Effect of beta-alanine supplementation on exercise capacity in people with type 2 diabetes

INTERVENTION: Experimental subjects will receive 4g beta‐alanine capsules (oral capsules) once daily for 28 days. An incremental treadmill test supervised by a PhD‐level accredited exercise physiologist will be carried out at baseline and at 28 days (4 weeks). We will employ a ramp protocol (ACSM Guidelines for Exercise Testing and Prescription, 8th edition, pg 114) for which we are assessing exercise endurance. The test will be terminated when the participant has reached at least 85% age‐predicted max heart rate or s/he requests to stop. We will also use an ECG to assess for any potential abnormal cardiac responses (i.e., ST segment depression, ventricular arrythmias, etc as per ACSM guidelines). HR and BP will be assessed to monitor for abnormal haemodynamic responses. Pre and post‐exercise blood glucose will be assessed to ensure participants are normoglycaemic. The protocol will be as follows: kmh % grade 0.8 0 1.6 0 2.4 0 3.2 0 4.0 0 4.8 0 4.8 1 4.8 2 4.8 3 Protocol will continue at 4.8 kmh plus 1% each minute until termination criteria have been achieved. CONDITION: Obesity Type 2 Diabetes Mellitus PRIMARY OUTCOME: Exercise capacity as determined by an incremental treadmill protocol SECONDARY OUTCOME: Blood lipids (Total Cholesterol, High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL), Triglycerides (TG) to be determined via standard enzymatic methods. LDL mathematically determined as total cholesterol minus HDL minus (0.45 x TG). Diabetes Quality of Life Questionnaire Haemodynamics (Heart rate (HR), cardiac rhythm, and Blood Pressure (BP)): Seated blood pressure measured in duplicate on the left arm after 5 minutes rest on a standard hospital‐grade sphygmomanometer. Exercise HR and cardiac rhythm determined by electrocardiogram. Insulin sensitivity: Determined from fasting glucose and insulin using the most recent HOMA2‐IR calculator (version 2.2.2, Oxford University). INCLUSION CRITERIA: Diagnosis of type 2 diabetes. Medically stable and medically managed. No documented cardiac history or stable cardiac history for previous 6 months. No change in diabetes medications for previous two months. Not currently taking exogenous insulin injections. Signed consent from their general practitioner (GP) or specialist.