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Randomized Controlled Trial
. 2013 Sep;230(1):125-30.
doi: 10.1016/j.atherosclerosis.2013.07.002. Epub 2013 Jul 14.

The effect of exercise training on ankle-brachial index in type 2 diabetes

Bethany Barone Gibbs  1 , Devon A Dobrosielski, Andrew D Althouse, Kerry J Stewart
Affiliations
Randomized Controlled Trial

The effect of exercise training on ankle-brachial index in type 2 diabetes

Bethany Barone Gibbs et al. Atherosclerosis. 2013 Sep.

Abstract

Introduction: Though being physically active has associated with a healthier ankle-brachial index (ABI) in observational studies, ABI usually does not change with exercise training in patients with peripheral artery disease (PAD). Less is known about the effect of exercise training on ABI in patients without PAD but at high risk due to the presence of type 2 diabetes (T2DM).

Methods: Participants (n = 140) with uncomplicated T2DM, and without known cardiovascular disease or PAD, aged 40-65 years, were randomized to supervised aerobic and resistance training 3 times per week for 6 months or to a usual care control group. ABI was measured before and after the intervention.

Results: Baseline ABI was 1.02 ± 0.02 in exercisers and 1.03 ± 0.01 in controls (p = 0.57). At 6 months, exercisers vs. controls improved ABI by 0.04 ± 0.02 vs. -0.03 ± 0.02 (p = 0.001). This change was driven by an increase in ankle pressures (p < 0.01) with no change in brachial pressures (p = 0.747). In subgroup analysis, ABI increased in exercisers vs. controls among those with baseline ABI <1.0 (0.14 ± 0.03 vs. 0.02 ± 0.02, p = 0.004), but not in those with a baseline ABI ≥1.0 (p = 0.085). The prevalence of ABI between 1.0 and 1.3 increased from 63% to 78% in exercisers and decreased from 62% to 53% in controls. Increased ABI correlated with decreased HbA1c, systolic and diastolic blood pressure, but the effect of exercise on ABI change remained significant after adjustment for these changes (β = 0.061, p = 0.004).

Conclusion: These data suggest a possible role for exercise training in the prevention or delay of PAD in T2DM, particularly among those starting with an ABI <1.0. Clinicaltrials.gov Registry Number: NCT00212303.

Keywords: Ankle-brachial index; Exercise; Peripheral artery disease; Type 2 diabetes.

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Figures

Figure 1
Figure 1
Flowchart of Study Participants in the Sugar Hypertension and Physical Exercise (SHAPE2) Trial
Figure 2
Figure 2
Baseline and 6-month Ankle Brachial Index Category in Exercisers (n=49) and Controls (n=60) in the SHAPE2 Study.
See this image and copyright information in PMC

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