Diabetes & Metabolism Journal

Original Articles

Arterial Stiffness by Aerobic Exercise Is Related with Aerobic Capacity, Physical Activity Energy Expenditure and Total Fat but not with Insulin Sensitivity in Obese Female Patients with Type 2 Diabetes: Ji Yeon Jung, Kyung Wan Min, Hee Jung Ahn, Hwi Ryun Kwon, Jae Hyuk Lee, Kang Seo Park, Kyung Ah Han; Diabetes Metab J. 2014;38(6):439-448. Published online December 15, 2014; DOI: https://doi.org/10.4093/dmj.2014.38.6.439

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Background

Arterial stiffness is an important factor in atherosclerosis. Thus we examined whether aerobic exercise could reduce arterial stiffness in obese women with type 2 diabetes without diabetic complication.

Methods

A total of 35 women with type 2 diabetes (body mass index, 26.6±2.8 kg/m²; age, 56.4±1.9 years; duration of diabetes, 4.7±4.8 years) were assigned to aerobic exercise group (AEG) or control group (CG). AEG completed a 12-week exercise program (3.6 to 5.2 metabolic equivalents, 3 day/week, 60 min/day), with their exercise activities monitored by accelerometers. We measured abdominal total fat area (TFA), visceral fat area (VFA), and subcutaneous fat area (SFA) by computed tomography, insulin sensitivity by insulin tolerance test (K_ITT), and augmentation index (AIx) by SphygmoCor at baseline and at the end of the 12-week program.

Results

The AIx was improved in the AEG compared with the CG (P<0.001). The percent change of AIx had significant correlation with the improvement of physical activity energy expenditure (PAEE), aerobic capacity, TFA, and SFA (r=-0.416, P=0.013; r=0.560, P<0.001; r=0.489, P=0.003; r=0.531, P=0.001, respectively), but not with insulin sensitivity, energy intake, or VFA.

Conclusion

Improvement in aortic stiffness by aerobic exercise is related with the improvement of aerobic capacity, PAEE, and total fat but not with insulin sensitivity or energy intake in obese women with type 2 diabetes.

Citations

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Relationship between objectively measured physical activity and subclinical cardiovascular disease: a systematic review
Aparna Narendrula, Ellen Brinza, Christine Horvat Davey, Chris T Longenecker, Allison R Webel
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Min Li, Qidong Zheng, Joshua D. Miller, Panpan Zuo, Xiaodan Yuan, Jitao Feng, Chao Liu, Shan Bao, Qingqing Lou
Diabetes/Metabolism Research and Reviews.2022;[Epub] CrossRef
Effect of aerobic exercise on waist circumference in adults with overweight or obesity: A systematic review and meta‐analysis
Alex Armstrong, Klaus Jungbluth Rodriguez, Angelo Sabag, Yorgi Mavros, Helen M. Parker, Shelley E. Keating, Nathan A. Johnson
Obesity Reviews.2022;[Epub] CrossRef
Aortic waveform responses to insulin in late versus early chronotype with metabolic syndrome
Mary‐Margaret E. Remchak, Emily M. Heiston, Anna Ballantyne, Brielle L. Dotson, Steven K. Malin
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Exercise and ectopic fat in type 2 diabetes: A systematic review and meta-analysis
A. Sabag, K.L. Way, S.E. Keating, R.N. Sultana, H.T. O’Connor, M.K. Baker, V.H. Chuter, J. George, N.A. Johnson
Diabetes & Metabolism.2017; 43(3): 195. CrossRef
Arterial Stiffness Measured with the Cuff Oscillometric Method Is Predictive of Exercise Capacity in Patients with Cardiac Diseases
Yasushi Tazawa, Nobuyoshi Mori, Yoshiko Ogawa, Osamu Ito, Masahiro Kohzuki
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Effects of Aerobic Exercise Intensity on Abdominal and Thigh Adipose Tissue and Skeletal Muscle Attenuation in Overweight Women with Type 2 Diabetes Mellitus: Ji Yeon Jung, Kyung Ah Han, Hee Jung Ahn, Hwi Ryun Kwon, Jae Hyuk Lee, Kang Seo Park, Kyung Wan Min; Diabetes Metab J. 2012;36(3):211-221. Published online June 14, 2012; DOI: https://doi.org/10.4093/dmj.2012.36.3.211

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Background

We investigated the effects of exercise intensity on abdominal and mid-thigh adipose tissue, attenuation of skeletal muscle, and insulin sensitivity in overweight women with type 2 diabetes mellitus (T2DM).

