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Effects of Low-Energy Diet or Exercise on Cardiovascular Function in Working-Age Adults With Type 2 Diabetes: A Prospective, Randomized, Open-Label, Blinded End Point Trial

OBJECTIVE

To confirm the presence of subclinical cardiovascular dysfunction in working-age adults with type 2 diabetes (T2D) and determine whether this is improved by a low-energy meal replacement diet (MRP) or exercise training.

RESEARCH DESIGN AND METHODS

This article reports on a prospective, randomized, open-label, blinded end point trial with nested case-control study. Asymptomatic younger adults with T2D were randomized 1:1:1 to a 12-week intervention of 1) routine care, 2) supervised aerobic exercise training, or 3) a low-energy (~810 kcal/day) MRP. Participants underwent echocardiography, cardiopulmonary exercise testing, and cardiac magnetic resonance (CMR) at baseline and 12 weeks. The primary outcome was change in left ventricular (LV) peak early diastolic strain rate (PEDSR) as measured by CMR. Healthy volunteers were enrolled for baseline case-control comparison.

RESULTS

Eighty-seven participants with T2D (age 51 ± 7 years, HbA1c 7.3 ± 1.1%) and 36 matched control participants were included. At baseline, those with T2D had evidence of diastolic dysfunction (PEDSR 1.01 ± 0.19 vs. 1.10 ± 0.16 s–1, P = 0.02) compared with control participants. Seventy-six participants with T2D completed the trial (30 routine care, 22 exercise, and 24 MRP). The MRP arm lost 13 kg in weight and had improved blood pressure, glycemia, LV mass/volume, and aortic stiffness. The exercise arm had negligible weight loss but increased exercise capacity. PEDSR increased in the exercise arm versus routine care (β = 0.132, P = 0.002) but did not improve with the MRP (β = 0.016, P = 0.731).

CONCLUSIONS

In asymptomatic working-age adults with T2D, exercise training improved diastolic function. Despite beneficial effects of weight loss on glycemic control, concentric LV remodeling, and aortic stiffness, a low-energy MRP did not improve diastolic function.




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Pennsylvania, Texas, California among states lifting coronavirus restrictions Friday

California, Iowa, Pennsylvania and Rhode Island are among states that are loosening coronavirus restrictions Friday to gradually revive their economies.




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Africa Deepens its Approach to Migration Governance, But Are Policies Translating to Action?

While migration once was a lower-priority topic for African governments, the last decade has seen a deepening in governance. Policymakers have integrated migration into their national development strategies and mainstreamed it across policy domains such as health and education. The actions are promising on paper, yet questions remain about the extent to which they will translate to more effective migration management.




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Ask Ariely: On Overwhelming Options, Better Budgets, and Expensive Emotions

Here’s my Q&A column from the WSJ this week — and if you have any questions for me, you can tweet them to @danariely with the hashtag #askariely, post a comment on my Ask Ariely Facebook page, or email them to AskAriely@wsj.com. ___________________________________________________ Hi, Dan. I offered to purchase a computer...




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Andrew Cuomo says N.Y. has COVID-19 'on the run'; Mike Pence aide tests positive

Vice President Mike Pence's press secretary has tested positive for the coronavirus disease, the White House said Friday. In New York, Gov. Andrew Cuomo said the state is finally getting ahead of the virus.




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[ Other - Vietnam ] Open Question : What is HIV and how is it related to covid19? Any cure soon for both?




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[ Dogs ] Open Question : I've come to a conclusion,Dogs section on YA is not worth my time or energy, it is bad enough it is full of what I assume are teenagers?

playing games but now I am being repeatedly harassed and accused of being a troll named Sophie. Well you all can just keep this grimy pool. I am not wasting my time or energy. Enjoy yourselves.




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[ Cell Phones & Plans ] Open Question : What is the closest android equivalent to the 1st generation iPhone SE?

