***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Evidence suggests that diet and exercise are associated with improved glucose tolerance for patients with non-insulin-dependent diabetes mellitus ( NIDDM ) . Seventy-six volunteer adult patients with NIDDM were each assigned to one of four programs : 1 ) diet , 2 ) exercise , 3 ) diet plus exercise , or 4 ) education ( control ) . Each program required ten weekly meetings . Detailed evaluations were completed prior to the program and after three , six , 12 , and 18 months . Evaluations included various psychosocial measures , measures of the quality of life , and fasting blood glucose , glycosylated hemoglobin , and relative weight determinations . Of the 76 original participants , 70 completed the 18-month follow-up study . At 18 months , the combination diet- and -exercise group had achieved the greatest reductions in glycosylated hemoglobin measures . In addition , this group showed significant improvements on a general quality of life measure . These improvements were largely uncorrelated with changes in weight . The authors conclude that the combination of dietary change and physical conditioning benefits NIDDM patients , and that the benefits may be independent of substantial weight loss The objective of this study was to determine the impact of an aerobic physical exercise program in the treatment of a group of elderly patients with type 2 diabetes mellitus ( DM ) in relation to metabolic control , physical capacity , quality of life ( QOL ) and attitudes toward diabetes . Patients were r and omly assigned to either an experimental ( n=19 ) or a control ( n=20 ) group . The following measurements were conducted at baseline and after week 16 : glycosylated hemoglobin ( hbA1c ) , fructosamine , 3 h oral glucose tolerance test , treadmill test ( Balke-Naughton ) , and a question naire on QOL and attitudes toward DM . After the intervention , the experimental group showed a significant decrease of glucose excursion during the oral glucose tolerance test ( OGTT ) ( area under the curve ) ( 16.6+/-3.8 vs. 15.3+/-3.1 , P<0.05 ) and an increase in total time on the treadmill ( s ) ( 423+/-207 vs. 471+/-230 , P<0.05 ) . An improvement in the attitudes toward DM was observed in the experimental group ( P=0.01 ) but not in the control group . Female gender , higher body mass index and hbA1c were factors associated with a response to the intervention . This study suggests that physical exercise has significant effects on glucose excursion during an OGTT and exercise tolerance in elderly patients with type 2 DM The purpose s of this study were 1 ) to investigate glucose tolerance and insulin action immediately after exercise and 2 ) to determine how long the improved glucose homeostatic mechanisms observed 12 - 16 h after exercise persist . Nine ( seven men , two women ) moderately trained middle-aged ( 51 + /- 3 yr ) subjects performed 45 min of exercise at 73 + /- 2 % of peak O2 uptake for 5 days , followed by 7 days of inactivity . Oral glucose tolerance tests  ( OGTT ; 75 g ) were performed immediately postexercise ( IPE ; approximately 30 min ) after the final exercise bout and 1 , 3 , 5 , and 7 days after exercise . The incremental area under the plasma glucose curve was markedly higher IPE ( 355 + /- 82 mM.min ) compared with those on days 1 ( 136 + /- 57 mM.min ; P < 0.05 ) and 3 ( 173 + /- 62 mM.min ; P < 0.05 ) . The glucose area was significantly higher on days 5 ( 213 + /- 80 mM.min ) and 7 ( 225 + /- 84 mM.min ) compared with those on days 1 and 3 ( P < 0.05 ) . The incremental insulin area IPE ( 3,729 + /- 1,104 microU.ml-1.min ) was 43 % higher compared with that on day 1 ( 2,603 + /- 635 microU.ml-1.min ; P < 0.05 ) and 66 % higher compared with that on day 3 ( 2,240 + /- 517 microU.ml-1.min ; P < 0.05 ) . The insulin area increased to 3,616 + /- 617 