Efeito de diferentes intensidades de exercícios físicos sobre parâmetros cardiometabólicos de mulheres portadoras de diabetes tipo 2 na menopausa

Abstract

Type 2 diabetes mellitus (T2DM) results from reduced pancreatic insulin production, peripheral resistance to insulin action or both. It is responsible for 85 to 90% of diabetes cases and its prevalence has been increasing in epidemic proportions due to the longevity of the population and the increase of physical inactivity and obesity in the world today. In women, the risk of developing the disease increases during menopause due to reduced ovarian estrogen production, leading to changes in body composition with increased visceral adiposity and consequent peripheral insulin resistance. In addition, hypoestrogenism contributes to the formation of a more atherogenic lipid profile, further increasing the cardiovascular risk in these women. Regular physical activity is one of the best non-pharmacological strategies for treating cardiometabolic diseases. Studies have suggested that combined aerobic and resistance exercise are accompanied by better health outcomes when compared to each modality alone. However, the intensity of physical exercise may also influence the improvement of cardiometabolic parameters, but it is not yet clear which intensity of physical exercise would be more appropriate to promote this improvement in postmenopausal diabetic women. Thus, the objective of this study was to evaluate the intensity of the combined physical exercise resulted in the greatest benefit to these women. Participated in this study, women aged 47 to 65 years, type 2 diabetic, registered in the Basic Health Units (BHU) of the city of Lavras-MG, which were evaluated in relation to quality of life, level of physical activity and fitness to practice. physical activity by completing specific questionnaires for these purposes. Subsequently, women who were in amenorrhea for more than twelve consecutive months and able to practice physical activity were invited to participate in the intervention. Combined aerobic and resistance exercise were performed for 8 weeks at different intensities. Participants were divided into 2 groups: high intensity (AI) and moderate intensity (MI). Before and after the intervention, anthropometric data (weight, height, body mass index - BMI and waist circumference - AC), body composition assessment by bioimpedance, blood pressure, heart rate (HR), laboratory tests (blood glucose) were evaluated. fasting (GJ, total cholesterol - TC, HDL-c, LDL-c, triglycerides - TAG, glycated hemoglobin) and quality of life assessment by the SF-36 questionnaire. The collected data were analyzed as mean ± standard error before and after the intervention, and delta mean (mean after 8 weeks of physical training - baseline mean) ± standard error by ANOVA (p <0.05). The results showed that there was an improvement in glycemic control, blood pressure levels and body composition after intervention in both groups. HDL-c and TAG improved only in the AI group while LDL-c reduced only in the MI group. Quality of life improved only in the MI group, in the domains functional capacity, pain and mental health. In conclusion, our study showed that 8 weeks of combined aerobic and resistance exercise, both at high and moderate intensity, was effective in promoting health improvements in postmenopausal type 2 diabetic women.