INTERPLAY OF EXERCISE AND DIABETES MEDICATION EFFECTS IN TYPE 2 DIABETES

While previous research has demonstrated the effect of various exercise modalities in improving HbA1c levels, little is known about how hypoglycemic medication usage influences chronic glucose control during exercise interventions. PURPOSE: The purpose of this study is to investigate the impact of hypoglycemic medications that can promote weight gain or weight loss on HbA1c improvement within three exercise training modalities: Aerobic (AT), Resistance (RT), and their Combination (CT). METHODS: Participants with type 2 diabetes (n = 212) took diabetic medications that have been shown to cause weight loss or weight gain. Based on the number of different medications taken, individuals were classified into weight Loss, Equal, and Gain groups. Each group was further divided into 9 months of non-exercise control (CON), AT, RT, or CT groups based on study randomization. The data were analyzed using a two-way analysis of covariance to examine the relationship between HbA1c changes and exercise modality across medication types, with baseline HbA1c as a covariate. RESULTS: Exercise modality and interaction between exercise modality and medication type showed significant effects on the change in HbA1c (p < 0.001, p = 0.029, p = 0.049, resp), whereas the main effect of medication type did not have an effect (p = 0.279). In the Lose medication group, the mean change in HbA1c increased in the CON group (0.57%; 95% CI, 0.09% to 1.05%) and decreased in the RT group (-0.35%; 95% CI, -0.69% to -0.02%). In the Equal medication group, the CT group showed a decrease in HbA1c level (-0.61%; 95% CI, -0.95% to -0.27%). In the Gain medication group, the AT group showed a decrease in HbA1c level (-0.71%; 95% CI, -1.29 to -0.13). These changes in HbA1c are likely moderated by changes in body composition (lean and fat mass). CONCLUSION: The medication group associated with weight loss suggests the potential for HbA1c reduction with resistance exercise. For patients with balanced medications, combination training could be effective, while aerobic training could be recommended for those on weight gain-related medication. These data suggest that training modality selection could be considered based on medication type.