Methods

Twenty-eight patients were randomly assigned to control (CG, n=12), moderate intensity exercise (MEG, n=8), or vigorous intensity exercise (VEG, n=8) group. Subjects in both exercise groups completed a 12-week exercise program (MEG, 3.6 to 5.2 METs; VEG, ≥5.2 METs) that was monitored by accelerometers. We assessed body mass index (BMI), total fat area (TFA), visceral fat area (VFA), subcutaneous fat area (SFA), mid-thigh intramuscular adipose tissue (TIMAT), total skeletal muscle (TTM), low density skeletal muscle (TLDM), and normal density skeletal muscle (TNDM) using computed tomography, and measured insulin sensitivity with an insulin tolerance test (K_ITT), before and after the intervention.

Results

At baseline, the mean age was 53.8±7.9 years, duration of diabetes was 3.8±2.3 years, and BMI was 26.6±2.6 kg/m². After 12 weeks, the percent change (%C) in BMI, TIMAT, and TLDM were not different among three groups. However, %C in TFA and VFA were significantly reduced in MEG compared to CG (P=0.026 and P=0.008, respectively). %C SFA was significantly reduced in VEG compared to CG (P=0.038) and %C TTM, TNDM, and K_ITT were significantly increased in VEG compared to the CG (P=0.044, P=0.007, and P=0.016, respectively).

Conclusion

Although there was no difference in the change in BMI among groups, TFA and VFA were more reduced in MEG, and only VEG increased TTM, TNDM, and insulin sensitivity compared to CG.

Citations

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Arterial Stiffness by Aerobic Exercise Is Related with Aerobic Capacity, Physical Activity Energy Expenditure and Total Fat but not with Insulin Sensitivity in Obese Female Patients with Type 2 Diabetes
Ji Yeon Jung, Kyung Wan Min, Hee Jung Ahn, Hwi Ryun Kwon, Jae Hyuk Lee, Kang Seo Park, Kyung Ah Han
Diabetes & Metabolism Journal.2014; 38(6): 439. CrossRef
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The Correlations between Extremity Circumferences with Total and Regional Amounts of Skeletal Muscle and Muscle Strength in Obese Women with Type 2 Diabetes: Hwi Ryun Kwon, Kyung Ah Han, Hee Jung Ahn, Jae Hyuk Lee, Gang Seo Park, Kyung Wan Min; Diabetes Metab J. 2011;35(4):374-383. Published online August 31, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.4.374

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Abstract PDF PubReader

Background

Insulin resistance is related to central obesity and the amount of skeletal muscle. A simple and practical anthropometric marker for muscle mass is not known, although waist circumference (WC) is used as an indicator of abdominal obesity. The aims of this study were to investigate whether arm (AC) and thigh circumferences (TC) can be used as an indicator of muscle mass and if they are related to muscle strength.

Methods

A total of 110 obese (body mass index [BMI]≥25 kg/m²) women with type 2 diabetes were enrolled, and WC, AC, and TC were measured. Abdominal visceral fat (AVF), subcutaneous fat (ASF), and total fat (ATF) were assessed by computed tomography, regional muscle (MM), and fat mass by dual-energy X-ray absorptiometry, muscle strength by one repetition maximum (1RM) of both extremities (chest and leg press) and insulin resistance by K_ITT.

Results

The mean age was 56.2±7.3 years, duration of diabetes was 4.2±4.4 years, and BMI was 27.2±2.8 kg/m². WC was correlated with ATF, AVF, and ASF (r=0.728, P<0.001; r=0.515, P<0.001; r=0.608, P<0.001, respectively). Arm MM was correlated with AC (r=0.500, P<0.001), and leg MM with TC (r=0.291, P=0.002). Upper 1RM was related to AC/WC ratio (r=0.359, P<0.001), and lower 1RM was to TC/WC ratio (r=0.286, P=0.003). Insulin resistance had significant relations with AVF, WC, and total MM (r=-0.262, P=0.008; r=-0.217, P=0.029; r=0.160, P=0.031, respectively).

