Understanding Artificial Pancreas Systems: Results from a 24-Month Trial

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Non-randomized (moderate): Randomization not used or not reported

No control group (high): Single-arm or uncontrolled design

Open-label or unblinded (moderate): No blinding reported

High risk of bias (high): Overall bias rated high

Chest press and leg press strength increased 27% and 18%, respectively, following the 12-week RT program (both<0.05).

Chest press strength increased 27% and leg press strength increased 18% following 12 weeks of resistance training (both p<0.05), indicating a clear and consistent improvement in muscular strength.

Waist circumference (-1.0%; pre 109.3±10.3 cm, post 108.2±10.6 cm)

Waist circumference decreased by 1.0% (from 109.3±10.3 cm to 108.2±10.6 cm) following the resistance training intervention, indicating favorable changes in central adiposity.

Body fat (-0.6%; pre 43.7±6.8%, post 43.1±6.8%)

Body fat percentage decreased by 0.6% (from 43.7±6.8% to 43.1±6.8%) following 12 weeks of resistance training, indicating a modest reduction in adiposity.

Lean body mass (+1.3%; pre 52.0±10.4 kg, post 52.7±10.7 kg)

Lean body mass increased by 1.3% (from 52.0±10.4 kg to 52.7±10.7 kg) following 12 weeks of resistance training, indicating favorable changes in body composition with increased muscle mass.

Fasting glucose concentrations did not change (>0.05) following the intervention.

Fasting glucose concentrations did not change significantly following the 12-week resistance training program (p>0.05), indicating that resistance training did not affect fasting glucose regulation.

2-hr oral glucose tolerance improved in those with IGT (pre 8.94±0.72 mmol/l, post 7.83±1.11 mmol/l,<0.05) and IFG/IGT (pre 9.66±1.11mmol/l, post 8.60±2.00 mmol/l) but not in those with IFG (pre 6.27±1.28mmol/l, post 6.33±1.55 mmol/l).

2-hour oral glucose tolerance improved significantly in those with IGT (pre 8.94±0.72, post 7.83±1.11 mmol/L, p<0.05) and IFG/IGT (pre 9.66±1.11, post 8.60±2.00 mmol/L), but did not change in those with isolated IFG (pre 6.27±1.28, post 6.33±1.55 mmol/L). The effect depended on prediabetes phenotype.

There were no significant changes in ISI following the RT program.

The Matsuda-DeFronza estimated insulin sensitivity index (ISI) showed no significant changes following the 12-week resistance training program.

There were no significant changes in glucose area under the curve following the RT program.

Glucose area under the curve during oral glucose tolerance test did not change significantly following the 12-week resistance training program.

Supervised full-body resistance training program, 2 sessions/week for 12 weeks, using progressive overload

Positive: 4; Negative: 0; No effect: 3; Mixed: 1

Extracted 8 outcome signals across the study

4 of 8 outcomes showed positive direction (muscular strength, waist circumference, body fat, lean body mass), 3 showed no effect (fasting glucose, insulin sensitivity, glucose AUC), and 1 was mixed (2-hour glucose by phenotype). No negative outcomes observed.

↑ Muscular strength (chest press +27%, leg press +18%)

↓ Waist circumference (-1.0%) and body fat (-0.6%)

Mostly intermediate or surrogate outcomes

Resistance training improved 2-hour glucose tolerance in IGT and combined IFG/IGT subgroups but not isolated IFG

Body composition improved: waist circumference, body fat decreased and lean mass increased

Fasting plasma glucose, insulin sensitivity, and glucose AUC did not change significantly

Eikenberg JD, Savla J, Marinik EL, et al. Prediabetes phenotype influences improvements in glucose homeostasis with resistance training. PLoS ONE. 2016;11(2):e0148009. doi:10.1371/journal.pone.0148009

No control group (single-arm pre-post design)

No HbA1c measurement, potentially missing a prediabetes phenotype

Indirect measure of insulin sensitivity (Matsuda index) may not detect small changes

No imaging-based measurement of visceral fat changes

A 12-week supervised resistance training program improved 2-hour oral glucose tolerance in older adults with IGT or combined IFG/IGT, but not in those with isolated IFG, without dietary changes.

↓ 2-hour glucose in IGT and IFG/IGT subgroups

Supervised RT program twice per week for 12 weeks. Chest press and leg press strength increased 27% and 18%.

Resistance training

No control group (high): No parallel control group reported

Limited population scope (moderate): Narrow population scope

Limited safety reporting (moderate): Safety reporting depth: not_reported

Resistance training improves 2-hour glucose tolerance in older adults with prediabetes, depending on phenotype

This study tested whether prediabetes type affects how well resistance training improves blood sugar handling. 159 older adults with prediabetes did supervised strength training twice weekly for 12 weeks. 2-hour glucose tolerance improved in those with impaired glucose tolerance, but not in those with isolated impaired fasting glucose.

Improvements in glucose tolerance were limited to those with IGT or combined IFG/IGT, not isolated IFG

The study lacked a non-exercise control group, so some changes could reflect regression to the mean

Results may not apply to younger adults or those without overweight

The 12-week program was supervised; adherence and effects in unsupervised settings are unknown

Effect of 12-week resistance training on glucose homeostasis by prediabetes phenotype

Resistance training improves 2-hour glucose tolerance in older adults with prediabetes, depending on phenotype

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