OBJECTIVE To investigate whether a dose-response relationship exists between volume of exercise and discontinuation of glucose-lowering medication treatment in patients with type 2 diabetes. PATIENTS AND METHODS Secondary analyses of a randomized controlled exercise-based lifestyle intervention trial (April 29, 2015 to August 17, 2016). Patients with non-insulin-dependent type 2 diabetes were randomly assigned to an intensive lifestyle intervention (U-TURN) or standard-care group. Both groups received lifestyle advice and objective target-driven medical regulation. Additionally, the U-TURN group received supervised exercise and individualized dietary counseling. Of the 98 randomly assigned participants, 92 were included in the analysis (U-TURN, n=61, standard care, n=31). Participants in the U-TURN group were stratified into tertiles based on accumulated volumes of exercise completed during the 1-year intervention. RESULTS Median exercise levels of 178 (interquartile range [IQR], 121-213; lower tertile), 296 (IQR, 261-310; intermediate tertile), and 380 minutes per week (IQR, 355-446; upper tertile) were associated with higher odds of discontinuing treatment with glucose-lowering medication, with corresponding odds ratios of 12.1 (95% CI, 1.2-119; number needed to treat: 4), 30.2 (95% CI, 2.9-318.5; 3), and 34.4 (95% CI, 4.1-290.1; 2), respectively, when comparing with standard care. Cardiovascular risk factors such as glycated hemoglobin A1c levels, fitness, 2-hour glucose levels, and triglyceride levels were improved significantly in the intermediate and upper tertiles, but not the lower tertile, compared with the standard-care group. CONCLUSION Exercise volume is associated with discontinuation of glucose-lowering medication treatment in a dose-dependent manner, as are important cardiovascular risk factors in well-treated participants with type 2 diabetes and disease duration less than 10 years. Further studies are needed to support these findings. STUDY REGISTRATION ClinicalTrials.gov registration (NCT02417012).

中文翻译：

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运动对2型糖尿病降糖药物的剂量反应效应：一项随机临床试验的次要分析。

目的探讨2型糖尿病患者运动量与停用降糖药之间是否存在剂量反应关系。患者与方法基于一项基于运动的随机对照生活方式干预试验的二次分析（2015年4月29日至2016年8月17日）。非胰岛素依赖型2型糖尿病患者被随机分入强化生活方式干预（U-TURN）或标准护理组。两组均接受了生活方式建议和目标驱动的客观医疗法规。此外，U-TURN小组接受了监督运动和个性化饮食咨询。在98位随机分配的参与者中，有92位被纳入分析（U-TURN，n = 61，标准护理，n = 31）。根据在1年干预期间完成的累积运动量，将U-TURN组的参与者分为三部分。结果相关的中位运动水平为178（四分位间距[IQR]，121-213；低三分位），296（IQR，261-310；中三分位）和每周380分钟（IQR，355-446；上三分位）停止使用降糖药治疗的几率更高，相应的几率比为12.1（95％CI，1.2-119;需要治疗的数字：4），30.2（95％CI，2.9-318.5; 3）和34.4与标准护理相比，分别为（95％CI，4.1-290.1; 2）。心血管风险因素，例如糖化血红蛋白A1c水平，适应性，2小时葡萄糖水平和甘油三酸酯水平在中三分位数和上三分位数中显着提高，而下三分位数则没有，与标准护理组相比。结论运动量与剂量降低方式的降糖药物治疗相关，这是治疗良好的2型糖尿病且病程少于10年的参与者中重要的心血管危险因素。需要进一步的研究来支持这些发现。研究注册ClinicalTrials.gov注册（NCT02417012）。