Conclusion

The muscle mass was related to extremity circumferences, and muscle strength was to extremity/waist circumference ratio in obese women with type 2 diabetes.

Citations

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Effects of Aerobic Exercise vs. Resistance Training on Endothelial Function in Women with Type 2 Diabetes Mellitus: Hwi Ryun Kwon, Kyung Wan Min, Hee Jung Ahn, Hee Geum Seok, Jae Hyuk Lee, Gang Seo Park, Kyung Ah Han; Diabetes Metab J. 2011;35(4):364-373. Published online August 31, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.4.364

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Abstract PDF PubReader

Background

There is controversy over whether aerobic or resistance exercise is more effective for improving endothelial function in type 2 diabetes mellitus (T2DM). This study was aimed to investigate the effects of an aerobic and resistance training program on endothelial function, and the influences of glycemic control, body weight changes, and aerobic capacity in T2DM.

Methods

Total 40 overweight women with T2DM were assigned into 3 groups: an aerobic exercise group (AEG, n=13), resistance exercise group (REG, n=12), and control group (CG, n=15), and followed either brisk walking for the AEG or resistance band training for the REG, 60 minutes per day, 5 days per week for 12 weeks with monitoring daily activity using accelerometers. We assessed endothelial function by flow-mediated dilation (FMD), and aerobic capacity by oxygen uptake at anaerobic threshold (AT_VO₂) at baseline and following training program.

Results

The mean participants' age was 57.0±6.8 years, and body mass index (BMI) was 27.0±2.3 kg/m². After intervention, FMD increased by 2.2±1.9% in AEG, which differed from REG and CG (P=0.002), despite of decreased body weight (BW) in both AG and RG (2.8±2.5%, P=0.002; 1.6±2.0%, P=0.017, respectively). A significant increased AT_VO₂ and decreased HbA1c were found only in AEG. In all participants, FMD was changed with the significant relations to the AT_VO₂ (r=0.348, P=0.035), but not to HbA1c levels or BW.

Conclusion

Aerobic exercise appears to be more beneficial than resistance exercise for improving endothelial function in T2DM. In addition, aerobic capacity could be a better predictor of changes in FMD than BW and glycemic control.

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The Usefulness of an Accelerometer for Monitoring Total Energy Expenditure and Its Clinical Application for Predicting Body Weight Changes in Type 2 Diabetic Korean Women: Ji Yeon Jung, Kyung Ah Han, Hwi Ryun Kwon, Hee Jung Ahn, Jae Hyuk Lee, Kang Seo Park, Kyung Wan Min; Korean Diabetes J. 2010;34(6):374-383. Published online December 31, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.6.374

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Abstract PDF PubReader

Background

The purpose of this study was to evaluate the usefulness of an accelerometer in predicting body weight (BW) change during a lifestyle intervention and to find out whether exercise or overall physical activity is associated with change in insulin sensitivity and body composition.

Methods

A total of 49 overweight (body mass index [BMI] ≥ 23 kg/m²) women with diabetes were enrolled and performed lifestyle intervention while monitoring BW, total energy expenditure (TEE) and physical activity energy expenditure (PAEE) using an accelerometer, and energy intake (EI) using a three-day dietary record at baseline and every 2 weeks for 12 weeks. We assessed body composition using bioimpedance analysis and compared the actual BW change to the predicted BW change, which was calculated from the energy deficit (ED) between EI and TEE (ED = EI-TEE).

Results

Mean age was 57.2 years, duration of diabetes was 8.0 years, and BMI was 27.8 kg/m². There was no significant difference between EI and TEE at baseline. For 12 weeks, the ED was 474.0 kcal·day^-1, which was significantly correlated with BW change (-3.1 kg) (r = 0.725, P < 0.001). However, the actual BW change was 50% lower than the predicted BW change. Both TEE and PAEE correlated with change in K_ITT (r = 0.334, P = 0.019; r = 0.358, P = 0.012, respectively), BMI (r = -0.395, P = 0.005; r = -0.347, P = 0.015, respectively), and fat mass (r = -0.383, P = 0.007; r = -0.395, P = 0.005, respectively), but only TEE correlated with fat free mass change (r = -0.314, P = 0.030).

