Integrated Exercise and Glycemic and Peripheral Sensation Control in Diabetic Neuropathy: A Single‑Blind, Randomized Controlled Trial

Masoome Heidari, Vahid Zolaktaf, Gholamali Ghasemi, Shahram Lenjan Nejadian

Abstract


Background: Neuropathy control and management is an objective in therapeutic exercises prescribed for patients with Type 2 diabetic peripheral neuropathy. We examined the effects of 12‑week integrated exercise (IE) on glycemic control and peripheral sensation criteria in patients with diabetic neuropathy. Methods: This study was carried out in 2019–2020 in Janan diabetic society of Najaf Abad in Iran. Based on MNSI scores, we assigned 40 patients into two equal paired random groups (control vs. IE). Pre and posttests were administered before and after three months of intervention. Results: Repeated measures ANOVA showed no significant interaction effect between the FBS of the groups (P = 0.26) but significant interaction effects were observed between the levels of 2 hrs pp G, 4 pm G, HbA1c, Diapason, Monofilament, and Thermofeel in favor of the IE group (P < 0.05). Conclusions: At the beginning of IE, we used massage and foam roller to release pain and improve blood circulation as well as sensation in the neuropathic areas. This may have helped the patients perform the aerobic and resistance exercises more easily. Therefore, better glycemic control and peripheral sensation were achieved. Verification of the long‑term effects of this training strategy requires further study. Verification of the long‑term effects of this training strategy requires further study.

Keywords


Blood glucose; diabetes mellitus type 2; diabetic neuropathies; exercise therapy; Michigan neuropathy screening instrument

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References


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persons. J Clin Epidemiol 2003;56:659‑68.

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prevalence of diabetes for 2010 and 2030. Diabetes Res Clin

Pract 2010;87:4‑14.

Javanbakht M, Mashayekhi A, Baradaran HR, Haghdoost A,

Afshin A. Projection of diabetes population size and associated

economic burden through 2030 in Iran: Evidence from

micro‑simulation Markov model and Bayesian meta‑analysis.

PloS One 2015;10:e0132505.

Sicree R, Shaw J, Zimmet P, Heart BI. The global burden.

Diabetes and impaired glucose tolerance. Baker IDI Heart and

Diabetes Institute. 2010.

Boulton AJ, Vinik AI, Arezzo JC, Bril V, Feldman EL,

Freeman R, et al. Diabetic neuropathies: A statement by the

American diabetes association. Diabetes Care 2005;28:956‑62.

Vinik AI, Nevoret ML, Casellini C, Parson H. Diabetic

neuropathy. Endocrinol Metab Clin North Am 2013;42:747‑87.

Rathur HM, Boulton AJ. The neuropathic diabetic foot. Nat Clin

Pract Endocrinol Metab 2007;3:14‑25.

Ites KI, Anderson EJ, Cahill ML, Kearney JA, Post EC,

Gilchrist LS. Balance interventions for diabetic peripheral

neuropathy: A systematic review. J Geriatr Phys Ther

;34:109‑16.

Menz HB, Lord SR, St George R, Fitzpatrick RC. Walking

stability and sensorimotor function in older people with diabetic

peripheral neuropathy. Arch Phys Med Rehabil 2004;85:245‑52.

Volpato S, Leveille SG, Blaum C, Fried LP, Guralnik JM. Risk

factors for falls in older disabled women with diabetes: The

women’s health and aging study. J Gerontol A Biol Sci Med Sci

;60:1539‑45.

Duby JJ, Campbell RK, Setter SM, White JR, Rasmussen KA.

Diabetic neuropathy: An intensive review. Am J Health Syst

Pharm 2004;61:160‑73; quiz 175‑6.

Yamamoto R, Kinoshita T, Momoki T, Arai T, Okamura A,

Hirao K, et al. Postural sway and diabetic peripheral neuropathy.

Diabetes Res Clin Pract 2001;52:213‑21.

Trikkalinou A, Papazafiropoulou AK, Melidonis A. Type 2

diabetes and quality of life. World J Diabetes 2017;8:120‑9.

Norris SL, Zhang X, Chowdhury FM, Zhang P. Health Related

Quality of Life Measured by SF‑36 for Adults with Diabetes:

A Meta–Analysis. Ottawa: Cochrane Collaboration; 2004. p. 111.

Wexler DJ, Grant RW, Wittenberg E, Bosch JL, Cagliero E,

Delahanty L, et al. Correlates of health‑related quality of life in

type 2 diabetes. Diabetologia 2006;49:1489‑97.

Boulé NG, Haddad E, Kenny GP, Wells GA, Sigal RJ. Effects of

exercise on glycemic control and body mass in type 2 diabetes

mellitus: A meta‑analysis of controlled clinical trials. JAMA

;286:1218‑27.

da Silva CA, Ribeiro JP, Canto JC, da Silva RE, Junior GB,

Botura E, et al. High‑intensity aerobic training improves

endothelium‑dependent vasodilation in patients with metabolic

syndrome and type 2 diabetes mellitus. Diabetes Res Clin Pract

;95:237‑45.

Stel VS, Smit JH, Pluijm SM, Lips P. Balance and mobility

performance as treatable risk factors for recurrent falling in older

persons. J Clin Epidemiol 2003;56:659‑68.