Influence of Resistance Exercise Training on Glucose Control in Women With Type 2 Diabetes L.M. Fenicchia, J.A. Kanaley, J.L. Azevedo Jr, C.S. Miller, R.S. Weinstock, R.L. Carhart, and L.L. Ploutz-Snyder The objective of the study was to evaluate the effects of acute and chronic resistance training on glucose and insulin responses to a glucose load in women with type 2 diabetes. Subjects consisted of type 2 diabetic women (n  7) and age-matched controls (n  8) with normal glucose tolerance. All subjects participated in 3 oral glucose tolerance tests: pretraining, 12 to 24 hours after the first exercise session (acute) and 60 to 72 hours after the final training session (chronic). Exercise training consisted of a whole body resistance exercise program using weight-lifting machines 3 days per week for 6 weeks. Resistance training was effective in increasing strength of all muscle groups in all subjects. Integrated glucose concentration expressed as area under the curve (AUC) was 3,355.0  324.6 mmol/L  min pretraining, improved significantly (P < .01) after the acute bout of exercise (2,868  324.0 mmol/L  min), but was not improved with chronic training (3,206.0  337.0 mmol/L  min) in diabetic subjects. A similar pattern of significance was observed with peak glucose concentration (pre: 20.2 1.4 mmol/L; acute: 17.2  1.7 mmol/L; chronic: 19.9  1.7 mmol/L). There were no significant changes in insulin concentrations after any exercise bout in the diabetic subjects. There were no changes in glucose or insulin levels in control subjects. An acute bout of resistance exercise was effective in improving integrated glucose concentration, including reducing peak glucose concentrations in women with type 2 diabetes, but not age-matched controls. There were no significant changes in insulin concentrations for either group. Resistance exercise offers an alternative to aerobic exercise for improving glucose control in diabetic patients. To realize optimal glucose control benefits, individuals must follow a regular schedule that includes daily exercise. © 2004 Elsevier Inc. All rights reserved. I T IS WELL KNOWN that muscle contraction increases glucose uptake in skeletal muscle. 1-5 This, in part, forms the basis for recommending exercise for individuals with type 2 diabetes. Most research studies have investigated the effects of aerobic types of exercise on integrated glucose concentration in diabetic patients, because aerobic exercise utilizes large muscle groups for extended periods of time. However, resis- tance exercise may provide an equally high, or higher, recruit- ment of muscle mass over a similar period of time. In fact, a few studies have shown the benefits of resistance exercise on glucose control in individuals with type 2 diabetes or impaired glucose tolerance, and such improvements are of similar mag- nitude as seen with aerobic exercise. 6,7 Furthermore, it has been shown that a whole body resistance training program involving repeated muscle contractions of the upper and lower body enhances insulin response in healthy individuals. 8-10 A single bout of resistance training can significantly enhance insulin clearance in young type 2 diabetics and controls for up to 18 hours after the exercise session. 11 There has been some controversy regarding whether the exercise-induced benefits in glucose and insulin control are a result of multiple single bouts of exercise or whether there is a chronic training benefit. 12 Improvements in integrated glucose concentration are greater at 12 hours than 72 hours after a bout of aerobic exercise. 13 Perhaps even more relevant is the finding that improvements in glycosylated hemoglobin in diabetic sub- jects is not related to initial maximal oxygen consumption or improvement in oxygen consumption and thus is not related to overall aerobic fitness level. Detraining studies also support the notion that improvements in glucose metabolism may be the result of repeated acute effects instead of chronic training as rapid deterioration of glucose tolerance occurs following the cessation of an aerobic training program even though changes in maximal oxygen consumption or muscle enzyme profiles associated with improved fitness persist for weeks. 14 Resistance exercise has not been as thoroughly studied; it is possible that an isolated bout of resistance exercise may be effective at improving integrated glucose concentration in type 2 diabetic subjects even in the absence of sustained effects after a chronic training program. The effects of an acute bout of resistance training compared with the effects of chronic resistance train- ing in women with type 2 diabetes have not been evaluated thus far. Therefore, the purpose of this study was to compare the effects of acute and chronic resistance training on integrated glucose concentration and the insulin response to a glucose load in healthy women and age-matched women with type 2 diabetes. MATERIALS AND METHODS Subjects Females with type 2 diabetes and age- and height-matched control women were studied; their descriptive statistics are shown in Table 1. Diabetic subjects had significantly greater body mass, fat mass, fat-free mass, percent fat, sagittal diameter, and waist circumference than control women (p  .05). Four women were premenopausal. All subjects provided informed written consent, and the study was ap- proved by the Institutional Review Boards of Syracuse University and SUNY Upstate Medical University. Subjects were included if they were not currently and had not participated in resistance training or aerobic exercise for the previous 6 months. Subjects were defined as From the Department of Exercise Science, Syracuse University, Syracuse; Department of Medicine, State University of New York Upstate Medical University, Syracuse; and the VA Medical Center, Syracuse, NY. Submitted July 8, 2002; accepted October 10, 2003. Supported by the NordicTrack Company. Address reprint requests to L.L. Ploutz-Snyder, PhD, Exercise Sci- ence, Rm 201 Womens Building, Syracuse University, Syracuse, NY 13244. © 2004 Elsevier Inc. All rights reserved. 0026-0495/04/5303-0007$30.00/0 doi:10.1016/j.metabol.2003.10.007 284 Metabolism, Vol 53, No 3 (March), 2004: pp 284-289