance in patients with type 2 diabetes may be due to minor changes in iron stores (at normal levels) in these patients. Probably one of the possible mechanisms in the effectiveness of exercise is to improve insulin function by modulating iron stores and improving insulin signaling in patients with type 2 diabetes.
