Background: Type2 diabetes (T2D) is a global health problem, which increases the risk of
cardiovascular disease (CVD). Aerobic capacity is lower in T2D individuals compared to
healthy, and women with T2D have even lower aerobic capacity compared to men with T2D.
These sex disparities could lead to increased CV morbidity and mortality in women
compared with men with T2D. However, the same exercise recommendations are given to
women and men.
Objectives: To compare the cardiometabolic training response in women and men with T2D
following the same exercise interventions. We hypothesized that women with T2D would
have a reduced exercise response compared to men.
Methods: Twenty-nine individuals with T2D (15 women, 14 men), were randomized and
stratified by sex to either supervised training group (STG) or active control group (ACG) for
12 weeks. The STG performed aerobic and resistance training three days a week, whereas
the ACG was advised to use a Mio Slice heart rate watch and reach 100 PAI (Personal
activity intelligence) each week. Changes in cardiac function, glycosylated hemoglobin
(HbA1c), insulin resistance, aerobic capacity (VO2peak) and heart rate recovery were
measured.
Results: Both STG and ACG showed significant improvements in cardiac function and
aerobic capacity with no significant difference between groups. In the STG, men improved
more than women in VO2peak (25%, p < 0.001 vs. 15%, p = 0.001) and stroke volume index
(15%, p = 0.10 vs. 11%, p = 0.04). Whereas, only women significantly improved heart rate
recovery (after 1min, 48%, p = 0.04), insulin resistance (25%, p = 0.03), insulin C-peptide
(27%, p = 0.02) and right ventricular systolic function (TAPSE, 21%, p=0.04). Both sexes
in the ACG showed improvements in cardiac function and aerobic capacity.
Conclusions: Women had less improvement in left ventricular cardiac function and aerobic
capacity compared to men after 3 months of supervised training. However, women had a
greater response in insulin resistance and heart rate recovery. Moreover, a weekly activity
index PAI can be an effective strategy to motivate and increase the exercise adherence for
both women and men. Further research is needed to investigate the sex differences in
training response to potentially develop sex specific training programs to optimize the
effects of training.
