Exercise individualized by TRIMPi method reduces arterial stiffness in early onset type 2 diabetic patients: A randomized controlled trial with aerobic interval training.

Background: Arterial stiffness (AS) and baroreflex sensitivity (BRS) are subclinical markers of vascular diseases in type 2 diabetes (T2D).We evaluated the effects of aerobic interval training (AIT),with loads prescribed according to individual heart rate and lactate profiling obtained during a baseline treadmill test (TRIMPi method), on AS and BRS in patients with early-onset T2D without cardiovascular complications. Population study and methods: Twenty-two sedentary overweight T2D patients (aged 57 ± 7 years) were randomized to 12-weeks open-label of supervised AIT by TRIMPi (n = 8) or unsupervised physical activity as per usual care (SOC) (n = 11). Following parameters were evaluated (pre- and post-): anthropometrics; sixminute walking test (6MWT); fasting glucose, insulin, HbA1c; Pulse Wave Velocity (PWV) and Augmentation Index (AIxHR75) using radial approach (SphigmoCor System); BRS using Finapress method. Results: Both interventions significantly improved distance walked during 6MWT (AIT 52 ± 21 m; SOC 39 ± 24 m, p b 0.001 for both). PWV significantly improved with AIT (p b 0.001) whereas did not vary with SOC (p = 0.47). Similar trend was observed for AIxHR75. Resulting percent changes from baseline were significantly better for AIT vs SOC, in both PWV (−15.8 ± 2.1 vs +1.50 ± 3.4%, p b 0.001) and AIxHR75 (−28.9 ± 3.2% vs +12.7 ± 2.4%, p b 0.001). BRS similarly improved in both groups (p b 0.001 for both), as well as body weight, HbA1c and blood pressure. Conclusion: In sedentary T2D patients, 12-weeks AIT individualized by TRIMPi method improved AS to a greater extent than usual recommendation on physical activity, whilst exerting comparable effects on exercise capacity, glycemic control and body weight. Further researches are needed to ascertain durability of these effects.