---

Background: Combination of physical activity and pharmacotherapy in diabetes may augment the effects of the drug and may allow lower doses of medication that can minimize the side effects. The goal of the study was to determine the effectiveness of aerobic training and Glibenclamide combination in type 2 diabetes.
Methods: A total of 28 men with type 2 diabetes were divided to 3 groups randomly: Glibenclamide (5 mg daily) only, Glibenclamide (5 mg daily) plus aerobic training, Glibenclamide (2.5 mg daily) plus aerobic training. Aerobic training protocol was performed for 12 week, 3 days (session) a week, 45 minutes in a session (ergo cycle program at 60-70 % heart rate reserve). Fasting glucose, HbA1c, fasting insulin, c-peptide, and insulin resistance were measured at pre, mid and post treatment periods. Analysis of Variance test (ANOVA) were used to evaluate data.
Results: HbA1c significantly decreased and c-peptide significantly increased in three groups (P<0.05).There were also no between-group differences for c-peptide and HbA1c (P>0.05). Fasting insulin concentration did not alter in three groups, however, insulin resistance decreased ( no significant ) after 12 weeks.
Conclusion: In type 2 diabetic patients, Glibenclamide treatment alone or combination of aerobic training and Glibenclamide treatment, was effective in improving glycemic control in patients with type 2 diabetes .As a result, in patients with type 2 diabetes, the addition of aerobic training to Glibencelamide treatment allow lower doses of Glibenclamide to be used without impairment in glycemic control.

---

Background: Diabetes is considered as one of the health problems in all societies. Exercise training and drug interventions, especially herbal medicines, consider as approaches to improving diabetes. The objective of this study was to investigate the effect of 6 weeks of aerobic training and Pistacia atlantica extract consumption on pancreatic β-cells function in streptozotocin-induced diabetic rats. Methods: Thirty six male Wistar rats divided into five groups: normal control, diabetic control, diabetes+aerobic training, diabetes+extract, diabetes+aerobic training+extract. Diabetes was induced by intra-peritoneal injection of streptozotocin (40mg/kg). Exercise program was include 6 weeks of aerobic training on a treadmill (5 sessions per week, 40 minutes per session, with a speed of 20m/min and 5% incline). Extract groups were received Pistacia atlantica extract based on body weight, at the end of each training session. After 6 weeks of aerobic training and Pistacia atlantica extract consumption, plasma glucose and insulin levels were measured for determination of β-cells function (HOMA-B). Data were analyzed via ANOVA, with a significant level P<0.05. Results: HOMA-B index in diabetic control group was significantly higher than normal control group (P=0.0001). Also mean of HOMA-B index in diabetes+extract and diabetes+exercise training+extract groups was significantly lower than diabetic control group (P values 0.003, 0.001 respectively) and between mean of HOMA-B index in diabetic control group with diabetes+aerobic training group were observed no significant differences (P=0.052). Conclusion: The results of this study showed that Pistacia atlantica extract consumption, alone and along with aerobic training leads to significant improvement in pancreatic β-cells function in diabetic rats. Also extract consumption along with aerobic training in comparison to training alone has had greater impact on the improvement of pancreatic β-cells function. It seems that aerobic training along with the use of specific herbal plants can be considered as a complementary therapy in improvement of diabetics.

---

Background: This study was conducted to determine the effect of 12 weeks of aerobic training on serum levels of vaspin and glucose homeostasis variables in patients with type 2 diabetes. Methods: In this quasi-experimental study, 20 women with type П diabetes (mean±SD: age 43.30 ±3.02 yr, body mass index 27.089±3.23 kg/m2 and body fat 29.46 ±2.71%) were randomized into experimental (n = 10) and control (n = 10) groups. Experimental group performed twelve weeks aerobic training (3 times per week at an intensity of 75-85 % of maximum heart rate reserve). Blood samples were collected 24h before and 48h after the training. Data was analyzed by paired and independent samples t-test (P <0.05). Results: Results showed a significant decrease in serum levels of vaspin, fasting blood sugar and insulin resistance index (P value 0.001, 0.01 and 0.007 respectively) ) in experimental group and body weight, body mass index, percent body fat and waist to hip ratio significantly decreased in experimental group (P value 0.002, 0.01, 0.04 and 0.03 respectively). Conclusion: The results of this study showed that aerobic training along with decrease in body weight and percent body fat leads to significant decrease in serum levels of vaspin, fasting glucose and insulin resistance index, so can be considered as a complementary therapy method in patients with type 2 diabetes.

