Kombinasi Aerobic dan Resistance Training terhadap Kontrol Glukosa Darah pada Pasien Diabetes Melitus (DM)
Abstract
This study aims to analyze the effect of a combination of aerobic and resistance training on blood glucose control in DM patients. The method used is a systematic review of the Scopus, Embase, EBSCO, ScienceDirect and ProQuest databases. The results showed that aerobic training carried out 5-6 times per week (150 hours per week) by running or cycling and resistance training performed 2-3 times per week (8-10 exercises per session) using weights, resistance bands, or body weights provided a positive impact on blood glucose control. In conclusion, the combination of aerobic and resistance training performed with the recommended frequency, duration, intensity and repetition can improve glycemic control in DM patients with indicators of blood sugar stability and HbA1c.
Keywords: Aerobic Training, DM, Blood Glucose, Resistance Training
References
American Diabetes Association. (2019). American Diabetes Association Standards of Medical Care in Diabetes-2019 Guidelines Update. https://www.piedmont.org/media/file/PAR-CME-Diabetes-Blair-ADA-Update-2019.pdf
Bonora, E., Trombetta, M., Dauriz, M., Travia, D., Cacciatori, V., Brangani, C., Negri, C., Perrone, F., Pichiri, I., Stoico, V., Zoppini, G., Rinaldi, E., Da Prato, G., Boselli, M. L., Santi, L., Moschetta, F., Zardini, M., & Bonadonna, R. C. (2020). Chronic Complications in Patients with Newly Diagnosed Type 2 Diabetes: Prevalence and Related Metabolic and Clinical Features: The Verona Newly Diagnosed Type 2 Diabetes Study (VNDS) 9. BMJ Open Diabetes Research and Care, 8(1), 1-7. https://doi.org/10.1136/bmjdrc-2020-001549
Chen, S. M., Shen, F. C., Chen, J. F., Chang, W. D., & Chang, N. J. (2020). Effects of Resistance Exercise on Glycated Hemoglobin and Functional Performance in Older Patients with Comorbid Diabetes Mellitus and Knee Osteoarthritis: A Randomized Trial. International Journal of Environmental Research and Public Health, 17(1), 1-13. https://doi.org/10.3390/ijerph17010224
Dela, F., Ingersen, A., Andersen, N. B., Nielsen, M. B., Petersen, H. H. H., Hansen, C. N., Larsen, S., Wojtaszewski, J., & Helge, J. W. (2019). Effects of One-Legged High-Intensity Interval Training on Insulin-Mediated Skeletal Muscle Glucose Homeostasis in Patients With Type 2 Diabetes. Acta Physiologica, 226(2), 1-18. https://doi.org/10.1111/apha.13245
Feldman, E. L., Callaghan, B. C., Pop-busui, R., Zochodne, D. W., Wright, D. E., Bennett, D. L., Bril, V., Russell, J. W., & Viswanathan, V. (2019). Diabetic Neuropathy. Nature Reviews Disease Primers, 5(41), 1-18. https://doi.org/10.1038/s41572-019-0092-1
Holzer, R., Schulteâ€körne, B., Seidler, J., Predel, H. G., & Brinkmann, C. (2021). Effects of Acute Resistance Exercise with and without Wholeâ€Body Electromyostimulation and Endurance Exercise on the Postprandial Glucose Regulation in Patients with Type 2 Diabetes Mellitus: A Randomized Crossover Study. Nutrients, 13(12), 1-12. https://doi.org/10.3390/nu13124322
Hsieh, P. L., Tseng, C. H., Tseng, Y. J., & Yang, W. S. (2018). Resistance Training Improves Muscle Function and Cardiometabolic Risks but Not Quality of Life in Older People with Type 2 Diabetes Mellitus: A Randomized Controlled Trial. Journal of Geriatric Physical Therapy, 41(2), 65–76. https://doi.org/10.1519/JPT.0000000000000107
International Diabetes Federation (2020). Diabetes Atlas. https://idf.org/our-network/regions-members/western-pacific/members/104-indonesia.html
