تاثیر 12 هفته تمرین هوازی به همراه مکمل‌‌ عصاره گیاه گالگا بر میزان شاخص‌‌های گلایسمیک، مقاومت به انسولین و نیمرخ لیپیدی در زنان مبتلا به دیابت نوع دو

نوع مقاله : مقاله پژوهشی

نویسندگان

1 کارشناس ارشد فیزیولوژی ورزشی، دانشکده علوم ورزشی، دانشگاه ارومیه، ارومیه، ایران.

2 استاد گروه فیزیولوژی ورزشی و حرکات اصلاحی، دانشکده علوم ورزشی، دانشگاه ارومیه، ارومیه، ایران.

3 دانشیار گروه فیزیولوژی ورزشی و حرکات اصلاحی، دانشکده علوم ورزشی، دانشگاه ارومیه، ارومیه، ایران.

4 استادیار گروه بیماری‌‌های داخلی، دانشکده پزشکی، دانشگاه علوم پزشکی ارومیه، ارومیه، ایران.

چکیده

مقدمه و هدف: دیابت نوع دو نوعی اختلال متابولیکی است که با افزایش گلوکز خون در شرایط مقاومت به انسولین شناسایی می‌‌شود.  مصرف گالگا و اجرای تمرینات ورزشی ممکن است رویکرد پیشگیرانه موثری در کنترل این بیماری باشد. هدف مطالعه حاضر بررسی تاثیر 12 هفته تمرین هوازی به همراه مکمل‌‌ عصاره گیاه گالگا بر میزان شاخص‌‌های گلایسمیک، مقاومت به انسولین و نیمرخ لیپیدی در زنان مبتلا به دیابت نوع دو بود.  روش‌‌ تحقیق: در این مطالعه نیمه تجربی، 40 زن مبتلا به دیابت نوع دو (میانگین سنی 27/57 سال و شاخص توده بدنی 66/30 کیلوگرم بر مترمربع) پس از فراخوان، انتخاب و به طور تصادفی به چهار گروه مساوی (10 نفره) تمرین هوازی، مکمل گالگا، تمرین هوازی به همراه مکمل گالگا و کنترل تقسیم شدند. گروه تمرین به مدت 12 هفته ( سه جلسه در هفته) تمرین هوازی پیاده‌‌روی با شدت 50 الی 70 درصد ضربان قلب ذخیره‌‌ انجام دادند و گروه مکمل نیز در این مدت روزانه دو گرم گالگا به‌صورت دمنوش مصرف کردند. خونگیری 48 ساعت قبل و بعد از مداخله در حالت ناشتایی انجام شد. سطوح سرمی گلوکز، هموگلوبین گلیکوزیله (A1C) و نیمرخ لیپیدی با روش‌‌ رنگ آمیزی آنزیمی و انسولین به روش الایزا اندازه‌‌گیری شدند. شاخص مقاومت به انسولین و حساسیت انسولینی بر اساس فرمول برآورد شدند. برای تحلیل داده‌ها از روش‌‌های آماری تحلیل واریانس دو راهه با اندازه‌‌گیری مکرر و آزمون تعقیبی توکی در سطح معنی‌داری 0/05>p استفاده شد. یافته‌‌ها: سطوح انسولین (001/0=p)، گلوکز (0/005=p)، هموگلوبین A1C (0/002=p)، لیپوپروتئین کلسترول کم چگال (0/02=p)، کلسترول تام (0/01=p)، تری گلیسیرید (0/006=p)، آسپارتات آمینوترانسفراز (AST) (0/002=p)، آلانین آمینو ترانسفراز (ALT) (0/005=p) و مقاومت به انسولین (001/0=p) در هر سه گروه نسبت به گروه کنترل کاهش معنی‌دار؛ و شاخص مک آلی (McAuley) (0/003=p)، لیپوپروتئین کلسترول پرچگال (01/0=p)، شاخص عملکرد سلول‌‌های بتای پانکراس (HOMA-β) (0/01=p) و شاخص حساسیت انسولینی (QUICKI) (0/002=p) افزایش معنی‌داری داشتند. همچنین، کاهش انسولین (0/001=p)، گلوکز (0/001=p)، هموگلوبین A1C و مقاومت به انسولین (001/0=p) در گروه ترکیبی تمرین هوازی و گالکا بیشتر از گروه‌‌های تمرین هوازی و گالگا به تنهایی بود. نتیجه‌‌گیری: هر دو مداخله تمرین هوازی و مکمل گالگا به تنهایی یا به صورت هم‌افزا، می‌‌تواند باعث بهبود شاخص‌‌های گلایسمیک، نیمرخ لیپیدی، آنزیم‌‌های کبدی و شاخص‌‌های مقاومت به انسولین و حساسیت انسولینی شوند. با این حال اثربخشی ترکیبی آنها در بهبود وضعیت گلایسمیک، مقاومت به انسولین بیشتر است. 