---

Background: Resistin levels and insulin resistance increase in obese humans. Also, inactive life is associated with high risk of increased insulin resistance. The purpose of this study was to investigate effect of twelve weeks aerobic training on serum levels of resistin, and adiponectin-resistin (AR), homeostasis model assessment-adiponectin (HOMA-AD), and IRAR indices in sedentary obese men. Methods: In a semi-experimental study, twenty one sedentary obese men were randomly placed into two groups: aerobic training (n=10, 27.8±3.2 yr, 93.5±7.1 kg, 31.7±3.4 %, BMI 32.0±3.5 kg/m2) and control (n=11, 27.1±3.1 yr, 94.7±6.0 kg, 31.2±3.1 %, 32.2±3.3 kg/m2). General characteristics of subjects, serum levels of resistin, and HOMA-AD, AR, and IRAR indices were assessed before and after training. Aerobic training consisted of twelve weeks pedaling on cycle ergometer (3 sessions per week, intensity 60-70% of reserved heart rate, duration of each session 20-40 min). Data analyzed by SPSS16 software. Statistical significance was considered at P<0.05. Results: After the training period, serum levels of resistin (P=0.016), HOMA-AD (P=0.007), AR (P=0.020) and IRAR (P=0.003) were reduced, while none of mentioned parameters in control group did not change significantly (P>0.05). Conclusion: Circulating levels of resistin and HOMA-AD, AR, and IRAR, that are novel indices for insulin resistance, were reduced after twelve weeks aerobic training. Therefore, sedentary obese men can reduce risk of type 2 diabetes and cardiovascular diseases with performing aerobic training.

---

Abstract: Pancreatic β-cells function and insulin sensitivity resistance were impaired in type 2 diabetes. Exercise training may improves these impairs, however, this is not well known. The aim of present study was to examine the Effect of 8 weeks aerobic training on pancreatic β-cells function and insulin resistance in female patients with type 2 diabetes.
Methods: Twenty middle-aged women (age, 40 -50 years) with type 2 diabetes participated as the subject. The subjects were randomly assign to control group (n=10) or the training group (n=10). The subjects in the training group performed 30 to 45 min aerobic training on the treadmill with 60- 75% of their maximum heart rate, 3 days a week for 8 weeks. The subjects in the control group were instructed to maintain their normal physical activity throughout the study.
Results: The results indicated that fasting blood sugar, fasting insulin and insulin resistance index decrease in the training group compare to the control group (P<0.05); however, pancreatic β-cells function has no significant change after the intervention (P=0.2).
Conclusion: In summary, it seems that aerobic training utilized in this study improves glucose entry into cells but it had not effective on pancreatic β-cells function.

---

Background: The mTORC1 pathway is one of the important pathways for protein synthesis in the heart, which can lead to physiological or pathological hypertrophy. Diabetes can lead to defects in this pathway. The aim of this study was to examine the effect of 4 weeks’ aerobic training on the content of mTORC1 signaling pathway proteins in heart tissue of type 1 diabetes rats.

Methods: In this experimental study, 16 Sprague-Dawley male rats (mean weight of 300 ± 20 gr) were selected and after induction of diabetes by STZ was randomly assigned into two groups: diabetic training and diabetic control. The experimental group performed HIIT training for 4 weeks’ accordance with the training program (each session 42 minutes, 10-20 m/m) for 4 weeks, while the control group did not have any training program. Dependent t-test and independent T-test were used to analyze the data
 

Results: Significant increase was observed in the content of AKT1 (p<0.015), mTOR (p<0.001), P70S6K1 (p<0.006), 4EBP1 (p<0.05) proteins in the aerobic training group compared to control group.
Conclusion: Aerobic training for 4 weeks enabled to activate the pathway AKT1/mTOR/P70S6K1 and AKT1/mTOR/4E-BP1 in mTORC1 pathway; therefore, due to cardiac complications in type 1 diabetic patients, aerobic training can lead to protein synthesis and physiological cardiac hypertrophy through mTORC1 pathway.
 

