Titel The impact of combined exercise programme in prediabetic, overweight or high risk individuals By Bandar Alharbi 1

Hemoglobin A1c(HbA1c) 5.7% to 6.4%

Risk factors can be used as predictors for prediabetes conditions Body Mass Index( BMI) ≥25kg/m2) and waist size ≥ 94cm for male and ≥80cm for female. Being 45 years or older A family history of diabetes Being physically inactive HDL below 0.90 mmol/L TRG above 1.7 mmol/L BP  140/90 mmHg or on therapy for hypertension

prevalence of prediabetes 37% of united states adult older than 20 years had prediabetes( nearly 86million) In England the rate increase from11.6% to 35.3% from 2003 to 2011 The word wide estimated to 7.8%(nearly 343 million) Expected to be 471 million globally by 2035 Between 5% to 10% of individuals with prediabetes progress to type2 diabetes in yearly basis

Aim of the study Prediabetes (based on ADA diagnostic criteria). Adults with metabolic syndrome. Adults who are overweight (BMI 25 kg/m2 and above) Women with history of gestational diabetes First-degree relative with diabetes Physical inactivity with age between 18-60

Objectives Ethical approvals. Learn first aid, phlebotomy, defibrillation techniques, ECG interpretation, oxygen administration and adrenaline administration. Perform OGTT,HbA1c, and other diagnostic techniques e.g. blood tests and lipid profile Use of a multi-array ELISA machine (Randox) to facilitate the assay of ranges of inflammatory markers such as, adiponectin, ferritin. IL-6 and TNF- α and CRP Metabolic parameters records

Inclusion criteria Prediabetes (based on ADA diagnostic criteria). Adults with metabolic syndrome. Adults who are overweight (BMI 25 kg/m2 and above) Women with history of gestational diabetes First-degree relative with diabetes Physical inactivity with age between 18-60

Study design

primary out come 1-improving in HbA1c 2- improving in insulin sensitivity 3- improve lipid profile

Results

Results

Results

Results

Results

conclusion A combination exercise programs, which involves both RE, and AE performed at moderate intensity (50 – 60% of 1RM) over 6-weeks period can be feasible and economical prevention strategies to minimize the risk factors for T2D in prediabetes subjects. A robust structure to identify high-risk individuals and prioritize those most likely to benefit is highly important. Involving the volunteer closely in monitoring their own improvement is highly important to apply concept of healthy life style.

Future work Continue recruitment of volunteer for control(no exercise) Continue recruitment of volunteer for intervention trail Multi-array machine wold be applied to assess change in serum level of inflammatory markers such interleukin 6 (IL-6), TNF-alpha , CRP , ferritin and adiponectin ELISA test wold be performed to assess insulin in order to determine change in insulin sensitivity

references CEFALU, W.T. et al. (2016) Update and Next Steps for Real-World Translation of Interventions for Type 2 Diabetes Prevention: Reflections From a Diabetes Care Editors’ Expert Forum. Diabetes Care, 39 (7), pp. 1186-1201. COLBERG, S.R. et al. (2016a) Physical activity/exercise and diabetes: a Position Statement of the American Diabetes Association. Diabetes Care, 39 (11), pp. 2065-2079. JOHANNSEN, N.M. et al. (2016) Combined Aerobic and Resistance Training Effects on Glucose Homeostasis, Fitness, and Other Major Health Indices: A Review of Current Guidelines. Sports Medicine, pp. 1-10.

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