کلیدواژه‌ها

عنوان مقاله [English]

The effect of 12-week of aerobic exercise combined with Galega officinalis extract supplementation on glycemic indices, insulin resistance and lipid profile in women with type 2 diabetes

نویسندگان [English]

  • Esmaeil Gholinezhad 1
  • Asghar Tofighi 2
  • Kazem Khodaei 3
  • Farhad Behzadi 4
1 MSc in Exercise Physiology, Sport Sciences Faculty, Urmia University, Urmia, Iran.
2 Professor at Department of Physiology and Corrective Movements, Sport Sciences Faculty, Urmia University, Urmia, Iran.
3 Assocaite Professor at Department of Physiology and Corrective Movements, Sport Sciences Faculty, Urmia University, Urmia, Iran.
4 Assistant Professor at Department of Internal Medicine, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
چکیده [English]

Extended Abstract
Background and Aim: Given the rising prevalence of type 2 diabetes (T2DM) and the associated complications, there is a critical need for low-cost, low-side-effect complementary strategies especially among women. Moderate-intensity aerobic exercise improves insulin sensitivity and glycemic control, however, long-term patient adherence is often poor due to physical limitations and sedentary lifestyles. On the other hand, Galega officinalis (goat’s rue), a natural source of biguanides similar to metformin, contains phenolic compounds and alkaloids can reduce oxidative stress and protect pancreatic beta-cells. Despite the individual benefits of both interventions, limited studied has investigated their synergistic effects on comprehensive metabolic outcomes—including insulin sensitivity indices (QUICKI and McAuley), liver enzymes such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and lipid profiles—in women with T2DM. Therefore, the research gap can be significant due to combining a safe herbal supplement with a standardized, tolerable exercise program (walking at 50–70% of heart rate reserve) could offer a practical and physiologically sound therapeutic strategy. Thus, the primary aim of this study—examining the effects of 12-week of aerobic exercise combined with Galega officinalis extract on glycemic indices, insulin resistance, and lipid profiles in women with T2DM—addresses a distinct clinical need. The findings may provide a foundation for more comprehensive, evidence-based, non-pharmacological management protocols for T2DM, particularly for patients unwilling or unable to rely solely on medications.
Materials and Methods: 40 women with T2DM (mean age 57.27 years and body mass index 30.66 kg/m²) were recruited and randomly assigned to 4 groups including aerobic exercise (n=10), Galega supplement (n=10), combined aerobic exercise and Galega supplement (n=10), and control (n=10) groups. The exercise groups engaged in aerobic walking for 12 weeks, 3 days per week, with intensity of 50 to 70 percent of maximal heart rate reserve. The supplement groups consumed 2 grams of Galega daily as tea at the evenings for the same duration. The combined group received the Galega supplement in beside the performing aerobic exercise. It was recommended that Galega extract is better to consume 2 to 3 hours after Metformin to avoid potential drug interactions. Blood samples were collected from participants before and after the intervention during fasting. Serum glucose, hemoglobin A1C, and lipid profiles were measured using enzyme staining, as the same, insulin levels also were quantified via ELISA. Insulin resistance and sensitivity indices were calculated using established formulas. The normality of the data was assessed using the Shapiro-Wilk test, and homogeneity of variance was evaluated using Levene’s test. Moreover, a Two-way analysis of variance with repeated measures and Tukey's post hoc tests were employed. All statistical analyses were conducted using SPSS version 26, with a significance level set at p≤0.05.
Findings: Means, standard deviations, percent changes, and Tukey’s post-hoc results are presented in Table 1. The results revealed significant time×group interaction effects for all outcome variables (p≤0.05). In this way, significant decreases in fasting insulin (p=0.001), fasting glucose (p=0.005), hemoglobin A1C (p=0.002), low density lipoprotein cholesterol (LDL-c) (p=0.02), total cholesterol (p=0.01), triglyceride (p=0.006), and HOMA-IR (p=0.001) were observed in all 3 intervention groups compared to the control group. Conversely, significant increases in HOMA-β (p=0.01), QUICKI (p=0.002), McAuley index (p=0.003), and high density lipoprotein cholesterol (HDL-c) (p=0.01) were found also in all 3 intervention groups relative to the control group.
