Age and Ageing Advance Access published online on October 25, 2007
Age and Ageing, doi:10.1093/ageing/afm127
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Effects of Tai Chi on glucose homeostasis and insulin sensitivity in older adults with type 2 diabetes: a randomised double-blind sham-exercise-controlled trial
1 School of Exercise and Sport Science, Faculty of Health Sciences, University of Sydney, Australia
2 Department of Family Medicine, University of New South Wales, Australia
3 Senior Research Fellow, School of Public Health and Community Medicine, University of New South Wales, Australia
4 Faculty of Medicine, University of Sydney, Sydney, Australia; Hebrew Rehabilitation Center for Aged and Jean Mayer USDA Human Nutrition Center on Aging at Tufts University, Boston, MA, USA
Address correspondence to: T. Tsang. Tel: 612 9894 8003; Fax: 612 9680 8377. Email: ttsa6920{at}mail.usyd.edu.au
Background: a large proportion of adults with type 2 diabetes remain sedentary despite evidence of benefits from exercise for type 2 diabetes. Simplified Yang Tai Chi has been shown in one study to have no effect on insulin sensitivity in older adults. However, a modified Tai Chi form, Tai Chi for Diabetes (TCD) has recently been composed, claiming to improve diabetes control.
Methods: subjects were randomised to Tai Chi or sham exercise, twice a week for 16 weeks. Primary outcomes were insulin resistance 72 h post-exercise (HOMA2-IR), and long-term glucose control (HbA1c).
Results: thirty-eight subjects (65 ± 7.8 years, 79% women) were enrolled. Baseline BMI was 32.2 ± 6.3 kg/m2, 84% had osteoarthritis, 76% hypertension, and 34% cardiac disease. There was one dropout, no adverse events, and median compliance was 100 (0 – 100)%. There were no effects of time or group assignment on insulin resistance or HbA1c ( –0.07 ± 0.4% Tai Chi versus 0.12 ± 0.3% Sham; P = 0.13) at 16 weeks. Improvement in HbA1c was related to decreased body fat (r = 0.484, P = 0.004) and improvement in insulin resistance was related to decreased body fat (r = 0.37, P = 0.03) and central adiposity (r = 0.38, P = 0.02), as well as increased fat-free mass (r = –0.46, P = 0.005).
Conclusions: TCD did not improve glucose homeostasis or insulin sensitivity measured 72 h after the last bout of exercise. More intense forms of Tai Chi may be required to produce the body composition changes associated with metabolic benefits in type 2 diabetes.
Keywords: Tai Chi, diabetes mellitus, type 2, insulin resistance, elderly
Received 19 July 2006; accepted in revised form 27 June 2007.
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