Main idea: High-intensity combined aerobic and resistance exercise may be safely prescribed for inactive individuals with type 2 diabetes and may reduce musculoskeletal pain but not neuropathic symptoms.
Abstract: People with type 2 diabetes (T2D) have a greater prevalence of musculoskeletal and neuropathic pain. This exploratory analysis investigated whether the exercise of different intensities leads to changes in self-reported musculoskeletal pain or symptoms of diabetic neuropathy in inactive individuals with type 2 diabetes. Thirty-two inactive adults with T2D (59% male, mean age 58.7 ± 9.1yrs, median HbA1c 7.8%) were randomized to usual care (CON), supervised combined aerobic and resistance moderate-intensity continuous training (C-MICT), or supervised combined high-intensity interval training (C-HIIT). At baseline and 8-weeks, musculoskeletal and neuropathic pain were evaluated using a modified Nordic Musculoskeletal Questionnaire and the Neuropathy Total Symptom Score-6 respectively. Quantitative sensory testing was used to determine thermal, mechanical, and vibration detection thresholds, as well as pain pressure thresholds. Adverse events were recorded throughout the intervention. Compared to CON, reduction in musculoskeletal pain intensity was significantly greater for C-HIIT and non-significantly greater for C-MICT. Changes in neuropathy symptoms were not different between C-HIIT and CON, or C-MICT and CON. No differences in sensory function were observed between groups. Similar rates of adverse events were seen in both exercise interventions, all but one of which was mild.