Impact of concurrent training sequence on heart rate variability, glycemic control, body composition, lipid profile, and cardiorespiratory fitness in type 2 diabetes patients with cardiac autonomic neuropathy: A randomized controlled trial

Background: Type 2 Diabetes Mellitus (T2DM) is a global health concern, with cardiac autonomic neuropathy (CAN) being a significant complication that exacerbates cardiovascular risks.Aerobic and resistance exercises are recognized for their benefits in managing T2DM, but the optimal integration of these modalities, especially for patients with T2DM, requires further exploration.Objective: To investigate the effects of the sequence of aerobic and resistance training in a concurrent training regimen on heart rate variability (HRV), glycemic control, body composition, lipid profile, and cardiorespiratory fitness (CRF) in patients with T2DM.Methods: In this randomized controlled trial, 45 T2DM patients with CAN were allocated to three groups: a control group, an aerobic then resistance training (ART) group, and a resistance then aerobic training (RAT) group.Measurements were taken at baseline and after a 13-week intervention, assessing HRV, glycemic control, body composition, lipid profile, and CRF.Results: Both ART and RAT groups showed significant improvements in HRV, glycemic control, body composition, lipid profile, and CRF compared to the control group.Notably, there were no significant differences between ART and RAT groups in these outcomes, suggesting that the sequence of aerobic and resistance exercises in concurrent training does not significantly affect the health benefits attained.Conclusion: Concurrent aerobic and resistance training, irrespective of the sequence, effectively improves HRV, glycemic control, body composition, lipid profile, and CRF in T2DM patients with CAN.This study supports the inclusion of concurrent training in exercise prescriptions for managing T2DM and its complications.