Conclusion

The accelerometer appears to be a useful tool for measuring TEE under free-living conditions for both short- and long-term periods.

Citations

Citations to this article as recorded by

Whether Smaller Plates Reduce Consumption Depends on Who’s Serving and Who’s Looking: A Meta-Analysis
Stephen S. Holden, Natalina Zlatevska, Chris Dubelaar
Journal of the Association for Consumer Research.2016; 1(1): 134. CrossRef

The Small Rice Bowl-Based Meal Plan was Effective at Reducing Dietary Energy Intake, Body Weight, and Blood Glucose Levels in Korean Women with Type 2 Diabetes Mellitus: Hee Jung Ahn, Kyung Ah Han, Hwi Ryun Kwon, Kyung Wan Min; Korean Diabetes J. 2010;34(6):340-349. Published online December 31, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.6.340

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Abstract PDF PubReader

Background

The typical Korean diet includes rice, which is usually served in a rice bowl. We investigated the effects of a meal plan using rice bowls of varying sizes on dietary energy intake (EI), body weight (BW), and blood glucose levels.

Methods

Forty-two obese women with type 2 diabetes mellitus were randomly assigned to use either a 200 mL small rice bowl (SB), a 380 mL regular rice bowl (RB), or to a control group (C). Both intervention groups were asked to reduce their EI by 500 kcal/day for 12 weeks and simple instructions for using the assigned bowl were provided. Dietary EI and proportion of macronutrients (PMN) were estimated from 3-day dietary records.

Results

Reduction of EI was more prominent in the SB group compared to the RB and C group, although EI decreased significantly from baseline in all groups. Carbohydrate and fat intakes of the SB group were decreased greater than those of the RB and C group. However, changes in PMN were not significant across the 3 groups. Reduction of BW and HbA1c levels in the SB group was more prominent compared to the C group. Although, BW and HbA1c were decreased significantly from baseline in both bowl groups. There was no statistical difference between the two groups.

Conclusion

The small rice bowl-based meal plan was effective at reducing EI, BW, and blood glucose levels, and the observed reductions in EI, carbohydrate, and fat intake were greater than those of the regular rice bowl-based meal plan.

Citations

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Impact of Portion Control Tools on Portion Size Awareness, Choice and Intake: Systematic Review and Meta-Analysis
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Do adults draw differently-sized meals on larger or smaller plates? Examining plate size in a community sample
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The Effects of Resistance Training on Muscle and Body Fat Mass and Muscle Strength in Type 2 Diabetic Women: Hwi Ryun Kwon, Kyung Ah Han, Yun Hyi Ku, Hee Jung Ahn, Bo-Kyung Koo, Ho Chul Kim, Kyung Wan Min; Korean Diabetes J. 2010;34(2):101-110. Published online April 30, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.2.101

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Abstract PDF PubReader

Background

Our goal was to investigate the effects of low intensity resistance training on body fat, muscle mass and strength, cardiovascular fitness, and insulin sensitivity in type 2 diabetes.

Methods

Twenty-eight overweight women with type 2 diabetes were randomly assigned to a resistance training group (RG, n = 13) or a control group (CG, n = 15). RG performed resistance training using elastic bands, of which strength was equal to 40 to 50% of one repetition maximum (1RM), for three days per week. Each exercise consisted of three sets for 60 minutes. We assessed abdominal fat using computed tomography, muscle mass using dual-energy X-ray absorptiometry, and muscle strength using Keiser's chest and leg press. Insulin sensitivity was measured using the insulin tolerance test, and aerobic capacity was expressed as oxygen uptake at the anaerobic threshold (AT-VO₂) before and after the 12-week exercise program.