microU.ml-1.min after 5 days of inactivity ( P < 0.05 ) . An additional 48 h of inactivity did not result in any further increase in the plasma insulin response . ( ABSTRACT TRUNCATED AT 250 WORDS OBJECTIVE To examine the effect of high-intensity progressive resistance training combined with moderate weight loss on glycemic control and body composition in older patients with type 2 diabetes . RESEARCH DESIGN AND METHODS Sedentary , overweight men and women with type 2 diabetes , aged 60 - 80 years ( n = 36 ) , were r and omized to high-intensity progressive resistance training plus moderate weight loss ( RT & WL group ) or moderate weight loss plus a control program ( WL group ) . Clinical and laboratory measurements were assessed at 0 , 3 , and 6 months . RESULTS HbA(1c ) fell significantly more in RT & WL than WL at 3 months ( 0.6 + /- 0.7 vs. 0.07 + /- 0.8 % , P < 0.05 ) and 6 months ( 1.2 + /- 1.0 vs. 0.4 + /- 0.8 % , P < 0.05 ) . Similar reductions in body weight ( RT & WL 2.5 + /- 2.9 vs. WL 3.1 + /- 2.1 kg ) and fat mass ( RT & WL 2.4 + /- 2.7 vs. WL 2.7 + /- 2.5 kg ) were observed after 6 months . In contrast , lean body mass ( LBM ) increased in the RT & WL group ( 0.5 + /- 1.1 kg ) and decreased in the WL group ( 0.4 + /- 1.0 ) after 6 months ( P < 0.05 ) . There were no between-group differences for fasting glucose , insulin , serum lipids and lipoproteins , or resting blood pressure . CONCLUSIONS High-intensity progressive resistance training , in combination with moderate weight loss , was effective in improving glycemic control in older patients with type 2 diabetes . Additional benefits of improved muscular strength and LBM identify high-intensity resistance training as a feasible and effective component in the management program for older patients with type 2 diabetes OBJECTIVE The purpose of this study was to evaluate whether a combined resistance and aerobic training program would improve insulin sensitivity compared with aerobic training alone in postmenopausal women with type 2 diabetes . A second objective was to relate the improved insulin sensitivity to changes in abdominal adipose tissue ( AT ) and thigh muscle density . RESEARCH DESIGN AND METHODS A total of 28 obese postmenopausal women with type 2 diabetes were r and omly assigned to one of three 16-week treatments : control , aerobic only training ( Ae only ) , or aerobic plus resistance training ( Ae+RT ) . Pre- and posttreatment outcome measures included glucose disposal by hyperinsulinemic-euglycemic clamp and computed tomography scans of abdominal AT and mid-thigh skeletal muscle . RESULTS Glucose infusion rates increased significantly ( P < 0.05 ) in the Ae+RT group . Both exercise groups had reduced abdominal subcutaneous and visceral AT and increased muscle density . The Ae+RT training group exhibited a significantly greater increase in muscle density than the Ae only group . Improved glucose disposal was independently associated with changes in subcutaneous AT , visceral AT , and muscle density . Muscle density retained a relationship with glucose disposal after controlling for abdominal AT . CONCLUSIONS Adding resistance training to aerobic training enhanced glucose disposal in postmenopausal women with type 2 diabetes . The improved insulin sensitivity is related to loss of abdominal subcutaneous and visceral AT and to increased muscle density High-density lipoprotein ( HDL ) cholesterol is known to be low in patients with diabetes mellitus . Low HDL levels are correlated with premature cardiovascular mortality in several major epidemiologic studies and many investigators believe increases in HDL cholesterol may reduce the risk of coronary heart disease . We evaluated dietary and exercise interventions in relation to HDL cholesterol in patients with type II diabetes mellitus . Sixty-five volunteers were r and omly assigned to one