The reductions in fasting insulin, fasting glucose, hemoglobin A1C, and HOMA-IR were significantly greater in the combined group (aerobic exercise+Galega) than aerobic exercise and Galega alone groups (p≤0.001 for all comparisons). Additionally, the increase in QUICKI was significantly greater in the combined group compared to the exercise (p=0.001) and the Galega (p=0.003) groups. Although reductions in LDL-c, total cholesterol, triglyceride, and increases in HDL-c were greater in the combined group than in the single-intervention groups, these differences were not statistically significant (p>0.05).
Conclusion: The findings of the present study are consistent with previous research that demonstrated the aerobic exercise improves glycemic control and insulin sensitivity through mechanisms such as increased (glucose transporter type 4) GLUT-4 translocation and enhanced skeletal muscle glucose uptake (Kumar et al., 2019; Merz & Thurmond, 2011). Furthermore, the results also align with some studies that reporting the antihyperglycemic and hepatoprotective effects of Galega officinalis, attributed to its biguanide content (particularly Galegin) and its ability to reduce oxidative stress and protect pancreatic beta-cells (Luka et al., 2017; Hachkova et al., 2021; Sukhtezari et al., 2024). The novel contribution of this study emphasize on the combination of aerobic exercise and Galega supplementation that produces significantly greater improvements in fasting insulin, fasting glucose, hemoglobin A1C, and HOMA-IR compared to either intervention alone. This synergistic effect is consistent with prior observations of combined exercise and herbal interventions (Salavati et al., 2024; Mosadeghi et al., 2024; Ghasemi Kahrizsangi et al., 2023), and may be explained by complementary mechanisms: exercise primarily enhances peripheral insulin sensitivity and glucose disposal, while Galega reduces oxidative stress and supports beta-cell function. The concurrent improvement in liver enzymes (ALT and AST) also observed in the combined group further supports a hepatoprotective synergy, as elevated liver enzymes are commonly associated with insulin resistance and non-alcoholic fatty liver disease in T2DM (Hejazi & Hackett, 2023). Therfore, these findings suggest that integrating aerobic exercise with Galega officinalis supplementation offers a promising, multifaceted non-pharmacological strategy for managing T2DM. However, given the relatively small sample size and 12-week intervention period, future studies with larger cohorts and longer follow-up durations are warranted to confirm the long-term efficacy and safety of this combined approach. Additionally, investigating the underlying molecular mechanisms—particularly the interaction between exercise-induced signaling pathways and bioactive compounds of Galega—would provide valuable insights for optimizing combined lifestyle-phytotherapy interventions in diverse diabetic populations.
Ethical Considerations: The present study was approved by the Research Ethics Committee of Urmia University (code IR.URMIA.REC.1403.014).
Compliance with ethical guideline: Participants were voluntarily selected from the West Azerbaijan province diabetes association. Informed consent was obtained, and confidentiality regarding participants’ information was strictly maintained throughout the study.
Funding: This study did not receive external funding and was conducted with the financial resources available to the research team.
Conflicts of Interest: The authors declare no conflicts of interest regarding this article.

کلیدواژه‌ها [English]

  • Aerobic exercise
  • Galega plant
  • Glycemic status
  • Lipid profile
  • Type 2 Diabetes

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مطالعات کاربردی علوم زیستی در ورزش
دوره 14، شماره 38
تیر 1405
صفحه 82-101

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