I am torn, I know it is time to upgrade my phone, but I don't know whether to upgrade to just accept the larger phone size and go with the 2nd gen SE or go with an android. I'd be interested to know what the closest equivalent android device there is to the 1st gen SE. I am open to a bigger screen size, but not a bigger phone. So, if there was an andriod that was all screen on the front, but was similar size to the original SE, I would be open to that.




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[ Religion & Spirituality ] Open Question : Christians, why do some people keep lying by saying trans been using other Gender's room for long time but that lie?

i even got this from pro trans page that say they have laws banning men from women's room & trans aka GD was put into mad house, & even then there been alot of time where rapists &perverted freaks been using other Gender's bath room too doesn't make it right, they go to prison if they find out




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[ Singles & Dating ] Open Question : Muslim man looking for relief?

I know it's Ramadan, but I've been feeling urges for a few years now and it's just getting more and more now. I always imagine about sex and loving my to-be wife. Right now, I'm studying medicine, so my parents told me it's too early to get married (24 years old). I just don't know really what to do. I prone masturbate to get some relief. What should I do?




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[ Yahoo Answers ] Open Question : Nowadays many of legit questions are getting removed without notice. There's no appeal options also. How can I report about these mistakes?

*my legit questions




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[ Polls & Surveys ] Open Question : Poll: Is it okay if I make love to my gin and tonic instead ?

It's lockdown after all. 




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[ Add-ons ] Open Question : Finding a way to backup with external harddrive?

I'm trying to make a backup to an external harddrive, but when I go to update & security and then to back up, I don't find the option to 'add a drive'. It's completely empty, even though my computer is detecting the external harddrive.  Where do I find the option to backup files? I'm using windows 10 




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[ Investing ] Open Question : What does an investor do when his stock notifies him...the company confirms a record date for a forward two for one stock split?




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[ Earth Sciences & Geology ] Open Question : Are earthquakes necessary to release the earth's energy?




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[ Other - Holidays ] Open Question : What should I give my mom for Mother’s Day ?

No pets no electronics so maybe something that is nice and simple but homemade




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[ Law & Ethics ] Open Question : Law and Ethics: Do you think gore should be illegal?

I certainly do, it doesn't make sense how someone crazy recording someone getting killed isn't illegal but CP is! That shouldn't be because, they should be either running away or trying to stop that super duper crazy person. Why can't both of them be illegal?




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[ Credit ] Open Question : I'm 23 with a 536 credit score because I was stupid from ages 18-20. Is there any way to make it higher? ?

I have 2500 worth of debt and most of it has been turned over into collections 




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[ Politics ] Open Question : Why are Democrats so fond of china?




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[ Politics ] Open Question : Why do people in Chicago kill themselves for nothing?




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[ Royalty ] Open Question : Why do males often name their male kids the same name, and a number, but females do not do the same for their daughters?

(I am in the USA). There was 8 Henry s https://en.wikipedia.org/wiki/Henry_VIII_of_England




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[ Religion & Spirituality ] Open Question : Does God love it when you call him Big Poppa?




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[ Singles & Dating ] Open Question : I miss my ex girlfriend's daughter what can I do ?

Hello I am a man 36 years old and, My ex girlfriend and I and I were together from January to August 2012, my ex girlfriend's daughter was very affectionate with me, I miss her what I can do I was very fond of her, what can I do ?




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[ Singles & Dating ] Open Question : WHAT TO DO, TO MAKE FRIENDS? I NEED ADVICE?




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[ Politics ] Open Question : Is Camp David going to be the new Trump “White House“ since Melania’s White House is at the top of the avoidance list for germaphobes?




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[ United States ] Open Question : Is my $1,200 stimulus check taxable as income?




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[ Politics ] Open Question : Where would you prefer to live in New York,Chicago or Los Angeles?




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[ Politics ] Open Question : How is Trump's new White House Press Secretary doing?

Good or bad? Better or worse than Huckabee?




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[ Polls & Surveys ] Open Question : Did you ever take your cat on the tube/subway and listen to music with him?




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[ Politics ] Open Question : Is Trump going to have to invade California?