Jiménez-Maldonado, A., GarcÃa-Suárez, P. C., RenterÃa, I., Moncada-Jiménez, J., & Plaisance, E. P. (2020). Impact of High-Intensity Interval Training and Sprint Interval Training on Peripheral Markers of Glycemic Control in Metabolic Syndrome and Type 2 Diabetes. Biochimica et Biophysica Acta - Molecular Basis of Disease, 1866(8), 165820-165835. https://doi.org/10.1016/j.bbadis.2020.165820
Johansen, M. Y., Karstoft, K., MacDonald, C. S., Hansen, K. B., Ellingsgaard, H., Hartmann, B., Wewer Albrechtsen, N. J., Vaag, A. A., Holst, J. J., Pedersen, B. K., & Ried-Larsen, M. (2020). Effects of an Intensive Lifestyle Intervention on The Underlying Mechanisms of Improved Glycaemic Control in Individuals with Type 2 Diabetes: A Secondary Analysis of a Randomised Clinical Trial. Diabetologia, 63(11), 2410–2422. https://doi.org/10.1007/s00125-020-05249-7
Kementerian Kesehatan RI. (2018). Hasil Utama Riset Kesehatan Dasar 2018. https://kesmas.kemkes.go.id/assets/upload/dir_519d41d8cd98f00/files/Hasil-riskesdas-2018_1274.pdf
Kumar, A. S., Maiya, A. G., Shastry, B. A., Vaishali, K., Ravishankar, N., Hazari, A., Gundmi, S., & Jadhav, R. (2019). Exercise and Insulin Resistance in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. Annals of Physical and Rehabilitation Medicine, 62(2), 98–103. https://doi.org/10.1016/j.rehab.2018.11.001
Magalhães, J. P., Júdice, P. B., Ribeiro, R., Andrade, R., Raposo, J., Dores, H., Bicho, M., & Sardinha, L. B. (2019). Effectiveness of High-Intensity Interval Training Combined with Resistance Training Versus Continuous Moderate-Intensity Training Combined with Resistance Training in Patients with Type 2 Diabetes: A One-Year Randomized Controlled Trial. Diabetes, Obesity and Metabolism, 21(3), 550–559. https://doi.org/10.1111/dom.13551
Minnock, D., Annibalini, G., Le Roux, C. W., Contarelli, S., Krause, M., Saltarelli, R., Valli, G., Stocchi, V., Barbieri, E., & De Vito, G. (2020). Effects of Acute Aerobic, Resistance and Combined Exercises on 24-H Glucose Variability and Skeletal Muscle Signalling Responses in Type 1 Diabetics. European Journal of Applied Physiology, 120(12), 2677–2691. https://doi.org/10.1007/s00421-020-04491-6
Najafi, B., Reeves, N. D., & Armstrong, D. G. (2020). Leveraging Smart Technologies to Improve The Management of Diabetic Foot Ulcers and Extend Ulcer-Free Days in Remission. Diabetes/Metabolism Research and Reviews, 36(1), 1–7. https://doi.org/10.1002/dmrr.3239
Reusch, J., Regensteiner, J. G., Stewart, K. J., & Veves, A. (2018). Diabetes and Exercise from Pathophysiology to Clinical Implementation. http://dx.doi.org/10.1007/978-3-319-61013-9
Searle, A., Spink, M. J., Oldmeadow, C., Chiu, S., & Chuter, V. H. (2019). Calf Muscle Stretching is Ineffective in Increasing Ankle Range of Motion or Reducing Plantar Pressures in People with Diabetes and Ankle Equinus: A Randomised Controlled Trial. Clinical Biomechanics, 69(7), 52–57. https://doi.org/10.1016/j.clinbiomech.2019.07.005
Setyawati, A., Ngo, T., Padila, P., & Andri, J. (2020). Obesity and Heredity for Diabetes Mellitus among Elderly. JOSING: Journal of Nursing and Health, 1(1), 26-31. https://doi.org/https://doi.org/10.31539/josing.v1i1.1149
Seyedizadeh, S. H., Cheragh-Birjandi, S., & Hamedi Nia, M. R. (2020). The Effects of Combined Exercise Training (Resistance-Aerobic) on Serum Kinesin and Physical Function in Type 2 Diabetes Patients with Diabetic Peripheral Neuropathy (Randomized Controlled Trials). Journal of Diabetes Research, 2020, 1-7. https://doi.org/10.1155/2020/6978128
