Effects of continuous aerobic training, high intensity interval training (HIIT) and combined aerobic with resistance training on glycated haemoglobin (HbA1c) in Type 2 Diabetes Mellitus patients with coronary artery disease

Introduction: Exercise is well known to be part of the prevention and management of type 2 diabetes mellitus (T2DM) as it helps with blood glucose control. Cardiovascular complication in diabetes is one of the components for morbidity and mortality in those patients. Objective: The aim of this study is to compare the reduction in glycated hemoglobin (HbA1c) between continuous aerobic training, high intensity interval training and combined aerobic with resistance training in T2DM patients with coronary artery disease (CAD). Design: This is a randomized clinical trial looking at 3 types of supervised exercise intervention involving T2DM patients with CAD. Settings and conduct: Type 2 diabetes mellitus patients with coronary artery disease is recruited from the endocrine and cardiology clinic University Malaya Medical Centre. Patients Participants: Patients who fulfill the inclusion and exclusion criteria as listed below are recruited: Inclusion criteria for the subjects are patients with type 2 diabetes mellitus with coronary artery disease co-morbidity manifested by one or more of these: -Ischemic Heart Disease, but no current angina -Post angioplasty / stenting or post coronary artery bypass surgery -Stable pharmacological therapy -Chronic Heart Failure New York Association (NYHA I, II and III) in the absence of congestive heart failure at the time of study Patients with the listed criteria are excluded from the study: -Myocardial Infarction, Cardiac arrest, symptomatic or sustained ventricular tachycardia in the previous 6 months -Unstable heart failure, or NYHA Class IV patients -Symptomatic or sustained ventricular tachycardia -Current angina or baseline assessment suggesting unsatisfactory control of heart failure -Current acute musculoskeletal event and/or neurological impairments that adversely affect exercise capacity. -Any other symptoms that prevent the patients from exercising. Intervention: Subjects are divided into 3 groups using the Peto et al. randomization method. Group 1 is doing continuous aerobic training, Group 2 doing high intensity interval training (HIIT) and Group 3 is doing combined aerobic with resistance training. Patient's assessments are done before and after 12 weeks of exercise intervention. Main outcome measure: To look at the changes in HbA1c after 12 weeks of exercise intervention. Venous blood is also withdrawn to look at the fasting blood glucose and fasting lipid profile. Patient's maximum oxygen consumption (VO2max) is measured with cycle ergo meter using either Astrand or Naughton protocol. Patient's body composition is also monitored using the InBody370 body impedance analysis machine

University Malaya Research Grant UMRG No. RG366-11HTM