The state leads the nation in poverty and homelessness while it's socialist elites live in absolute luxury. It's like some third world nation the US is obligated to invade on the basis of humanitarianism.




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[ Law & Ethics ] Open Question : If a relict population of Neandertals were found to be living in a certain cave, on a certain remote island, or in a certain house on?

Pennsylvania Avenue, would placing some of them in zoos be unethical? Would they be considered human enough to receive human rights?




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[ Religion & Spirituality ] Open Question : My mother keeps turning water into wine, walking on water and resurrecting from the dead. Is she a witch?




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[ Politics ] Open Question : Libtards, don't get your panties in a bunch when those two Georgia 2nd amendment warriors are found innocent of killing that black guy?

He shouldn't have fought back when the guy pointed the shot gun at him




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[ Politics ] Open Question : Why hasn't there ever been a great Democrat presidents' face on Mount Rushmore?

Maybe because there's never been a great Democrat president?  And never will be.  They're all horrible.




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[ Religion & Spirituality ] Open Question : IMAGINE YOU HEARD KIDS ON PHONE TALKING about their difficult reducing MASTURBATION?




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[ Singles & Dating ] Open Question : The man that’s showed clear/obvious interest in me had no contact with me yesterday, is this normal?

I’ve been talking to a man, we have mutual interest in each other. We talked on the phone for over an hour the night before last and it was an amazing conversation. The next day he had no contact with me, which in my mind it didn’t bother me and still kind of isn’t I think he just is doing his own thing and likes his personal space. I’m not too bothered or worried but still questioning why? Is it normal for a man to kinda disappear and have no contact for a day?




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[ Politics ] Open Question : Why are other countries like New Zealand and Australia destroying the virus while America is killing people off to restart the economy?




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[ Other - Australia ] Open Question : Where is the to go menu for Outback?




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[ Politics ] Open Question : Why do so me people worship celebrities?




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[ Singles & Dating ] Open Question : What is this?  What is it for?




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[ Women's Health ] Open Question : Ovulation like discharge before period?

I have a 23 day cycle and around day 19 up until my period I produce a ovulation like discharge, it’s clear/ white and super stretchy. I don’t get this during the “ovulation” time frame, it tends to be thick and cloudy then. Why? And when am I ovulating?




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[ Polls & Surveys ] Open Question : What is your opinion on neofolk?




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[ Religion & Spirituality ] Open Question : Atheists, I always thought Roger Daltrey led the WHO, and not this Ted Ross guy. Who is he anyway? What instrument does he play?

What band was he with before?




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[ Other - Business & Finance ] Open Question : Can I apply for unemployment as a gig worker?

If so, can you do it online? I don't want to catch COVID-19 waiting in some packed line, as I live with an 80 year old.




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[ Politics ] Open Question : IF Cons rewrote the Constitution of the United States would it have less laws, more liberty, & move power from DC to the State Capitals?

Oh would that 'less laws/more liberty/more state capital power' look anything like Mike Pence's Religious Freedom Restoration Act or in other words the 'we Conservative Republican Christians are such oppressed persecuted victims WAAAAA WAAAA' Bill. https://www.youtube.com/watch?v=KIikqPmbgvI 




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[ Baby Names ] Open Question : Which boy name do you prefer: Stephen, Thomas, Sean or Ethan?

For Stephen we'd  use the nickname "Stevie" and for Thomas we'd use the nickname "Tommy" if that helps.




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[ Politics ] Open Question : When will the democrats be arrested for being trators to SAmerica by conspiring with chine to make trump looik bad?




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[ Politics ] Open Question : Trump supporters: Do you watch Disney and Pixar movies even though they carry hidden liberal agendas?

Do you let your kids watch Disney and Pixar movies? They're all created by liberals.




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[ Politics ] Open Question : Is it true many British and American banks and companies(Bank of England,UIC,Prescott Bush,etc) gave money and goods to Hitler secretly?




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[ Rock and Pop ] Open Question : Rock was invented by blacks? R.I.P Little Richard?