Results

The age of participants was 56.4 ± 7.1 years, duration of diabetes was 5.9 ± 5.5 years, and BMI was 27.4 ± 2.5 kg/m², without significant differences between two groups. During intervention, a greater increase in muscle mass and greater decreases in both total fat mass and abdominal fat were observed in RG compared to those of CG (P = 0.015, P = 0.011, P = 0.010, respectively). Increase in 1RM of upper and lower extremities was observed in the RG (P = 0.004, P = 0.040, respectively), without changes in AT-VO₂ and insulin resistance in either group.

Conclusion

In conclusion, the low intensity resistance training was effective in increasing muscle mass and strength and reducing total fat mass without change of insulin sensitivity in type 2 diabetic patients.

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Effects of Aerobic Exercise on Abdominal Fat, Thigh Muscle Mass and Muscle Strength in Type 2 Diabetic Subject: Hwi Ryun Kwon, Kyung Wan Min, Hee Jung Ahn, Hee Geum Seok, Bo Kyung Koo, Ho Chul Kim, Kyung Ah Han; Korean Diabetes J. 2010;34(1):23-31. Published online February 28, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.1.23

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Background

Aerobic exercise can effectively reduce visceral fat. However, few studies have examined the effect of daily physical activity on obesity and cardiopulmonary function in the subjects with diabetes. We examined the effect of moderate intensity of walking in obese diabetes patients by monitoring of daily activity and measuring the change in abdominal fat area, muscle are and maximal muscle strength.

Methods

We randomly assigned 27 obese women with type 2 diabetes to an aerobic exercise group (AG, n = 13) and control group (CG, n = 14). The AG performed moderate intensity walking for 60 minutes per exercise, 5 times per week, and for 12 weeks. The activity energy expenditure was monitored by a multi-record accelerometer. The CG maintained routine daily activities. At the time of the initiation of the study and after 12 weeks of exercise, the aerobic exercise capacity was assessed using oxygen consumption rate at anaerobic threshold (VO₂-AT). The abdominal fat area and the quadriceps muscle area were measured by computed tomography, and the maximum muscle strength of the upper and lower limbs was measured by a chest press and a leg press, respectively.

Results

The mean age of the study subjects was 56.6 ± 8.0 years, the mean duration of diabetes was 6.3 ± 6.0 years, and the body weight index (BMI) was 27.3 ± 2.7 kg/m². The BMI of the AG was significantly decreased (P = 0.003). In the AG, the visceral fat area and subcutaneous fat area were also significantly decreased (P = 0.018 and P < 0.001, respectively) but not in CG. VO₂-AT of the AG was significantly improved, while that of the CG did not change (P = 0.009 and P = 0.115, respectively). The quadriceps muscle mass and the maximal muscle strength of the AG did not change, however, the CG showed a significant decrease. Duration of moderate intensity exercise was correlated with the decrease in total abdominal fat area (r = -0.484; P = 0.011) and that of high intensity exercise was correlated with improvement of cardiopulmonary function (r = 0.414; P = 0.032).

Conclusion

Daily moderate intensity aerobic exercise is effective at reducing abdominal fat mass, while high intensity exercise improves cardiopulmonary function.

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Randomized Controlled Trial

The Effects of Low-Calorie Diets on Abdominal Visceral Fat, Muscle Mass, and Dietary Quality in Obese Type 2 Diabetic Subjects.: Hee Jung Ahn, Youn Ok Cho, Hwi Ryun Kwon, Yun Hyi Ku, Bo Kyung Koo, Kyung Ah Han, Kyung Wan Min; Korean Diabetes J. 2009;33(6):526-536. Published online December 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.6.526

