Study: Exercise More Effective Than Weight Loss for Improving Heart Function in Diabetes

A study completed by the University Hospitals at Leicester showed that heart function in patients with type 2 diabetes (T2D) may be improved more effectively through exercise training than through a weight loss regimen.

The study was funded by the National Institute for Health Research (NIHR) and similarly conducted at the NIHR Leicester Biomedical Research Centre (BRC).

“Heart failure is one of the most common complications in people with type 2 diabetes, and younger adults with type 2 diabetes already have changes in their heart structure and function that pose a risk of developing heart failure,” Gaurav Gulsin, a BHF clinical research fellow at the University of Leicester, trainee heart physician, and a lead author of the study, said We wanted to confirm the abnormalities in the structure and function of the heart in this patient population using the latest scanning techniques, and explore whether it is possible to reverse these through exercise and/or weight loss.”

The randomized study incorporated a total of 87 participants, between 18 and 65 years of age, with type 2 diabetes, who underwent echocardiography and a magnetic resonance imaging (MRI) scan in order to verify their early heart dysfunction, as well as exercise tests to analyze cardiovascular fitness. Patients were randomly selected into 1 of 3 groups – routine care, supervised aerobic exercise training, or low-energy meal replacement program – all of which lasted for 12 weeks; 76 participants remained on the program for the entire duration of the study.

Researchers from the University Hospitals of Leicester reported that those who followed the supervised exercise program demonstrated significantly improved heart function compared with the control group.

The results also suggested that while a low-energy diet did not alter heart function, the program did show favorable effects on heart structure, vascular function, and diabetes reversal in 83% of the patient group.

Limitations of the study included small population size and failure of nearly 1 in 5 patients in the exercise arm of the study to complete the program, effectively restricting the study’s application in future clinical practice. 

Senior study author Gerry McCann, NIHR research professor and professor of cardiac imaging at the University of Leicester and a consultant cardiologist at Leicester’s Hospitals said, “Through this research we have shown that lifestyle interventions in the form of regular exercise training may be important in limiting and even reversing the damage to heart structure and function seen in younger adults with type 2 diabetes. While losing weight has a beneficial effect on heart structure, our study shows that on its own it does not appear to improve heart function.”

The findings have been published in the journal Diabetes Care.

References:

1. Exercise training better than weight loss for improving heart function in type 2 diabetes. News Release. University Hospitals of Leicester; March 30, 2020. https://www.leicestershospitals.nhs.uk/aboutus/our-news/press-release-centre/?entryid8=75619. Accessed April 29, 2020.