Journal of Exercise & Organ Cross Talk

Abstract This randomized controlled trial evaluated the effects of combined mobile-based digital education ("DiabetiFit Pro") and aerobic-resistance exercise on treatment adherence, glycemic control, and tissue markers (lipotoxicity, sarcopenia, and necrosis) among underserved type 2 diabetes patients. In this 12-week RCT, 250 patients (mean age 54.3±10.7 years; HbA1c 9.2%) from underserved Iranian regions were randomized to intervention (n=125; 3 weekly sessions: 10-min app-based education + 35-50 min ACSM-guided exercise) or control (n=125; usual care). Primary outcomes were HbA1c and MMAS-8 adherence scores. Secondary outcomes included glycemic variability and tissue biomarkers. Analysis used ITT with ANCOVA, regression, and χ² (α=0.05). Intervention produced superior HbA1c reduction (-1.70% vs -0.70% control; between-group diff: -1.00%, η²=0.18, p<.001) and adherence gains (+1.30 vs +0.40 points; η²=0.16, p<.001). High adherence increased from 23.2% to 48.8% (χ²=22.45, p<.001). Dose-response: modules completed explained 11.5% HbA1c variance (β=-0.34); app hours predicted 16.8% adherence variance (β=0.41). Favorable lipotoxicity/ sarcopenia improvements observed. Combined digital education-exercise interventions significantly enhance adherence, glycemic control, and tissue health in underserved T2DM populations, demonstrating dose-response efficacy and clinical meaningfulness per ADA standards. Health systems should scale such integrated mHealth platforms.

Abstract This study aimed to investigate the effects of eight weeks of resistance training (Ex), vitamin D supplementation (VD), and their combination (VD+Ex) on insulin resistance (HOMA IR), glycemic control (HbA1c, fasting glucose), inflammatory markers (interleukin 6 [IL 6] and C reactive protein [CRP]), and anthropometric measures in men with T2DM. In this single blind randomized controlled trial, 40 men with T2DM (aged 40–55 years) were randomly allocated into four groups (n=10 each): placebo control (PI), vitamin D supplementation (2000 IU/day, VD), resistance training (three sessions/week, 60–70% of 1RM, progressive overload, Ex), and combined VD+Ex. All participants maintained their usual diet, lifestyle, and anti diabetic medications. Fasting blood samples were collected pre and post intervention to measure serum glucose, insulin, 25 hydroxy vitamin D, IL 6, and CRP. HOMA IR was calculated. Post hoc analysis showed that the Ex group had significantly lower HOMA IR than the placebo group (p=0.002), and the VD+Ex group had significantly lower HOMA IR compared to both placebo (p<0.001) and VD alone (p=0.001). The comparison between VD+Ex and Ex was not statistically significant (p>0.05). No significant difference in HbA1c was observed (p=0.210). For body fat percentage, both Ex (p=0.043) and VD+Ex (p<0.001 vs. placebo;p=0.009 vs. VD) showed significant reductions. IL 6 levels were significantly lower in the Ex and VD+Ex groups compared to placebo and VD groups (p<0.001 for both). No significant changes were found in CRP levels (p=0.078).

Abstract Type 2 diabetes in older adults is characterized by chronic low-grade inflammation and oxidative stress, with elevated interleukin-1β (IL-1β) and reduced superoxide dismutase (SOD) activity playing central roles in disease progression.  This study aimed to investigate the independent and combined effects of eight weeks of moderate-intensity aerobic exercise and NBS superfood supplementation on serum IL-1β and SOD levels in elderly men with type 2 diabetes. Forty older men (aged 60–75 years) with type 2 diabetes were randomly allocated using stratified block randomization to four groups (n=10 each): control, exercise-only (TR), supplement-only (SUP), and exercise + supplement (TR+SUP). The exercise groups performed supervised cycling at 60–70% Wmax, 30 min/session, 3 sessions/week for 8 weeks. The supplementation groups received 10 g/day NBS superfood. Fasting serum IL-1β and SOD were measured before and 48 hours after the intervention using ELISA. Two-way repeated-measures ANOVA revealed significant time × group interactions for both IL-1β (p<0.001, η²p=0.372) and SOD (p<0.001, η²p=0.892). Post-hoc tests showed the greatest reductions in IL-1β and largest increases in SOD occurred in the TR+SUP group compared to all other groups (p<0.001), indicating a synergistic effect. Eight weeks of moderate-intensity aerobic exercise combined with NBS superfood supplementation exerts potent synergistic anti-inflammatory and antioxidant effects in older men with type 2 diabetes, suggesting a promising non-pharmacological strategy for managing chronic inflammation and oxidative stress.

Abstract Crosstalk between muscle and adipose tissue via myokines and adipokines has critical implications for the metabolic regulation of type 2 diabetes. Irisin and adipolin are key secretory proteins involved in glucose homeostasis and anti-inflammatory pathways, yet the combined impact of pharmacological and physical interventions on their metabolism remains insufficiently characterized. This experimental study investigated the effects of metformin therapy and structured exercise on serum levels of irisin and adipolin, as well as related metabolic parameters, in male diabetic rats. Type 2 diabetes was induced in male Wistar rats (fasting glucose >250 mg/dl), while the healthy control group maintained normal glucose levels (~95 mg/dl). Animals were randomly assigned to control, metformin, or exercise (combined aerobic and resistance training) groups. Over eight weeks, interventions were administered and serum irisin, adipolin, and fasting blood glucose were measured pre- and post-intervention. Data were analyzed using the Shapiro–Wilk test, ANOVA, and Tukey post hoc tests. Results showed that both metformin and exercise significantly increased adipolin levels (p<0.01). As expected, irisin levels were higher in the non-diabetic control group compared to diabetic groups (p<0.05), consistent with the known reduction of irisin in diabetes. Fasting glucose improved most notably in the exercise group. These findings indicate that metformin and exercise exert distinct yet complementary effects on key metabolic regulators—adipolin and irisin—highlighting the benefits of integrating pharmacological and lifestyle approaches in type 2 diabetes management. Future research should explore underlying molecular mechanisms and translational potential in human populations.

Abstract Fat mass and obesity-associated gene (FTO) is directly associated with increased risk of obesity and type 2 diabetes mellitus (T2DM). The purpose of current study was to investigate the effect of 12 weeks of resistance training (RT) on FTO expression in subcutaneous adipose tissue, glucose, and insulin levels in T2DM rats. Sixteen males Wistar rats (220±10 gr) with T2DM induced by streptozotocin-nicotinamide injection were randomly assigned into resistance training (RT; n=8) and control (Con; n=8) groups. RT was performed for 12 weeks, 5 days per week. FTO expression in subcutaneous adipose tissue, fasting blood glucose (FBS), insulin and insulin resistance (HOMA-IR) were measured 48 hours after the last exercise training session.   After the exercise training intervention, the FTO expression (p=0.004) and FBS (p=0.001) were significantly lower in the RT compared to the Con group while the insulin in the RT was significantly higher than that in the Con group (p=0.001). There was no significant difference in the insulin resistance between the two groups (p˃0.05). According to findings, it seems that RT can decrease FBS and FTO expression in subcutaneous adipose tissue of T2DM rats. Improved blood glucose in diabetic rats might be partially attributed to reduced FTO expression in response to RT.