Browsing by Author "Alsubaie, Nawal"

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    The effects of a combined aerobic and resistance exercise programme on insulin resistance among prediabetes subjects
    (2019-04-10) Alharbi, Bander; Alsubaie, Nawal; Sahota, T. S.; Taylor, M. Joan
    Aim: Insulin resistance is a common health disorder that contributes to developed overt diabetes among prediabetes subjects. The aim of the study is to examine the effects of a combined programme of aerobic and resistance exercise on insulin resistance among prediabetes subjects (Pre-D) using Oral Glucose Tolerance Test (OGTT) as a tool to define the improvement in insulin resistance. Method: 20 prediabetes subjects were asked to join a supervised combined exercise program consists of 30 min of resistance exercise followed by 20 min cycling twice at moderate-intensity a week for 6 weeks. Result: a significant improvement in Blood Glucose (BG) after combination exercise at two occasions when compared to BG before exercise (Pre S1), after 1st exercise session (Post S1) and at the end of intervention trial (Post S12). Conclusion: The result of this study has shown that 6 weeks of moderate-intensity exercise combined with aerobic and resistance exercise program had significantly ameliorated insulin resistance among Pre-D.
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    The effects of a combined exercise programme aerobic and resistance on blood glucose, incretin, metabolic and inflammatory mediators that could control the diabetes and improve insulin sensitivity in type 2 diabetes patients
    (De Montfort University, 2019) Alsubaie, Nawal
    An excessive number of calories consumed daily, in addition to a sedentary lifestyle, are the main causes of increasing type 2 diabetes (T2D) prevalence worldwide (LEE, H.K. et al., 2010). Diabetes is usually accompanied by hypertension, lipid disorders and obesity. The aim of this study isto show that combination exercise is effective. It will compare T2D and non-diabetes (ND) volunteers doing combination exercise consisting of resistance and cycling. The interventions are minor and fairly short consisting of 12 episodes of exercise over 6 weeks, yet this was enough to produce measurable change and improvement. This included the re-categorization of two T2D volunteers to being ND, using normal metrics. Method: in each exercise session the participant should perform a combined exercise program consists of 30 min of resistance exercise followed by 20 min moderate cycling. This is done twice a week for 6 weeks. At the beginning of each session the participants have to stretch-up for 11 steps of stretching, then he/she must cycle for five minutes to warm up. The RE consist of 3 sets, in each set the volunteer performed (squat, chest, back, biceps and triceps) 10 times. HbA1c, lipid profile, weight, BMI, waist and lung capacity also measured at baseline and the 12th exercise session. OGTT were done at the beginning, after 1st session and finally after session 12. Moreover, BG and HR measured before exercise, after 1st, 2ndand 3rd RE then after 10 and 20 minutes of AE. BP also checked before exercise after RE and then after AE. RPE were checked after 1st, 2nd and 3rd RE as well as after 10 and 20 minutes AE. Blood samples collected at base line after these sessions (S1, S2, S4, S6, S8, S10 and S12), centrifuge and refrigerate the plasma to be analysed later by a commercially-available enzyme-linked immunosorbent assay (ELISA) and by The Evidence Investigator™ Biochip Array technology (Randox, UK). Results: After just six weeks, there was a reduction in the HbA1c level for the T2D volunteers which is significant (P= 0.000). Moreover, in ND the reduction was also significant (P= 0.000). In T2D, the OGTT result shows that the AUC of BG for the 1st OGTT was (30.55±2.5 mmol/L/h) but then decreased in the 2nd and 3rd OGTT, finally decreasing to (24.4±1.9 mmol/L/h). This reduction reflects a clear improvement in the IS in T2D. It shows that the reduction of BG in the OGTT after chronic effect of exercise was better than acute effect (after the first session). Meanwhile in ND, the AUC for the 1st OGTT was (14.9±3.2 mmol/L/h) and although became (13.9±3.0 mmol/L/h) in the 2nd OGTT returned to the original in the third reading. In the T2D group who are using (Metformin and SGT2-I group), their