---

Background: Obesity increases the risk of developing type 2 diabetes with regard to the hormones involved. The purpose of this quasi-experimental study was to investigate the effect of aerobic exercise on Dpp-4 and GLP-1 in obese women with type 2 diabetes.
Methods: From among obese women with type-2 diabetes mellitus 35-50 years old referred to the Diabetes Association of Saveh, 20 people were voluntarily selected and randomly assigned to two groups of control (10) and Experiment group (10) were divided. Twenty four hours before the beginning of the training, the individual characteristics of the subjects included age, height, weight, body mass index and research variables (insulin resistance, Dpp-4 and GLP-1) in the pre-test and the training group Aerobic exercise lasted for 8 weeks, 3 sessions per week, and 45-60 minutes each session, and the control group did not practice. After 8 weeks and 24 hours after the last training session, the individual characteristics and variables of the research were again measured. Data were analyzed by independent t-test and dependent t-test at p≤0.05.
Results: There was a significant increase in the level of GLP-1 (P= 0.001) and a significant decrease in DPP-4 level (P= 0.001) in the aerobic exercise group compared to the control group.
Conclusion: Results showed that Dpp-4 and GLP-1 values were significantly different in aerobic training group after 8 weeks compared to control group. It was also found that aerobic training significantly increased the level of GLP-1 and decreased the level of DPP-4.

---

Background: Cardiomyopathy is one of adverse effects of diabetes that associated with cardiac muscle metabolism and function disruption. Exercise training decreases adverse effects of diabetes on heart by changing genes involved in cardiac metabolism and increasing myokines secretion. So, the aim of this study was to investigate of 8 weeks aerobic training on cardiac PGC-1α gene expression and plasma irisin in STZ-induced diabetics’ rats.
Methods: 16 STZ-induced diabetics Wistar rats (10 weeks old) divided into control and aerobic training groups. Time and intensity of exercise session began with 15 minutes and 10 m/min, and gradually increased to 40 minutes and 25 m/min at seventh week and kept to the end of eighth’s week (8 weeks). Cardiac PGC-1α gene expression analyzed by PCR, and plasma concentration of insulin, glucose were analyzed by ELISA method 48 hours after the last session of exercise training. Data were analyzed by independent t test at alpha level of 0/05.
Results: the results showed that aerobic exercise training increased PGC-1α concentration (P<0/001) and plasma irisin (P<0/001). Further analysis showed that aerobic exercise training decreased glucose concentration (P<0/001) and increased insulin concentration (P<0/001), but had no effect of insulin resistance (P=0/79). In addition, the results revealed that there is a positive correlation between PGC-1α and plasma irisin (P<0/001) and insulin (P=0/019), but it has a negative correlation with plasma glucose (P=0/001). There is also a positive significant correlation between isirin and insulin (P=0/001), and a negative correlation between irisin and glucose (P=0/002).
Conclusion: The findings suggest that aerobic exercise training induces increased cardiac PGC-1α gene expression and plasma irisin. These changes have a significant correlation with lowered glucose and increased plasma insulin insulin in STZ-induced diabetics’ rats.
 

---

Background: Nesfatin-1 is an adipokine that released by adipose tissue and participated in the regulation of insulin activity and glucose metabolism. The aim of this research is the investigation the effect of aerobic training and walnut consumption on nesfatin-1 and insulin resistance index of women Type 2 diabetes.

Methods: 40 women aged 40 to 50  years old with type 2 diabetes after homogenization based on Bruce test were selected through targeted sampling and they were randomly assigned to four groups of training, walnut, training + walnut and control (each group was 10). The 8-week aerobic training was three sessions per week for 16 minutes with 65% of maximal heart rate in the first week, while in the eighth week it reached 30 minutes with 80% of maximal heart rate. The walnut groups each day replaced 25 to 27 grams of walnuts as part of a diet rich in PUFA fatty acids, replacing one third of total dietary fat. 24 hours before the first session and 48 hours after the last session of the protocol, all subjects received blood samples. The inter-subject inter-analysis variance analysis was used. The significance level was considered as P <0.05.

Results: In the training groups, weight, body mass index, glucose, insulin and insulin resistance decreased significantly and the maximum oxygen consumption and nesfatin -1 increased significantly(P<0.05). 

