Moderate exercise could be a key strategy for tackling pre-diabetes

Researchers from Duke University School of Medicine carried out a randomized, six-month study of 150 participants diagnosed as having pre-diabetes.

The participants were divided into four groups, with one group following a program modelled on the Diabetes Prevention Program (DPP), considered a 'gold standard' intervention.

The program aims to reduce body weight by 7 percent over a six-month period by reducing calories, reducing fat intake and increasing exercise.

To complete the exercise part of the program, the group's participants took part in exercise equivalent to 7.5 miles of brisk walking in a week.

As it can be difficult to get patients engaged in all three DPP behaviors, the team also wanted to know what effect could be achieved through exercise alone. In order to do this the remaining participants also completed exercise, but they did not complete any other part of the DPP program.

One group took part in a low amount of exercise at moderate intensity (equivalent to walking briskly for 7.5 miles per week); another in a high amount of exercise at moderate intensity (equivalent to walking briskly for 11.5 miles per week); and the third in a high amount at vigorous intensity (equivalent to jogging for 11.5 miles per week).

The results showed that on average, participants in the DPP group enjoyed the largest benefits, with a 9 percent improvement in oral glucose tolerance -- a key indicator used to predict progression to diabetes.

Only one of the remaining exercise-only groups showed similar results, with participants in the moderate-intensity, 11.5-mile group benefiting from a 7 percent improvement in glucose tolerance on average.

The moderate-intensity, 7.5-mile group only showed a 5 percent improvement on average, while those in the vigorous-intensity, 11.5-mile group only a had 2 percent improvement on average.

Explaining the findings, Kraus and co-author Cris Slentz commented that moderate-intensity exercise could be beneficial to patients with pre-diabetes as it burns off fat in the muscles, relieving the block of glucose uptake by the muscles, unlike high-intensity exercise which tends to burn more glucose.

Although the authors noted that more research is needed, Kraus did add that, "When faced with the decision of trying to do weight loss, diet, and exercise versus exercise alone, the study indicates you can achieve nearly 80 percent of the effect of doing all three with just a high amount of moderate-intensity exercise," he said.

"I was heartened by the fact that I found out that I can give patients one message and they can get nearly the same effect as when required to exercise, diet and lose weight all at the same time."