Shoji, T., Hamasaki, H., Kawaguchi, A., Waragai, Y., & Yanai, H. (2021). Effects of Low-Intensity Resistance Exercise with Slow Movement and Tonic Force Generation on Short-Term Glycemic Variability in Healthy Subjects: A Randomized Controlled Study. Applied Sciences (Switzerland), 11(4), 1–10. https://doi.org/10.3390/app11041536
Silva, É. Q., Santos, D. P., Beteli, R. I., Monteiro, R. L., Ferreira, J. S. S. P., Cruvinel-Junior, R. H., Donini, A., VerissÃmo, J. L., Suda, E. Y., & Sacco, I. C. N. (2021). Feasibility of a Home-Based Foot–Ankle Exercise Programme for Musculoskeletal Dysfunctions in People with Diabetes: Randomised Controlled FOotCAre (FOCA) Trial II. Scientific Reports, 11(1), 1–12. https://doi.org/10.1038/s41598-021-91901-0
Wahl, M. P., Scalzo, R. L., Regensteiner, J. G., & Reusch, J. E. B. (2018). Mechanisms of Aerobic Exercise Impairment in Diabetes: A Narrative Review. Frontiers in Endocrinology, 9(4), 1–9. https://doi.org/10.3389/fendo.2018.00181
Winding, K. M., Munch, G. W., Iepsen, U. W., Van Hall, G., Pedersen, B. K., & Mortensen, S. P. (2018). The Effect on Glycaemic Control of Low-Volume High-Intensity Interval Training Versus Endurance Training in Individuals with Type 2 Diabetes. Diabetes, Obesity and Metabolism, 20(5), 1131–1139. https://doi.org/10.1111/dom.13198
Wrobel, M., Rokicka, D., Goła, A., Drozd, M., & Nowowiejska-wiewi, A. (2021). Combined Aerobic and Resistance Training Performed Under Conditions of Normobaric Hypoxia and Normoxia has the Same Impact on Metabolic Control in Men with Type 1 Diabetes. International Journal of Environmental Research and Public Health, 18, 1-13; https://doi.org/10.3390/ijerph182413058
Yan, J., Dai, X., Feng, J., Yuan, X., Li, J., Yang, L., Zuo, P., Fang, Z., Liu, C., Hsue, C., Zhu, J., Miller, J. D., & Lou, Q. (2019). Effect of 12-Month Resistance Training on Changes in Abdominal Adipose Tissue and Metabolic Variables in Patients with Prediabetes: A Randomized Controlled Trial. Journal of Diabetes Research, 2019, 1–11. https://doi.org/10.1155/2019/8469739
Zembron-Lacny, A., Tylutka, A., Zeromska, A., Kasperska, A., & Wolny-Rokicka, E. (2019). Does High Volume of Exercise Training Increase Aseptic Vascular Inflammation in Male Athletes? American Journal of Men’s Health, 13(3), 1-8. https://doi.org/10.1177/1557988319858838
Zilliox, L. A., & Russell, J. W. (2020). Is There Cardiac Autonomic Neuropathy in Prediabetes? Autonomic Neuroscience: Basic and Clinical, 229, 1-25. https://doi.org/10.1016/j.autneu.2020.102722
Bonora, E., Trombetta, M., Dauriz, M., Travia, D., Cacciatori, V., Brangani, C., Negri, C., Perrone, F., Pichiri, I., Stoico, V., Zoppini, G., Rinaldi, E., Da Prato, G., Boselli, M. L., Santi, L., Moschetta, F., Zardini, M., & Bonadonna, R. C. (2020). Chronic Complications in Patients with Newly Diagnosed Type 2 Diabetes: Prevalence and Related Metabolic and Clinical Features: The Verona Newly Diagnosed Type 2 Diabetes Study (VNDS) 9. BMJ Open Diabetes Research and Care, 8(1), 1-7. https://doi.org/10.1136/bmjdrc-2020-001549
Chen, S. M., Shen, F. C., Chen, J. F., Chang, W. D., & Chang, N. J. (2020). Effects of Resistance Exercise on Glycated Hemoglobin and Functional Performance in Older Patients with Comorbid Diabetes Mellitus and Knee Osteoarthritis: A Randomized Trial. International Journal of Environmental Research and Public Health, 17(1), 1-13. https://doi.org/10.3390/ijerph17010224
Dela, F., Ingersen, A., Andersen, N. B., Nielsen, M. B., Petersen, H. H. H., Hansen, C. N., Larsen, S., Wojtaszewski, J., & Helge, J. W. (2019). Effects of One-Legged High-Intensity Interval Training on Insulin-Mediated Skeletal Muscle Glucose Homeostasis in Patients With Type 2 Diabetes. Acta Physiologica, 226(2), 1-18. https://doi.org/10.1111/apha.13245