Conclusion: Aerobic training with this intensity and amount can be recommended as auxiliary treatment for type 2 diabetic women. Walnut consumption with this value did not affect the level of blood glucose, insulin resistance index and nesfatin-1 in type 2 diabetic women. It is recommended that high-dose walnuts be used for effective operation.

---

Background: Skeletal muscle as an endocrine tissue is involved in the regulation of metabolic activity, production and secretion of hormones including myokines. The aim of the present study was to investigate the effect of eight weeks of aerobic training combined with ethanol consumption on plasma lipid profile and glucose levels, triglyceride content and mayonectin, irisin and leptin gene expression in the gastrocnemius muscle in male rats.
Methods: A number of 32 rats with a weighing average of 200 ± 10 g were divided into four groups control, aerobic training, ethanol with dose of 4 g/kgbw, and ethanol +aerobic training. At the end of the period, values of lipid profile and plasma glucose, the amount of triglyceride of the gastrocnemius muscle and the relative levels of mayonectin, irisin and leptin gene expression were evaluated. Data were analyzed using two-way ANOVA.
Results: The plasma triglyceride levels in the aerobic training and ethanol+aerobic training groups were significantly decreased compared to the control group (P≤0.05). The gastrocnemius muscle triglyceride values were significantly increased in the ethanol +aerobic training (P≤0.0001) and aerobic training groups (P≤0.01) compared to the control group. The results showed that aerobic training significantly increased myonectin gene expression in aerobic training group (P≤0.05), but the expression of irisin and leptin genes did not change significantly in different groups.
Conclusion: Aerobic training during the eight-week was able to improve lipid content, especially plasma triglyceride and skeletal muscle triglyceride, and possibly regulate body metabolism by altering the levels of myokines, especially myonectin.

---

Background: Imbalanced production of adipokines as leptin and adiponectin in diabetic patients may lead to the development of metabolic complications. Therefore, the aim of this study was to determine the effects of 2-month of caffeine ingestion along with aerobic training on changes in serum leptin and adiponectin levels and leptin/adiponectin ratio (LAR) in type 2 diabetic men.
Methods: Thirty-two diabetic men participated in a quasi-experimental designs in the four groups for two-months period of a aerobic training (treadmill walking 3 times/week, 1.5 hour/session, 65-85% HRR) with and without caffeine ingestion (3 mg.kg^-1.day). Serum changes in leptin and adiponectin were measured during two phases (baseline and 24-hours after completing of the training program). Data were analyzed by one-way ANOVA and bonferroni's post-hoc test at level P≤0.05.
Results: Administration of two-months caffeine (CA) alone and combination with aerobic training (AT) were significantly could reduced and increased in leptin and adiponectin level, respectively (P=0.001). Thus, the combined group (AT+CA) effect were far more appropriate intervention in changing the studied indices (P=0.001). Also, the LAR method was notable reduced in all study groups, although these effects were more significantly in the combined group (AT+CA) (P=0.001).
Conclusion: It seems administration of caffeine supplementation and aerobic training for two-months have a positive effects on the improved relative of leptin and adiponectin levels as well as their ratio in diabetics, although the combination of these two variables has been shown to have far more dual effects.

---

Background: Cardiovascular disease is a major cause of death in patients with type 1 diabetes, and cardiovascular risk remains high even in patients with type 1 diabetes with good metabolic control. The aim of this study was to evaluate the effect of six weeks of aerobic exercise on inflammation and damage indicators of heart tissue in type 1 diabetic male rats.
Methods: In this experimental study, 19 male Wistar rats (mean weight 200-250 g) were randomly divided into four groups: aerobic training, sham, control and healthy. In this study, induction of type 1 diabetes was performed by injecting a single dose of streptozotocin dissolved in sodium citrate buffer intraperitoneally. Aerobic exercise program was performed with intensity of 50-60% VO2max, 5 days a week for 6 weeks. After anesthesia, an autopsy was performed and left ventricle of the heart was removed. Levels of Tumour necrosis factor α (TNF-α), Peroxisome proliferator-activated receptor-γ coactivator (PGC-1α) and Creatine kinase (CK) in rat heart tissue were measured by Western blotting. Data were analyzed by One-way ANOVA and Tukey post hoc test at the P<0.05.
Results:  The results showed that six weeks of aerobic training led to significant decrease in TNF-α and CK and significant increase in PGC-1α of the heart tissue in type 1 diabetic rats (P<0.001).
Conclusion:  According to the results, it seems that aerobic training can help improve the inflammation and damage indicators of heart in type 1 diabetes.

