K Mohsina Hyder1, Jithin Mohan2, Visakh Varma3, Ponnusankar Sivasankaran1, D Raja4
1Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Ooty, Tamil Nadu, India.
2Department of General Medicine, Aster Wayanad Specialty Hospital, Wayanad, Kerala, India.
3Department of Podiatry, Aster Wayanad Specialty Hospital, Wayanad, Kerala, India.
4GITS Academy, Bengaluru, Karnataka, India.
Background: India is among the top three countries with diabetes and prediabetes, but interventional studies on prediabetes are less compared to other developed countries. Research design and Methods: This prospective open-label randomized interventional study was conducted among newly diagnosed prediabetes in selected districts of Kerala and Tamil Nadu in South India. Participants were randomized to six treatment groups: Group 1 – walking exercise, Group 2 – muscle-specific exercise (ME), Group 3 – metformin intervention, Group 4 – metformin with muscle-specific exercise, Group 5 – antioxidant intervention, and Group 6 – antioxidants with muscle-specific exercise. Drug intervention was for 12 weeks, and the study parameters of the subjects were measured at predefined intervals. The main outcome measures were homeostasis model assessment (HOMA), glycated hemoglobin (HbA1c), fasting blood sugar (FBS), body mass index (BMI), and waist-to-hip ratio. Results: ME intervention in prediabetes significantly reduced BMI, FBS, HbA1c, and HOMA levels (P < 0.05) during the study period. There was also a significant reduction in waist-to-hip ratio among participants taking low-dose metformin along with muscle-specific exercises. Environmental mobility barriers such as weather, traffic, pollution, social support, and even female gender created obstacles in the walking group that led to nonadherence and no significant results in the walking group compared to other groups. Conclusions: Results showed that muscle-specific indoor exercises can be an effective strategy in early management of insulin resistance with better exercise adherence compared to existing interventions. The Implementation of Prediabetes Education Program increased awareness and self-management skills among the prediabetes population.
Keywords: Antioxidants, India, intervention, metformin, muscle-specific exercises, prediabetes.