Exercise improves fitness in diabetes with rapid kidney decline
Estimated VO2peak rose from 19.3 to 22.0 mL.min-1.kg-1 with high-intensity training compared with a slight drop from 19.9 to 19.7 in standard recommendations.
Frontiers in Sports and Active Living
In 103 adults with type 2 diabetes and rapid renal function decline, a two-year randomized controlled trial evaluated the effects of a structured high-intensity physical activity program. The ACTIDIANE trial, conducted across 21 centers, assigned participants to either standard physical activity recommendations or two supervised sessions per week delivered by certified professionals over 24 months. Researchers tracked physical fitness and spontaneous physical activity as pre-specified secondary outcomes. Participants in the supervised high-intensity group experienced significant improvements in estimated cardiorespiratory fitness. However, the two-year program did not modify spontaneous physical activity levels or sedentary behaviors outside the sessions.
Why it matters
Cardiorespiratory fitness is strongly associated with long-term cardiovascular and all-cause mortality. Preserving functional capacity through structured exercise may help counter physical decline in high-risk metabolic conditions.
Caveats
The trial used an open-label design with a modest sample size of 103 participants. The authors also noted feasibility challenges when implementing long-term, high-intensity exercise regimens in real-life clinical settings.
The paper
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Elsa Heyman, Mélanie Marias, Laurent Mourot, Philippe Sosner, Oualid Ayad, Edith Bigot Corbel, Sophie Borot, Claire Carette, Bertrand Cariou, Nicolas Chevalier, Cécile Ciangura, Séverine CLERJAUD, Pierre‐Henri Ducluzeau, Lisa Durocher, Jean François Gautier, Pierre Gourdy, Amine Kasmi, Laurence Kessler, Arnaud Monier, Pierre Morcel, Myriam Moret, Philippe Moulin, Nicolas Paquot, Stéphanie Ragot, Vincent Rigalleau, Pierre‐Jean Saulnier, André Jacques Scheen, Igor Tauveron, A. Vambergue, Tiphaine Vidal Trecan,Université de Poitiers · Inserm
Frontiers in Sports and Active Living · 11 Sep 2026 · CC BY