Metabolic effects of exercise training among fitness- nonresponsive patients with type 2 diabetes: The HART-D study

Ambarish Pandey, Damon L. Swift, Darren K McGuire, Colby R. Ayers, Ian J Neeland, Steven N. Blair, Neil Johannsen, Conrad P. Earnest, Jarett D Berry, Timothy S. Church

Research output: Contribution to journalArticlepeer-review

56 Scopus citations


OBJECTIVE To evaluate the impact of exercise training (ET) on metabolic parameters among participants with type 2 diabetes mellitus (T2DM) who do not improve their cardiorespiratory fitness (CRF) with training. RESEARCH DESIGN AND METHODS We studied participants with T2DM participating in the Health Benefits of Aerobic and Resistance Training in Individuals With Type 2 Diabetes (HART-D) trial who were randomized to a control group or one of three supervised ET groups for 9 months. Fitness response to ET was defined as a change in measured peak absolute oxygen uptake (ΔVO2peak, in liters per minute) from baseline to follow-up. ET participants were classified based on ΔVO2peak into fitness responders (ΔVO2peak ‡5%) and nonresponders (ΔVO2peak <5%), and changes in metabolic profiles were compared across control, fitness responder, and fitness nonresponder groups. RESULTS A total of 202 participants (mean age 57.1 6 7.9 years, 63% women) were included. Among the exercise groups (n = 161), there was substantial heterogeneity in DVO2peak 57% had some improvement in CRF (ΔVO2peak >0), with only 36.6% having a ‡5% increase in VO2peak. Both fitness responders and nonresponders (respectively) had significant improvements in hemoglobin A1c and measures of adiposity (ΔHbA1c:20.26%[95% CI20.5 to20.01] and20.26%[20.45 to20.08]; Δwaist circumference: 22.6 cm [23.7 to 21.5] and 21.8 cm [22.6 to 21.0]; Δbody fat:21.07% [21.5 to20.62] and20.75% [21.09 to20.41]). No significant differences were observed in the degree of change of thesemetabolic parameters between fitness responders and nonresponders. Control group participants had no significant changes in any of these metabolic parameters. CONCLUSIONS ET is associated with significant improvements in metabolic parameters irrespective of improvement in cardiorespiratory fitness.

Original languageEnglish (US)
Pages (from-to)1494-1501
Number of pages8
JournalDiabetes care
Issue number8
StatePublished - Aug 2015

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing


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