The Resistance Exercise in Already Active Diabetic Individuals (READI) Randomized Clinical Trial

Ronald J Sigal; Jane E Yardley; Bruce A Perkins; Michael C Riddell; Gary S Goldfield; Lois Donovan; Janine Malcolm; Stasia Hadjiyannakis; Alun L Edwards; Réjeanne Gougeon; George A Wells; Danièle Pacaud; Vincent Woo; Gordon T Ford; Doug Coyle; Penny Phillips; Steve Doucette; Farah Khandwala; Glen P Kenny; READI Trial Investigators

doi:10.1210/clinem/dgac682

The Resistance Exercise in Already Active Diabetic Individuals (READI) Randomized Clinical Trial

J Clin Endocrinol Metab. 2023 Apr 13;108(5):e63-e75. doi: 10.1210/clinem/dgac682.

Authors

Ronald J Sigal^{1

2

3}, Jane E Yardley^{2

4

5}, Bruce A Perkins⁶, Michael C Riddell⁷, Gary S Goldfield⁸, Lois Donovan⁹, Janine Malcolm^{3

10}, Stasia Hadjiyannakis⁸, Alun L Edwards¹, Réjeanne Gougeon¹¹, George A Wells^{12

13}, Danièle Pacaud¹⁴, Vincent Woo¹⁵, Gordon T Ford¹⁶, Doug Coyle¹³, Penny Phillips³, Steve Doucette¹⁷, Farah Khandwala¹⁸, Glen P Kenny^{2

3}; READI Trial Investigators

Collaborators

Affiliations

¹ Departments of Medicine, Cardiac Sciences and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2T 5C7, Canada.
² Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada.
³ Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada.
⁴ Augustana Faculty, University of Alberta, Camrose, AB T4V 2R3, Canada.
⁵ Alberta Diabetes Institute, Edmonton, AB T6G 2E1, Canada.
⁶ Mount Sinai Hospital and Lunenfeld Tanenbaum Research Institute, University of Toronto, Toronto, ON M5T 3L9, Canada.
⁷ School of Kinesiology and Health Science, York University, Toronto, ON M3J 1P3, Canada.
⁸ Healthy Active Living & Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada.
⁹ Departments of Medicine, Obstetrics and Gynecology, Alberta Children's Hospital Research Institute, University of Calgary Cumming School of Medicine, Calgary, AB T2N 2T9, Canada.
¹⁰ Department of Medicine, University of Ottawa, Ottawa, ON K1H 7W9, Canada.
¹¹ Research Institute and Department of Medicine, Crabtree Nutrition Laboratories, McGill University Health Centre, Montreal, QC H4A 3J1, Canada.
¹² Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada.
¹³ School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1G 5Z3, Canada.
¹⁴ Department of Pediatrics, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, Calgary, AB T3B 6A8, Canada.
¹⁵ Section of Endocrinology and Metabolism, Health Sciences Centre, University of Manitoba, Winnipeg, MB R3E 0V9, Canada.
¹⁶ Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 2T9, Canada.
¹⁷ Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS B3H 1V7, Canada.
¹⁸ Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB T2S 3C3, Canada.

PMID: 36459469
DOI: 10.1210/clinem/dgac682

Abstract

Context: Resistance exercise training (strength training) and aerobic exercise training are both recommended for people with type 1 diabetes, but it is unknown whether adding resistance exercise provides incremental benefits in people with this condition who already perform aerobic exercise regularly.

Objective: This work aimed to evaluate the incremental effect of resistance training on glycated hemoglobin A1c (HbA1c), fitness, body composition, and cardiometabolic risk factors in aerobically active people with type 1 diabetes.

Methods: The Resistance Exercise in Already-active Diabetic Individuals (READI) trial (NCT00410436) was a 4-center, randomized, parallel-group trial. After a 5-week run-in period with diabetes management optimization, 131 aerobically active individuals with type 1 diabetes were randomly assigned to resistance exercise (n = 71, intervention-INT) or control (n = 60, CON) for 22 additional weeks. Both groups maintained their aerobic activities and were provided dietary counseling throughout. Exercise training was 3 times per week at community-based facilities. The primary outcome was HbA1c, and secondary outcomes included fitness (peak oxygen consumption, muscle strength), body composition (anthropometrics, dual-energy x-ray absorptiometry, computed tomography), and cardiometabolic risk markers (lipids, apolipoproteins). Assessors were blinded to group allocation.

Results: There were no significant differences in HbA1c change between INT and CON. Declines in HbA1c (INT: 7.75 ± 0.10% [61.2 ± 1.1 mmol/mol] to 7.55 ± 0.10% [59 ± 1.1 mmol/mol]; CON: 7.70 ± 0.11% [60.7 ± 1.2 mmol/mol] to 7.57 ± 0.11% [59.6 ± 1.3 mmol/mol]; intergroup difference in change -0.07 [95% CI, -0.31 to 0.18]). Waist circumference decreased more in INT than CON after 6 months (P = .02). Muscular strength increased more in INT than in CON (P < .001). There were no intergroup differences in hypoglycemia or any other variables.

Conclusion: Adding resistance training did not affect glycemia, but it increased strength and reduced waist circumference, in aerobically active individuals with type 1 diabetes.

Keywords: HbA1c; exercise training; physical activity; strength training; type 1 diabetes.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Diabetes Mellitus, Type 1* / etiology
Diabetes Mellitus, Type 1* / therapy
Exercise
Exercise Therapy / methods
Glycated Hemoglobin
Humans
Resistance Training*

Substances

Glycated Hemoglobin

Grants and funding

MCT-154710/CIHR/Canada