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Abstract PDF

BACKGROUND
Weight loss through low-calorie diets (LCDs) decreases visceral fat (VF). However, the effects on muscle mass, changes of dietary quality, and insulin sensitivity are unknown for Korean obese type 2 diabetic subjects. Therefore, this study examined such effects of LCDs. METHODS: A total of 30 obese type 2 diabetic subjects (body mass index, 27.0 +/- 2.2 kg/m2) were randomly assigned to an LCD or control group. Subjects on LCDs took 500~1,000 kcal fewer energy than their usual dietary intake (1,000~1,500 kcal/day) over the course of 12 weeks. The abdominal VF and femoral muscle mass were evaluated by computed tomography, and insulin sensitivity was assessed using an insulin tolerance test (Kitt; rate constant for plasma glucose disappearance, %/min). Dietary nutrient intake consumed by subjects was assessed by 3-day food records. RESULTS: The percent VF reduction was -23.4 +/- 17.2% in the LCD group and -9.8 +/- 11.8% in the control group after 12 weeks (P < 0.001, P = 0.002). However, significant decrease in femoral mass or proportional change of marcronutrient intake and mean adequacy ratio were not found in the LCD group, as compared to the control group. Insulin sensitivity improved in the LCD group, as compared to the control group (P = 0.040). CONCLUSION: LCD effectively improved insulin sensitivity and reduced abdominal VF without reduction of femoral muscle and dietary quality in obese type 2 diabetic subjects.

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The Usefulness of an Accelerometer for Monitoring Total Energy Expenditure and Its Clinical Application for Predicting Body Weight Changes in Type 2 Diabetic Korean Women
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Original Articles

Relationship of Maximal Muscle Strength with Body Mass Index and Aerobics Capacity in Type 2 Diabetic Patients.: Hwi Ryun Kwon, Kyung Ah Han, Yun Hyi Ku, Hee Jung Ahn, Bo Kyung Koo, Kyung Wan Min; Korean Diabetes J. 2009;33(6):511-517. Published online December 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.6.511

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Abstract PDF

BACKGROUND
Combination fitness regimens (including aerobic and resistance exercises) are effective for improving cardio-respiratory fitness, reducing visceral fat and increasing insulin sensitivity in diabetic patients. The combination exercise intensity that a patient is capable of is limited by his or her aerobic capacity and one repetition maximum (1RM). We investigated the relationships between 1RM, aerobic exercise capacity and body mass index in patients with type 2 diabetes. METHODS: A total of 177 (men: 85, women: 92) diabetic subjects with HbA1c < or = 10% were enrolled. Muscle strength and 1RM were assessed bychest press (upper body) and leg press (lower body). We assessed aerobic capacity by VO2max and muscle mass by bioimpedance analysis. RESULTS: There was no correlation between 1RM and VO2max in type 2 diabetic patients (upper: P = 0.122, lower: P = 0.138 for men, and upper: P = 0.952, lower: P = 0.570 for women). However, 1RM was significantly correlated with muscle mass both in men and women (upper: r = 0.493, P < 0.001, r = 0.315, P = 0.002 lower: r = 0.437 P < 0.001, r = 0.307, P =0.003, respectively). There was also a significant correlation between 1RM and BMI. In obese male subjects with BMI > or = 25 kg/m2, we observed a significant correlation between muscle mass and BMI (r = 0.374, P = 0.032), but this correlation was not observed in women. CONCLUSION: Clinicians treating Korean type 2 diabetic subjects should recommend resistance exercise to their patients. In particular, obese women with diabetes may receive greater benefits by increasing muscle mass through resistance exercises.

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Arati V Mahishale, Manali P Kulkarni
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The Correlations between Extremity Circumferences with Total and Regional Amounts of Skeletal Muscle and Muscle Strength in Obese Women with Type 2 Diabetes
Hwi Ryun Kwon, Kyung Ah Han, Hee Jung Ahn, Jae Hyuk Lee, Gang Seo Park, Kyung Wan Min
Diabetes & Metabolism Journal.2011; 35(4): 374. CrossRef
The Effects of Aerobic/Resistance Exercise on Body Fat Mass, Muscle Strength and Endothelial Function in Korean Type 2 Diabetes mellitus Patients
Kyung Wan Min
Journal of Korean Diabetes.2011; 12(1): 6. CrossRef
The Effects of Resistance Training on Muscle and Body Fat Mass and Muscle Strength in Type 2 Diabetic Women
Hwi Ryun Kwon, Kyung Ah Han, Yun Hyi Ku, Hee Jung Ahn, Bo-Kyung Koo, Ho Chul Kim, Kyung Wan Min
Korean Diabetes Journal.2010; 34(2): 101. CrossRef

