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Rowing and Cycling Reduce Inflammation in Early-Stage Type 2 Diabetes
Condition(s) studied
Diabetes
Investigational drug(s) / intervention(s)
Continuous Exercise - Cycling GroupRowing Ergometer High-Intensity Interval TrainingCombined Training Standard
Continuous Exercise - Cycling Group: Warm-up: 5 minutes of low-intensity cycling (50-60 W, approximately 40%-50% HRmax of continuous power cycling at) Main Training: 40 minutes 65%-75% HRmax (approximately 60%-70% VO₂peak), maintaining a cadence of 60-80 rpm Cool-down: 5 minutes of low-intensity cycling followed by stretching Total Duration: 50 minutes
Rowing Ergometer High-Intensity Interval Training: Warm-up:
5 minutes of low-intensity rowing at approximately 50% of maximum heart rate (HRmax).
Main Training:
24 minutes of interval training consisting of 4 sets of high-intensity rowing for 4 minutes each (85%-90% HRmax), with 2 minutes of low-intensity active recovery (50%-60% HRmax) between each set. Maintain a stroke rate of 24-30 strokes per minute (SPM) for high-intensity intervals and 18-22 SPM for recovery intervals.
Cool-down:
5 minutes of low-intensity rowing combined with stretching.
Total Duration:
34 minutes
Combined Training Standard: Warm-up:
5 minutes of low-intensity activity (choose either cycling or rowing).
Rowing Machine Segment:
20 minutes at an intensity of 65%-75% of maximum heart rate (HRmax) (approximately 60%-70% of VO₂peak), with a stroke rate of 22-26 strokes per minute (SPM).
Bicycle Segment:
20 minutes at an intensity of 65%-75% of HRmax (approximately 60%-70% of VO₂peak), with a cadence of 60-80 revolutions per minute (rpm).
Cool-down:
5 minutes of stretching.
Total Duration:
50 minutes
Study summary
This multicenter randomized controlled trial evaluates the short-term (7-day) effects of different rowing-cycling exercise regimens on postprandial glycemic excursions in newly diagnosed type 2 diabetes patients (aged 18-60 years, diagnosis ≤12 months, drug-naïve). A total of 120 participants will be randomized into five groups: control, moderate-intensity continuous cycling, high-intensity interval rowing, and standard combined exercise (rowing + cycling, 50 min). The primary outcome is inflammatory cytokines (IL-6, TNF-α, IL-1β, IL-1ra, IL-10, hs-CRP), body Composition and functional Indicators. Secondary outcomes include change in continuous glucose monitoring-derived glycemic variability (CONGA), and time-in-range. Mixed-effects models will quantify dose-response relationships and identify key effect modifiers (e.g., age). This study aims to establish an evidence-based precision exercise prescription for early-stage type 2 diabetes management.
Eligibility
Inclusion Criteria:
1. Age between 18-60 years, no gender limited;
2. Meeting the WHO 1999 diagnostic criteria for T2DM, with a diagnosis time ≤12 months;
3. Not having received hypoglycemic drug treatment (or only lifestyle intervention, and stopped medication ≥4 weeks before enrollment);
4. Fasting blood glucose 7.0-13.9 mmol/L, glycated hemoglobin (HbA1c) 6.5%-10.0%;
5. No regular exercise in the past 3 months (less than 2 times per week of moderate or higher intensity exercise, each \<30 minutes);
6. Voluntarily signing the informed consent form.
Exclusion Criteria:
1. Type 1 diabetes, gestational diabetes, or other special types of diabetes;
2. Severe cardiovascular or cerebrovascular diseases (NYHA heart function ≥III, recent myocardial infarction or unstable angina);
3. Uncontrolled hypertension (resting systolic blood pressure ≥160 mmHg or diastolic blood pressure ≥100 mmHg);
4. Severe liver or kidney dysfunction (ALT/AST ≥3 times the upper limit of normal, or eGFR\<60 mL/min/1.73m²);
5. Severe diabetic complications (such as proliferative retinopathy, severe neuropathy, diabetic foot);
6. Pregnant or breastfeeding women;
7. Mental illness or cognitive impairment that prevents compliance with the study;
8. Stress events such as infection, trauma, or surgery in the past month;
9. Participation in other interventional clinical studies;
10. Musculoskeletal diseases of the upper or lower limbs that affect rowing machine or bicycle exercise.
Primary outcome measure(s)
- inflammatory cytokines — 1.4 weeks
IL-6 (Interleukin-6) - The first muscle factor induced by exercise, is the core molecule connecting exercise to systemic anti-inflammatory effects. IL-6 produced by skeletal muscles during exercise inhibits TNF-α and stimulates IL-1ra to exert anti-inflammatory effects. Different exercise patterns have varying regulations on IL-6, with both aerobic training and combined training significantly reducing IL-6 levels in T2DM patients.
TNF-α (Tumor Necrosis Factor Alpha) - A key pro-inflammatory factor in insulin resistance in T2DM. Exercise improves insulin sensitivity by inhibiting the production of TNF-α. Meta-analyses confirm that exercise significantly reduces TNF-α levels in T2DM patients.
hs-CRP (High-sensitivity C-reactive protein) - A classic marker of systemic low-grade inflammation, identified as a key baseline biomarker to distinguish well-controlled T2DM patients from healthy adults.
- Body Composition — 1.4 weeks
DEXA to detect body fat percentage (BF%) and skeletal muscle index (SMI)
- maximal oxygen uptake (VO₂max) — 1.4 weeks
Cardiopulmonary exercise testing to determine maximal oxygen uptake (VO₂max)
Trial sites (1)
| Facility | City | Region | Status |
|---|
| The Ethics Committee of Putian 95 Hospital |
Putian |
Fujian |
|
More The 95th Hospital of Putian，Putian, Fujian, China trials in China
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