Feldman, E. L., Callaghan, B. C., Pop-busui, R., Zochodne, D. W., Wright, D. E., Bennett, D. L., Bril, V., Russell, J. W., & Viswanathan, V. (2019). Diabetic Neuropathy. Nature Reviews Disease Primers, 5(41), 1-18. https://doi.org/10.1038/s41572-019-0092-1
Holzer, R., Schulteâ€körne, B., Seidler, J., Predel, H. G., & Brinkmann, C. (2021). Effects of Acute Resistance Exercise with and without Wholeâ€Body Electromyostimulation and Endurance Exercise on the Postprandial Glucose Regulation in Patients with Type 2 Diabetes Mellitus: A Randomized Crossover Study. Nutrients, 13(12), 1-12. https://doi.org/10.3390/nu13124322
Hsieh, P. L., Tseng, C. H., Tseng, Y. J., & Yang, W. S. (2018). Resistance Training Improves Muscle Function and Cardiometabolic Risks but Not Quality of Life in Older People with Type 2 Diabetes Mellitus: A Randomized Controlled Trial. Journal of Geriatric Physical Therapy, 41(2), 65–76. https://doi.org/10.1519/JPT.0000000000000107
International Diabetes Federation (2020). Diabetes Atlas. https://idf.org/our-network/regions-members/western-pacific/members/104-indonesia.html
Jiménez-Maldonado, A., GarcÃa-Suárez, P. C., RenterÃa, I., Moncada-Jiménez, J., & Plaisance, E. P. (2020). Impact of High-Intensity Interval Training and Sprint Interval Training on Peripheral Markers of Glycemic Control in Metabolic Syndrome and Type 2 Diabetes. Biochimica et Biophysica Acta - Molecular Basis of Disease, 1866(8), 165820-165835. https://doi.org/10.1016/j.bbadis.2020.165820
Johansen, M. Y., Karstoft, K., MacDonald, C. S., Hansen, K. B., Ellingsgaard, H., Hartmann, B., Wewer Albrechtsen, N. J., Vaag, A. A., Holst, J. J., Pedersen, B. K., & Ried-Larsen, M. (2020). Effects of an Intensive Lifestyle Intervention on The Underlying Mechanisms of Improved Glycaemic Control in Individuals with Type 2 Diabetes: A Secondary Analysis of a Randomised Clinical Trial. Diabetologia, 63(11), 2410–2422. https://doi.org/10.1007/s00125-020-05249-7
Kementerian Kesehatan RI. (2018). Hasil Utama Riset Kesehatan Dasar 2018. https://kesmas.kemkes.go.id/assets/upload/dir_519d41d8cd98f00/files/Hasil-riskesdas-2018_1274.pdf
Kumar, A. S., Maiya, A. G., Shastry, B. A., Vaishali, K., Ravishankar, N., Hazari, A., Gundmi, S., & Jadhav, R. (2019). Exercise and Insulin Resistance in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. Annals of Physical and Rehabilitation Medicine, 62(2), 98–103. https://doi.org/10.1016/j.rehab.2018.11.001
Magalhães, J. P., Júdice, P. B., Ribeiro, R., Andrade, R., Raposo, J., Dores, H., Bicho, M., & Sardinha, L. B. (2019). Effectiveness of High-Intensity Interval Training Combined with Resistance Training Versus Continuous Moderate-Intensity Training Combined with Resistance Training in Patients with Type 2 Diabetes: A One-Year Randomized Controlled Trial. Diabetes, Obesity and Metabolism, 21(3), 550–559. https://doi.org/10.1111/dom.13551
Minnock, D., Annibalini, G., Le Roux, C. W., Contarelli, S., Krause, M., Saltarelli, R., Valli, G., Stocchi, V., Barbieri, E., & De Vito, G. (2020). Effects of Acute Aerobic, Resistance and Combined Exercises on 24-H Glucose Variability and Skeletal Muscle Signalling Responses in Type 1 Diabetics. European Journal of Applied Physiology, 120(12), 2677–2691. https://doi.org/10.1007/s00421-020-04491-6
Najafi, B., Reeves, N. D., & Armstrong, D. G. (2020). Leveraging Smart Technologies to Improve The Management of Diabetic Foot Ulcers and Extend Ulcer-Free Days in Remission. Diabetes/Metabolism Research and Reviews, 36(1), 1–7. https://doi.org/10.1002/dmrr.3239