result shows elevation in GLP-1 in the assessment of both acute and chronic effect of the programme. GLP-1 in this group was (3.9±1.5) and increased to (8.4±1.2), (P= 0.345) after S1 and then increased more to (11.0±0.8), (P=0.196) after 6 weeks of exercise. Conclusion: In T2D and ND combination exercise has a beneficial effect on HbA1c, the improvement was higher in T2D. The anthropometric variables (weight, waist, BMI and lung capacity) improved significantly as well in T2D and ND. OGTT shows a very significant improvement of BG and insulin level in both groups that was higher in T2D, which shows that there was an improvement in insulin sensitivity. Exercise is also important to improve GLP-1 secretion. Despite the range of studies on incretin undertaken here, still there is a need to compare the effect of exercise and different types of pharmacological therapy on GLP1. This study compared the effect of exercise on T2D plus medication in volunteers. It has been found that within T2D group only Metformin and SGT2-I group was improved. Both SGLT2 inhibitors and metformin have been found to affect body weight and this may explain the improvement of GLP-1 level, suggesting an area for future investigation. Finally, exercise has different effect on the inflammatory markers, it shows elevation of IL-6 in T2D after 6 weeks of exercise. CRP represent significant reduction after 6 weeks as well which illustrates that exercise has good impact in decreasing inflammation by reducing CRP. Moreover, there is a little published data on the effect of exercise and medication type on the inflammatory markers. The present study illustrates a significant reduction in Cystatin C after 6 weeks within T2D group who are using (metformin and DDP4-I). Therefore, there is increasing concern that some medication plus exercise improve inflammatory markers which need further investigations.
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    The impact of moderate combination exercise on HbA1c, IL-6, and TNF in type 2 diabetic and non-diabetic subjects: an interventional non-randomized clinical trial
    (Global Healthcare Activities Academy, 2021-06-14) Sahota, T. S.; Taylor, M. Joan; Alsubaie, Nawal; Alharbi, Bandar
    Introduction: The main causes of worldwide increase in prevalence of type 2 diabetes are the daily consumption of excessive number of calories and sedentary lifestyle. Diabetes is usually accompanied by hypertension, lipid disorders and obesity that are considered as risk factors for developing diabetes. This study is designed to assess the benefit of a combined exercise programme (cardio “aerobic” and resistance) on HbA1c and the inflammatory markers (IL-6, and TNF) in type 2 diabetic (T2D) and non-diabetic (ND) subjects. Materials and methods: This is an interventional non randomized clinical trial conducted from 2016 to 2019 at exercise physiology laboratory at De Montfort University (DMU). Our target volunteers are T2D (HbA1c > 6.4), and ND (HbA1c < 5.8) with age group from 18-60 years old who are fit and able to do exercise. No restriction on weight. HbA1c, weight, BMI, waist and lung capacity were measured at baseline and at the 12th exercise session. In each exercise session the participant performed a combined exercise program consists of 30 min of resistance exercise followed by 20 min moderate cycling to be done twice a week for 6 weeks. Results: We enrolled 17 T2D intervention group 4 female and 13 male and 8 ND control group 5 female and 3 male. In both groups there was a significant reduction in HbA1c level after 6 weeks (P= 0.000). In T2D there were a significant weight reduction that decreased from (92.0± 4.3) to (90.0±4.5), (P< 0.001), BMI reduction that decreased from (30.8± 1.0) to (30.2± 0.9), (P< 0.001). In ND, the changes in weight reduction and BMI level were not significant. In T2D the changes in IL-6 level were only significant after the last exercise session. It was increased from 1.79±0.4 to 3.88±1.9 pg/ml (P=0.002), while it was not significant in ND group. In T2D and ND subjects, the changes in TNF level were insignificant. Conclusion: Development of combination exercise programs as a non-pharmacological intervention for diabetic and non-diabetic population are essential to decrease the prevalence of diabetes worldwide. In addition to conduction of public awareness events for proper implementation.