Maximal Muscle Strength Deteriorates with Age in Subjects with Type 2 Diabetes Mellitus.: Hwi Ryun Kwon, Yun Hyi Ku, Hee Jung Ahn, Ji Yun Jeong, Sang Ryol Ryu, Bo Kyung Koo, Kyung Ah Han, Kyung Wan Min; Korean Diabetes J. 2009;33(5):412-420. Published online October 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.5.412

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Abstract PDF

BACKGROUND
It is difficult to improve muscle strength with only aerobic exercise training in type 2 diabetes patients. Resistance training is effective for improving muscle mass, muscle strength and insulin sensitivity. One repetition maxima (1RM), or the maximum amount of weight a subject can lift in a single repetition, may be a useful unit for evaluating the results of resistance training in type 2 diabetic patients. This study was aimed to assess baseline values for 1RM in a sample of Korean type 2 diabetes mellitus patients that are scaled for intensity and load of exercise, and to assess the relationship of 1RM to age. METHODS: A total of 266 (male: 95, female: 171) Korean patients with type 2 diabetes mellitus were included in the study sample. Maximal muscle strength was assessed by measuring 1RM for each subject (KEISER, Fresno, CA, USA). Two different exercises were used to measure 1RM: the chest press for the upper extremities, and the leg press for the lower extremities. RESULTS: Both upper and lower values of 1RM decreased with age in men and women; upper 1RM: r = -0.454, P<0.001 in men, r = -0.480, P< 0.001 in women, lower 1RM: r = -0.569, P<0.001 in men, and r = -0.452, P<0.001 in women. Values of 1RM significantly decreased in men only after the age of 70. In women, values of 1RM continuously decreased after the age of 60. CONCLUSION: The maximal muscle strength of individuals with type 2 diabetes decreases with age. We believe that resistance training is especially beneficial for type 2 diabetes mellitus patients after the sixth decade of life.

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The Effects of Floor-seated Exercise Program on Physical Fitness, Depression, and Sleep in Older Adults: A Cluster Randomized Controlled Trial
Min-Jung Choi, Kyeong-Yae Sohng
International Journal of Gerontology.2018; 12(2): 116. CrossRef
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Kyung Wan Min
Journal of Korean Diabetes.2011; 12(1): 6. CrossRef
The Correlations between Extremity Circumferences with Total and Regional Amounts of Skeletal Muscle and Muscle Strength in Obese Women with Type 2 Diabetes
Hwi Ryun Kwon, Kyung Ah Han, Hee Jung Ahn, Jae Hyuk Lee, Gang Seo Park, Kyung Wan Min
Diabetes & Metabolism Journal.2011; 35(4): 374. CrossRef
The Effects of Resistance Training on Muscle and Body Fat Mass and Muscle Strength in Type 2 Diabetic Women
Hwi Ryun Kwon, Kyung Ah Han, Yun Hyi Ku, Hee Jung Ahn, Bo-Kyung Koo, Ho Chul Kim, Kyung Wan Min
Korean Diabetes Journal.2010; 34(2): 101. CrossRef
Relationship of Maximal Muscle Strength with Body Mass Index and Aerobics Capacity in Type 2 Diabetic Patients
Hwi Ryun Kwon, Kyung Ah Han, Yun Hyi Ku, Hee Jung Ahn, Bo Kyung Koo, Kyung Wan Min
Korean Diabetes Journal.2009; 33(6): 511. CrossRef

Association Between Volume of Bowls and the Dietary Intakes in Subjects with Type 2 Diabetes.: Hee Jung Ahn, Bo Kyung Koo, Ji Yeon Jung, Hwi Ryun Kwon, Mi Yeon Chung, Yun Hyi Ku, Jin Taek Kim, Kyung Ah Han, Kyung Wan Min; Korean Diabetes J. 2009;33(4):335-343. Published online August 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.4.335