Reusch, J., Regensteiner, J. G., Stewart, K. J., & Veves, A. (2018). Diabetes and Exercise from Pathophysiology to Clinical Implementation. http://dx.doi.org/10.1007/978-3-319-61013-9
Searle, A., Spink, M. J., Oldmeadow, C., Chiu, S., & Chuter, V. H. (2019). Calf Muscle Stretching is Ineffective in Increasing Ankle Range of Motion or Reducing Plantar Pressures in People with Diabetes and Ankle Equinus: A Randomised Controlled Trial. Clinical Biomechanics, 69(7), 52–57. https://doi.org/10.1016/j.clinbiomech.2019.07.005
Setyawati, A., Ngo, T., Padila, P., & Andri, J. (2020). Obesity and Heredity for Diabetes Mellitus among Elderly. JOSING: Journal of Nursing and Health, 1(1), 26-31. https://doi.org/https://doi.org/10.31539/josing.v1i1.1149
Seyedizadeh, S. H., Cheragh-Birjandi, S., & Hamedi Nia, M. R. (2020). The Effects of Combined Exercise Training (Resistance-Aerobic) on Serum Kinesin and Physical Function in Type 2 Diabetes Patients with Diabetic Peripheral Neuropathy (Randomized Controlled Trials). Journal of Diabetes Research, 2020, 1-7. https://doi.org/10.1155/2020/6978128
Shoji, T., Hamasaki, H., Kawaguchi, A., Waragai, Y., & Yanai, H. (2021). Effects of Low-Intensity Resistance Exercise with Slow Movement and Tonic Force Generation on Short-Term Glycemic Variability in Healthy Subjects: A Randomized Controlled Study. Applied Sciences (Switzerland), 11(4), 1–10. https://doi.org/10.3390/app11041536
Silva, É. Q., Santos, D. P., Beteli, R. I., Monteiro, R. L., Ferreira, J. S. S. P., Cruvinel-Junior, R. H., Donini, A., VerissÃmo, J. L., Suda, E. Y., & Sacco, I. C. N. (2021). Feasibility of a Home-Based Foot–Ankle Exercise Programme for Musculoskeletal Dysfunctions in People with Diabetes: Randomised Controlled FOotCAre (FOCA) Trial II. Scientific Reports, 11(1), 1–12. https://doi.org/10.1038/s41598-021-91901-0
Wahl, M. P., Scalzo, R. L., Regensteiner, J. G., & Reusch, J. E. B. (2018). Mechanisms of Aerobic Exercise Impairment in Diabetes: A Narrative Review. Frontiers in Endocrinology, 9(4), 1–9. https://doi.org/10.3389/fendo.2018.00181
Winding, K. M., Munch, G. W., Iepsen, U. W., Van Hall, G., Pedersen, B. K., & Mortensen, S. P. (2018). The Effect on Glycaemic Control of Low-Volume High-Intensity Interval Training Versus Endurance Training in Individuals with Type 2 Diabetes. Diabetes, Obesity and Metabolism, 20(5), 1131–1139. https://doi.org/10.1111/dom.13198
Wrobel, M., Rokicka, D., Goła, A., Drozd, M., & Nowowiejska-wiewi, A. (2021). Combined Aerobic and Resistance Training Performed Under Conditions of Normobaric Hypoxia and Normoxia has the Same Impact on Metabolic Control in Men with Type 1 Diabetes. International Journal of Environmental Research and Public Health, 18, 1-13; https://doi.org/10.3390/ijerph182413058
Yan, J., Dai, X., Feng, J., Yuan, X., Li, J., Yang, L., Zuo, P., Fang, Z., Liu, C., Hsue, C., Zhu, J., Miller, J. D., & Lou, Q. (2019). Effect of 12-Month Resistance Training on Changes in Abdominal Adipose Tissue and Metabolic Variables in Patients with Prediabetes: A Randomized Controlled Trial. Journal of Diabetes Research, 2019, 1–11. https://doi.org/10.1155/2019/8469739
Zembron-Lacny, A., Tylutka, A., Zeromska, A., Kasperska, A., & Wolny-Rokicka, E. (2019). Does High Volume of Exercise Training Increase Aseptic Vascular Inflammation in Male Athletes? American Journal of Men’s Health, 13(3), 1-8. https://doi.org/10.1177/1557988319858838
Zilliox, L. A., & Russell, J. W. (2020). Is There Cardiac Autonomic Neuropathy in Prediabetes? Autonomic Neuroscience: Basic and Clinical, 229, 1-25. https://doi.org/10.1016/j.autneu.2020.102722