---

Background: Obesity has been recognized as one of the top 10 health problems by the World Health Organization. The purpose of the present study was to the effect of aerobic training on atrogin, eotaxin and IL-10 indices in obese women. 

Method: The present applied research was a quasi-experimental study in which 30 obese women aged 30-45 years were selected by available method from South Tehran Azad University (2016-2017) and randomly divided into two groups of aerobic exercise and control. 24 hours before the start of training, the individual characteristics of the subjects and the research variables (atrogen, eutoxin and IL-10) were measured in blood tissue, then the subjects of the experimental group had their training program for 8 weeks, 3 They performed one session per week and each session lasted 45-60 minutes under the supervision of a researcher. Dependent and independent t-test was used to analyze the data.

Results: Due to the lack of differences in pre-test scores, it was found that the groups were identical. It was also found that 8 weeks of aerobic exercise had a significant effect on the levels of eutoxin, atrogen and interleukin-10 in obese women (p = 0.001)

Conclusion: According to the research results, it is recommended that obese women exercise aerobically. Use to reduce the negative effects of obesity.

---

Background: Damage to the heart tissue in diabetics causes inflammation and destruction of heart cells, which in turn leads to apoptosis or cell death. The aim of this study was to investigate compare the effect of six weeks of aerobic and resistance training on apoptotic indice of caspase-8 and catalase in the heart tissue of male diabetic rats.
Method: In this experimental study, 24 male Wistar rats were divided into six groups: aerobic training, resistance training, aerobic sham, resistance sham, control and healthy. Diabetes was induced by intraperitoneal injection of a single dose of streptozotocin in the amount of 30 mg per kg. The aerobic and resistance training program was performed for six weeks. Western blotting was used to measure caspase-8 and catalase. Data were analyzed by one-way analysis of variance and Tukey post hoc test at the P<0.05.
Results: The results showed that the mean difference of caspase-8 between aerobic training group and healthy group (P=0.752), resistance training group with healthy group (P=0.723) and resistance training with aerobic training group (P=1.00) were significant. Caspase 8 was lower in the aerobic exercise group than in the resistance exercise group. The difference between the mean catalase between the aerobic training group with the healthy group (P=0.024) and the aerobic training group with the resistance training group (P=0.023) was significant and the amount of catalase in the resistance training group was higher than aerobic training.
Conclusion: Aerobic and resistance training can reduce the apoptotic index of caspase-8 and increase catalase in the heart tissue of diabetic rats.

---

Background: The present study was conducted to investigate the effect of eight weeks of aerobic training and vitamin D3 supplementation on cardiac irisin protein levels, insulin resistance and lipid profile in rats induced with type 2 diabetes.
Methods: Forty male Wistar rats after induction of type 2 diabetes through the combination of high-fat diet +streptozotocin were randomly divided into five groups: 1) Normal control (NC) ,2) Diabetic Control (DC), 3) Diabetes+ Aerobic Training (DAT) ,4) Diabetes+ Vitamin D3 (DVD) and 5) Diabetes+ Aerobic Training+ Vitamin D3 (DVDAT). Aerobic training program (five times a week with 60% intensity of maximum running speed for one hour) and vitamin D3 supplementation (10000 IU/kg every week) were performed. After anesthetizing the rats, blood samples were taken to evaluate serum glucose, insulin, triglyceride, cholesterol, LDL and HDL levels. The heart tissue was isolated to evaluate the irisin.protein.
Results: The results of the one way analysis of variance showed that the irisin protein level of the heart tissue in DAT, DVD and DVDAT groups had a significant increase of 14.04, 12.28 and 24.56%, respectively compared to DC (P<0.001). Insulin resistance also showed a significant decrease in all intervention groups compared to the DC group (P<0.001); However, HDL, triglyceride and cholesterol levels were significantly decreased in DAT and DVDAT groups compared to DC group (P<0.001).
Conclusion: According to the results, it seems that eight weeks of aerobic training and vitamin D3 supplementation probably improves the insulin resistance index and lipid profile in rats induced to type 2 diabetes through increasing the cardiac irisin.

