Association of Aerobic Physical Activity and Resistance Exercise with Glycated Hemoglobin in Women with Diabetes

The American Diabetes Association recommends that patients with diabetes engage in at least 150 minutes of physical activity (PA) per week and perform resistance exercise (RE) at least twice weekly. However, their benefits in controlling glucose levels among women with diabetes are not completely understood. Therefore, we investigated whether meeting PA or RE guidelines is associated with lower odds of uncontrolled glycated hemoglobin (HbA1c) among women.

We analyzed 1213 women with diabetes from the Korea National Health and Nutrition Examination Survey 2014-2018. Using PA questionnaires, participants were categorized according to whether they met aerobic PA guidelines (≥150 minutes of moderate-to-vigorous PA), RE guidelines (≥twice weekly), or both. Further, HbA1c levels >7.5% were classified as uncontrolled glycemic levels. Multivariate logistic regression models were employed to investigate whether meeting PA or RE guidelines is associated with uncontrolled HbA1c.

There was no association between meeting aerobic PA guidelines of >150 minutes per week and uncontrolled HbA1c. However, participating in RE > twice weekly was associated with a 49% lower odds of HbA1c >7.5% in fully adjusted models (odds ratio: 0.51; 95% confidence interval: 0.30-0.87; p<0.05). Moreover, the association between RE participation and lower odds of HbA1c >7.5% was observed regardless of age, body mass index, and prevalence of hypertension.

Participation in RE may be important for women with diabetes for glycemic control. Further research is needed to better understand the associations between HbA1c and different exercise modalities (i.e., resistance vs. aerobic exercise) in women with diabetes.