A systematic review showed that resistance exercise alone reduced HbA1c by 0.3% but was not significantly different when compared to aerobic exercise (Irvine and Taylor 2009). Our study showed that, controlling find protocol for exercise volume, duration, and intensity, aerobic exercise and progressive resistance exercise had similar improvement. The degree of change in HbA1c seen in both groups in our study was similar to that seen with oral medications and diet (Irvine and Taylor 2009). Despite similar effects on body fat percentage, progressive resistance exercise resulted in a greater reduction in waist circumference than aerobic exercise – a finding in line with a previous study showing

that progressive resistance exercise reduced visceral and subcutaneous abdominal fat (Ibanez et al 2005). The different exercise physiology and mechanisms of action of progressive resistance exercise and aerobic exercise may have also played a role. Progressive

resistance exercise increases muscle strength Ibrutinib manufacturer or fat free mass and mobilises visceral adipose tissue, thus enhancing insulin sensitivity (Tresierras and Balady 2009). Unfortunately, the greater reduction in waist circumference was not also associated with any additional benefit in terms of blood pressure or lipid profile, all of which are closely related parameters. A study on obese Japanese men with metabolic syndrome, which can be considered closest to our population, suggested that a reduction of at least 3 cm in waist circumference was required for any change in metabolic profile (Miyatake et al 2008). The average reduction observed for the progressive resistance exercise group in the present study was only about half of that, at 1.6 cm (SD 2.6). The effect of aerobic exercise on peak oxygen consumption over was significantly greater than that of progressive resistance exercise. Previous studies showed that resistance exercise can elicit modest improvement in peak oxygen consumption, by approximately 6% (ACSM 1998). The progressive resistance exercise

group in our study improved their peak oxygen consumption by approximately 14%, comparable to that observed in a previous 6-month study on progressive resistance exercise on cardiorespiratory fitness in elderly men and women (Vincent et al 2003). This can be attributed to increased lower limb strength (Vincent et al 2003). These improvements may be clinically important as physical activity in patients with chronic conditions can reduce mortality (Martinson et al 2001, Sigal et al 2006). The training duration of 8 weeks was brief compared to the 12-week regimens examined in earlier studies. The 8-week duration was chosen to minimise or avoid the influence of any medication change during the course of the trial.