Effect of aerobic exercises on blood coagulation and fibrinolytic system in type 2 diabetic patients

Background: Diabetes is a major worldwide health problem. It is associated with the long-term vascular complications particularly cardiovascular disease which is the commonest cause of death in diabetic patients. Abnormalities in endogenous coagulation and fibrinolysis may play an important role in the risk of acute cardiovascular event. Regular physical activity is associated with decrease in all causes of mortality especially cardiovascular disease. So, the current study was carried out to investigate the effect of aerobic exercises on blood coagulation and fibrinolysis in type 2 diabetic patients. Subjects and Methods: This study was conducted on fifty type 2 diabetic male patients. All were randomly selected from outpatients’ clinic of Zagazig University hospitals. The included subjects were subdivided into two equal groups (25 patients for each). The first group (group A) received a low calorie diet without aerobic exercise and the second group (group B) received a low calorie diet with a program of aerobic exercise in addition to the standard treatment of the diabetic state. All patients subjected to full history and clinical examination and routine laboratory investigations including random blood glucose? glycosylated haemoglobin (HbA1c), liver and kidney function tests. In addition to measurement of prothrombin time, fibrinogen, tissue plasminogen activator (tPA) and plasminogen activator inhibitor-1(PAI-1) before starting program and after the end of program (12 weeks). Results: The present study showed that both groups were matched with each other as regard to age, HA1c ,and coagulation profiles before the start of the study ,and An aerobic exercises with low calorie diet significantly increase each of prothrombin time, and tissue plasminogen activator and significantly decrease each of fibrinogen and plasminogen activator inhibitor-1 levels in group B .while there was no significantly difference in the previous parameters in group A without aerobic exercise. In pretreatment status there was no significant difference in the previous parameters between groups A and B .while in posttreatment status there was significant increase each of prothrombin time and tissue plasminogen activator and significantly decrease each of fibrinogen and plasminogen activator inhibitor-1 levels in group B as compared to group A. Conclusion: We conclude that low-calorie diet with aerobic exercise is more effective than the low-calorie diet only for reducing blood coagulation and increasing fibrinolysis in type 2 diabetes on a short term program (up to twelve weeks), and this may lead to protection against cardio vascular events on along term and further studies can be performed to show the efficacy of anaerobic versus aerobic exercise on blood coagulation in diabetic patients.