Sarcouncil Journal of Internal Medicine and Public Health

Abstract: Background: Type 2 diabetes mellitus (T2DM) is a condition that is presently afflicting over four hundred million adults in the world. The initial belief system of therapeutic intervention to attain glycaemic control is lifestyle interventions, but the relative efficacy of an isolated versus combined exercise and dietary intervention has been debatable in the short-term pragmatic studies. The effects of these modalities on HbA1c have been observed in meta-analytical assessments that found improvements of between 0.5% to 1.0% but the real-life superiority of integrative modalities requires testing in community-based, well-balanced cohorts. Methods: This was a 12-week, single-blinded and randomized controlled trial consisting of 144 adults with ,,,,, (30 80 years; baseline HbA1c 7010 0g; BMI 2550kg1kg). They were stratified and randomly assigned to four parallel arms (n=36 each): Exercise Only (150min/week -1 of moderate-intensity aerobic exercise and resistance training), Diet Only (individualized low-glycaemic 1,8002,200 kcal/kg-1week -1), Combined (integrated exercise-diet programs), and Control (standard medical treatment). The main outcome was the alteration in the HbA1c through high-performance liquid chromatography (HPLC); the secondary ones included fasting glucose, HOMA-IR, anthropometric weight, triglyceride concentration, and systolic blood pressure. The intention-to-treat analysis was used based on the analysis of variance (one-way) with the post-hoc analysis to calculate the HbA1c within a 3.46 standard deviation (alpha = 0.05), in which the study had a power of 80 percent to identify a 0.5 percent difference in HbA1c. Findings: The baseline demographic and clinical data were balanced (mean age 54.857.0 yr; mean BMI 30.732.0 kg/m 2). The mean HbA1c decrement was not significantly different between the four cohorts (−0.53 to -0.57 percentage; ANOVA F =.06, p =.9801), with the Combined group showing the largest numerically HbA1c reduction (7.74-1.38 percentage). The secondary metrics were biased towards the interventional arms: a weight loss of 4.7,⁻1.4, 00.3, a HOMA-IR minimization of 1.26,0046; a reduction of triglycerides 26.0 -21.0 00. mg/dl of, and a reduction of systolic blood pressure of 8.0 -6.0 mmHg among the combined participants. The adherence rates were over 74 percent in all arms. Conclusions: Despite the statistical non-significance of the statistical superiority of the combined intervention, due to the weak statistical power and effect sizes, the integrated exercise-diet programme presented clinically important, directionally significant changes in glycaemic and cardiometabolic biomarkers with a twelve-week follow-up.