of four experimental conditions : diet , exercise , diet plus exercise , or education control . Three months after entering the program , those exposed to the dietary intervention had significant increases in HDL cholesterol . HDL increases for the other two treatment groups did not differ significantly from the education control OBJECTIVE The triglyceride-lowering effects of ω-3 fats and HDL cholesterol-raising effects of exercise may be appropriate management for dyslipidemia in NIDDM . However , fish oil may impair glycemic control in NIDDM . The present study examined the effects of moderate aerobic exercise and the incorporation of fish into a low-fat ( 30 % total energy ) diet on serum lipids and glycemic control in dyslipidemic NIDDM patients . RESEARCH DESIGN AND METHODS In a controlled , 8-week intervention , 55 sedentary NIDDM subjects with serum triglycerides > 1.8 mmol/l and /or HDL cholesterol < 1.0 mmol/l were r and omly assigned to a low-fat diet ( 30 % daily energy intake ) with or without one fish meal daily ( 3.6 g ω-3/day ) and further r and omized to a moderate ( 55–65 % VO2max ) or light ( heart rate < 100 bpm ) exercise program .  An oral glucose tolerance test ( 75 g ) , fasting serum glucose , insulin , lipids , and GHb were measured before and after intervention . Self-monitoring of blood glucose was performed throughout . RESULTS In the 49 subjects who completed the study , moderate exercise  improved aerobic fitness ( VO2max ) by 12 % ( from 1.87 to 2.07 l/min , P = 0.0001 ) . Fish consumption  reduced triglycerides ( 0.80 mmol/l , P = 0.03 ) and HDL3 cholesterol ( 0.05 mmol/l , P = 0.02 ) and increased HDL2 cholesterol ( 0.06 mmol/l , P = 0.01 ) . After adjustment for age , sex , and changes in body weight , fish diets were associated with increases in GHb ( 0.50 % , P = 0.05 ) and self-monitored glucose ( 0.57 mmol/l , P = 0.0002 ) , which were prevented by moderate exercise . CONCLUSIONS A reduced fat diet incorporating one daily fish meal reduces serum triglycerides and increases HDL2 cholesterol in dyslipidemic NIDDM patients . Associated deterioration in glycemic control can be prevented by a concomitant program of moderate exercise OBJECTIVE : To investigate the effect of an exercise training program on lipid profile in correlation with DHEA level and body weight and body composition in type 2 diabetic men . DESIGN : Longitudinal , controlled clinical intervention study with exercise training consisting of an 8 week supervised program of aerobic exercise ( 75 % VO2 peak , 45 min ) , twice a week and intermittent exercise , once a week , on a bicyle ergometer . SUBJECTS : Sixteen men ( age 45.4±7.2 y ( mean±s.d . ) , HbA1c 8.15±1.7 % , body mass index ( BMI ) 29.6±4.6 kg/m2 ) were r and omly divided into two groups : trained group ( n=8 ) and control group ( n=8 ) . MEASUREMENTS : Lipid , apo- and lipoprotein and DHEA concentrations . Cross-sectional areas of subcutaneous and visceral adipose tissue and mid-thigh muscle by magnetic resonance imaging . RESULTS : Training decreased visceral ( 153.25±38.55 vs 84.20±21.30 cm2 , P<0.001 ) , subcutaneous ( 241.55±49.55 vs 198.00±39.99 cm2 , P<0.001 ) adipose tissue area and triglyceride levels ( 2.59±1.90 vs 1.79±1.08 nmol/l , P<0.05 ) and increased mid-thigh muscle cross-sectional area ( 148.30±36.10 vs 184.35±35.85 cm2 , P<0.001 ) , and DHEA levels ( 11.00±3.10 vs 14.25±4.10 nmol/l , P<0.05 ) with no modification in body weight . Changes in triglycerides were negatively correlated with changes in DHEA ( r=−0.81 , P=0.03 ) . This correlation was independent of changes in ab 
    Output:
    
AUTHORS ' CONCLUSIONS The meta- analysis shows that exercise significantly improves glycaemic control and reduces visceral adipose tissue and plasma triglycerides , but not plasma cholesterol , in people with type 2 diabetes , even without weight loss