Effect Of Aerobic Training On Cognitive Function And Brain Functional Structure In Patients With Type 2 Diabetes Mellitus

Objective:The purpose of this study was to evaluate the difference on cognitive function and brain functional structure between exercise group and control group by performing regular one-year moderate-intensity aerobic training in type 2 diabetes mellitus(T2DM)with normal cognitive function,providing scientific basis for the early prevention and delay of cognitive dysfunction in T2DM patients.Methods:This was a randomized controlled trial study.A total of 100 patients with T2DM were randomized into the aerobic training group(AT,n=50)and control group(n=50).The control group followed the primary lifestyle without exercise intervention and recorded 24 hours dietary intake.The aerobic training group participated in moderate-intensity aerobic rhythm exercise 3 times per week for 60 minutes within one-year.Before and after one year of exercise training,biochemical Indicators(HbA1c,blood glucose,insulin,lipid profile)were tested,brain hippocampal volume was calculated.In addition to this,cognitive function(MMSE,MoCA),well-being index(WHO-5)and diabetes-related emotional distress(PAID-5)were also evaluated.Results:100 participants with type 2 diabetes mellitus were recruited in the study.A total of 82 participants finally completed the study(40 in the aerobic training group,42 in the control group).Before intervention,there were no significant difference in demographic and clinical characteristics of two groups at baseline(P>0.05).After one-year intervention,the difference value of WC,FPG,30minPG,HOMA2-?,?I30/?G30,right hippocampal and the total hippocampal volumes were significant difference between two groups(P=0.029,P=0.021,P=0.036,P=0.003,P=0.046,P=0.043,P=0.027,respectively).In within-groups analyses,compared to the baseline,BMI,SBP,DBP,2hPG and HDL-c were significant difference in aerobic training group after intervention(P=0.023,P<0.001,P<0.001,P=0.006,P=0.004).In terms of cognitive function,a significant decrease in MMSE,Memory capacity and MoCA were observed in aerobic training group compared to control group(P=0.045,P=0.032,P=0,018).On the well-being and problems areas in diabetes,no substantial changes were noted between groups in the score of WHO-5 and PAID-5.Conclusions:1.After one year,moderate-intensity aerobic training can effectively increase the right hippocampal and the total of hippocampal volume.2.After one year,moderate-intensity aerobic training can improve cognitive function,especially in terms of memory capacity.3.After one year,no significant differences were found in the WHO-5 and PAID-5 between group.However,moderate-intensity aerobic training had a tendency to increase well-being index and reduce the diabetes-related emotional distress levels.4.After one year,moderate-intensity aerobic training can improve beta cell function and early insulin secretion index.