---

Background: Type 2 diabetes mellitus, like other inflammatory diseases, causes a change in the levels of pro-inflammatory (such as gremlin-1) and anti-inflammatory (such as pentraxin-3) markers. The aim of the present study was to compare the effects of 10 weeks of aerobic and resistance training on serum levels of pentraxin-3, gremlin-1 and insulin resistance in men with type 2 diabetes.
Methods: In this semi-experimental study, 29 men with type 2 diabetes in the age range of 25-45 years were selected and randomly divided into three groups: aerobic training, resistance training and control. Aerobic training program with an intensity of 55-75% of the maximum heart rate and resistance training with an intensity of 55-75% of one repetition maximum was implemented during 10 weeks and 3 sessions per week. Before and after the intervention period, serum levels of pentraxin-3, gremlin-1 were measured and also insulin resistance index was calculated.
Results: In both aerobic (P= 0.039) and resistance (P= 0.019) training groups, pentraxin-3 serum level increased significantly compared to the control group; but there was no difference between the two groups (P= 0.703). Also, serum levels of gremlin-1 and insulin resistance of the aerobic (P= 0.022 and P= 0.040, respectively) and resistance (P= 0.037 and P= 0.031, respectively) training groups showed a significant decrease compared to the control group; Although there was no difference between the training groups (P= 0.815 and P= 0.659, respectively).
Conclusion: This findings demonstrate that both types of aerobic and resistance training are equally effective in improving inflammatory markers and insulin resistance in type 2 diabetes patients.

---

Background: Glucose transporter4 (GLUT4) is the main glucose transporter in skeletal muscle. Impaired GLUT4 expression plays a role in the disorders of glycemic homeostasis. The aim of the present study was to investigate the combined effects of aerobic training and vitamin D3 supplementation on Glut4 protein levels and insulin resistance in the soleus muscle of diabetic rats with STZ and high-fat diet.
Methods: In 40 male Wistar rats type 2 diabetes was induced by 6 weeks high-fat diet followed by streptozotocin injection. Then rats were randomly divided into five groups: Healthy control (HC), Diabetic control (DC). Diabetes+Aerobic training (DAT), Diabetes+Vitamin D3 (DVD) and Diabetes+Aerobic training+ Vitamin D3 (DVDAT). The rats underwent eight weeks of aerobic training and vitamin D3 supplementation. 24h after last session of training and, the rats were anesthetized and soleus muscle was isolated for measurement of Glut4 protein concentrations and serum levels of insulin, glucose, vitamin D3 index were measured.
Results: One-way ANOVA showed that GLUT4 protein levels in DC group was significantly lower than HC group (P<0.001), but in DVDAT group was significantly higher than DC group (P<0.04) and DVD group (P<0.005). Also in DAT group was significantly higher than DVD (P<0.018). The HOMA-IR index also in DVDAT, DAT and DVD groups was significantly lower than DC group (P<0.001).
Conclusion: It seems that Eight weeks of aerobic training with vitamin D3 supplementation improves glucose metabolism in diabetic rats via increasing Glut4 protein levels and improving insulin resistance index.

---

Results: After 12 weeks of combined, aerobic, high intensity and resistance training, anti-inflammatory indices (adiponectin and SFRP5) showed a significant increase compared to the baseline (before starting the training program) (P < 0.05). Regarding pro-inflammatory and anti-inflammatory indicators (IL-6, TNF-α, resistin and leptin), a significant decrease was observed in all groups after 12 weeks of training program (P < 0.05). In this study, a significant improvement in weight loss and blood glucose was observed after 12 weeks of exercise program in all 4 exercise groups (P < 0.05). In the second part of the findings (non-training or durability of training effect), it was resistance training that showed a lower percentage decrease (P < 0.05) in anti-inflammatory indices and an increase in pro-inflammatory and inflammatory indices after 12 weeks of non-training, which showed the durability It shows more recovery in obese type 2 diabetic patients (P < 0.05).
Conclusion: The findings of the research showed that high-intensity interval training after 12 weeks can cause a greater effect on inflammatory, pro-inflammatory and anti-inflammatory indicators compared to aerobic, combined and resistance training. But this is the resistance exercise that caused the reduction in inflammatory, pro-inflammatory indicators and increase in anti-inflammatory indicators in obese type 2 diabetic patients to be more permanent.