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

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After 3 months of RT, 34% were no longer prediabetic; maintained through month 15 (30%), with no group difference.

After 3 months of resistance training, about 34% of participants were no longer prediabetic. Normoglycemia prevalence was maintained through month 15 at about 30%, but there was no clear difference between SCT and standard care maintenance groups.

Strength increases were maintained through month 15 and represented improvements of 21% and 14% for chest and leg press.

Muscular strength increased by month 3 and was maintained through month 15. Reported improvements were 21% for chest press and 14% for leg press, with no clear differences between maintenance groups.

Adherence was high during supervised initiation at 91%, then declined during community-based maintenance. At month 15, adherence was 53% among those assessed and 42% to 44% when non-completers were counted as nonadherent, with no group difference.

No changes were noted in fasting glucose concentrations.

The results excerpt states that no changes were noted in fasting glucose concentrations over the study period.

Glucose tolerance improved in the standard group during the first 3 months and was maintained at 15 months, but the improvement was not described as a consistent between-group advantage.

No group differences over time were detected for HOMA-IR, insulin AUC, or related insulin measures, suggesting no clear effect on insulin resistance measures in this report.

Waist circumference decreased in both groups from baseline to month 15, but no group differences were reported for this anthropometric outcome.

Four serious adverse events were reported during the 15-month trial, with no significant difference by group. Three involved musculoskeletal or joint pain lasting more than 3 to 4 days.

Whole-body resistance training performed two times per week. The supervised initiation phase used 12 Nautilus exercises, one set of 8-12 repetitions at moderate resistance with effort to concentric failure, followed by community-based maintenance training.

The higher-contact SCT-based maintenance approach did not improve resistance training adherence compared with standard care. At month 15, adherence was 53% in both groups among assessed participants.

The SCT group had slightly higher odds of achieving normoglycemia, but differences between SCT and standard care were not statistically significant.

The SCT-based maintenance condition used self-regulation procedures such as goal setting, monitoring, feedback, planning, and problem solving to support resistance training maintenance after supervised initiation.

Positive: 4; Negative: 0; No effect: 4; Mixed: 2

Direction counts recalculated from intervention outcomes due to mismatch with AI-provided counts.

Extracted 10 outcome signals across the study

Normoglycemia and strength improved overall after resistance training, but SCT maintenance support was not superior to standard care and several glycemic biomarkers did not change.

Direction counts were recalculated from extracted outcomes because the AI-provided totals did not match.

Normoglycemia status ↑ (34% after 3 months; 30% at 15 months)

Mostly intermediate or surrogate outcomes

A supervised twice-weekly resistance training initiation phase was followed by sustained normoglycemia in about one-third of participants.

Strength gains were evident by month 3 and maintained through month 15, with no clear difference between maintenance groups.

Higher-contact SCT-based maintenance support did not show greater benefit than lower-contact standard care.

Davy BM, Winett RA, Savla J, et al. Resist diabetes: A randomized clinical trial for resistance training maintenance in adults with prediabetes. PLoS One. 2017;12(2):e0172610. doi:10.1371/journal.pone.0172610

No no-exercise control group over the full 15-month trial

Participants were mostly White, female, and college educated

Maintenance adherence declined by month 15

Findings may not generalize to younger or more diverse populations

In overweight or obese older adults with prediabetes, twice-weekly resistance training was linked to sustained normoglycemia in about one-third of participants, but SCT maintenance support was not better than standard care.

Muscular strength ↑ (chest press 21%, leg press 14%)

Fasting plasma glucose → (no clear change reported)

Social Cognitive Theory-based resistance training maintenance support

Standard care resistance training maintenance support

High dropout rate (moderate): 24% dropout

Includes self-reported outcomes (moderate): Self-reported outcomes used

Limited population scope (moderate): Narrow population scope

Relies on surrogate outcomes (moderate): No hard clinical outcomes reported

Resistance training may help reverse prediabetes and improve strength

This trial tested whether adults with prediabetes could start and maintain resistance training. After a supervised 3-month training phase, about one-third of participants were no longer prediabetic, and this was mostly maintained through 15 months. Extra social-cognitive support did not outperform lower-contact standard care.

The study excluded people with diabetes or diabetes medication use at baseline.

All participants received resistance training, so the trial does not isolate training versus no training.

The added SCT support did not clearly improve outcomes over standard care.

Glucose and strength outcomes were measured in a research setting with structured follow-up.

Resistance training initiation and maintenance support in older adults with prediabetes

Sedentary adults aged 50 to 69 years with prediabetes

Adults with overweight or obesity who can safely perform resistance training

People without known cardiovascular disease or conditions preventing resistance training

Resistance training may help reverse prediabetes and improve strength

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