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Abstract PDF

BACKGROUND
The results of previous studies suggest that portion size is a major factor dictating dietary energy intake. We investigated the relationship between frequencies of rice meals, bowl volumes, and dietary energy intake in a sample of patients with type 2 diabetes. METHODS: A total of 203 type 2 diabetes patients were enrolled in the study. A one-week food diary was collected from each patient and used to assess the types of meal consumed as well as the context of consumption. The volumes of the eating vessels (rice, soup and side dish bowls) used by each patient were obtained by comparisons to measuring cylinders, and dietary energy and macronutrient intake were estimated for each patient by consulting three-day dietary records. RESULTS: The mean age of the 203 subjects (male: 76, female: 127) was 53.9 +/- 9.1 years and the average body mass index (BMI) was 25.6 +/- 4.2 kg/m2. Among the subjects who ate three times per day, 96.4% consumed rice more than twice out of three meals. The median volume of rice bowls used by patients was 350 cc, of soup bowls was 530 cc and of side dish bowls was 260 cc. Portion size, as estimated by rice bowl volume, was not associated with BMI. Male subjects tended to eat out of larger rice and soup bowls (P < 0.001). Portion size was correlated with energy intake from rice (P = 0.021), but not with total energy intake (kcal/kg/day), especially in male subjects. CONCLUSION: Portion size of rice bowl was correlated with energy intake from rice, but not with total energy intake in male subjects with type 2 diabetes. To design effective meal planning methods for patients with type 2 diabetes, further prospective studies are warranted to investigate causative relationships between portion size andmetabolic conditions as well as variation by gender.

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Kyong Park
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Small Rice Bowl-Based Meal Plan versus Food Exchange-Based Meal Plan for Weight, Glucose and Lipid Control in Obese Type 2 Diabetic Patients
Hee-Jung Ahn, Kyung-Ah Han, Hwi-Ryun Kwon, Bo-Kyung Koo, Hyun-Jin Kim, Kang-Seo Park, Kyung-Wan Min
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Hee-Jung Ahn, Yu-Kyung Eom, Kyung-Ah Han, Hwi-Ryun Kwon, Hyun Jin Kim, Kang Seo Park, Kyung-Wan Min
Korean Diabetes Journal.2010; 34(3): 166. CrossRef
The Small Rice Bowl-Based Meal Plan was Effective at Reducing Dietary Energy Intake, Body Weight, and Blood Glucose Levels in Korean Women with Type 2 Diabetes Mellitus
Hee Jung Ahn, Kyung Ah Han, Hwi Ryun Kwon, Kyung Wan Min
Korean Diabetes Journal.2010; 34(6): 340. CrossRef

Bowl-Based Meal Plan versus Food Exchange-Based Meal Plan for Dietary Intake Control in Korean Type 2 Diabetic Patients.: Hee Jung Ahn, Boo Kyung Koo, Ji Yeon Jung, Hwi Ryun Kwon, Hyun Jin Kim, Kang Seo Park, Kyung Ah Han, Kyung Wan Min; Korean Diabetes J. 2009;33(2):155-163. Published online April 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.2.155

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Abstract PDF

BACKGROUND
The food exchange-based meal plan is effective in controlling dietary energy intake with a macronutrient balance. However, it is difficult to practice for relatively low-literacy patients. As an alternative, we developed a system employing a standardized-sized bowl and investigated its effectiveness on achieving proper energy intake and macronutrient composition and patient compliance, compared to the conventional food exchange system in Korean type 2 diabetes patients. METHODS: Eighty subjects with type 2 diabetes were assigned to both the novel bowl-based meal plan group (BG) and the food exchange-based meal plan group (ExG). BG received limited simple instructions for the plan. Time spent for plan instruction was 10 min for BG and 40 min for ExG. Dietary energy and macronutrient intake were estimated with 3-day dietary records and patient comprehension of the plan was estimated with a 5-point Likert scale. RESULTS: After 12 weeks, dietary energy compliance showed no difference between the groups (BG: 103 +/- 10%, ExG: 101 +/- 17%). Both groups showed significant reduction in carbohydrate and protein intake and there was no difference in the proportion of carbohydrate, protein and fat in energy intake between the groups despite the shorter instruction time for BG. Following the instruction period, there was no difference in the understanding score between the groups. CONCLUSION: This bowl-based plan was equally effective as the food exchange-based plan in controlling dietary energy intake and macronutrient composition, as well as patient comprehension and compliance. Our novel plan may allow for more cost-effective methods in terms of time needed for plan instruction.

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