Both resistance- and endurance-type exercise reduce the prevalence of hyperglycaemia in individuals with impaired glucose tolerance and in insulin-treated and non-insulin-treated type 2 diabetic patients

Abstract

Aims/hypothesisThe present study compares the impact of endurance- vs resistance-type exercise on subsequent 24 h blood glucose homeostasis in individuals with impaired glucose tolerance (IGT) and type 2 diabetes.MethodsFifteen individuals with IGT, 15 type 2 diabetic patients treated with exogenous insulin (INS), and 15 type 2 diabetic patients treated with oral glucose-lowering medication (OGLM) participated in a randomised crossover experiment. Participants were studied on three occasions for 3 days under strict dietary standardisation, but otherwise free-living conditions. Blood glucose homeostasis was assessed by ambulatory continuous glucose monitoring over the 24 h period following a 45 min session of resistance-type exercise (75% one repetition maximum), endurance-type exercise (50% maximum workload capacity) or no exercise at all.ResultsAverage 24 h blood glucose concentrations were reduced from 7.4 ± 0.2, 9.6 ± 0.5 and 9.2 ± 0.7 mmol/l during the control experiment to 6.9 ± 0.2, 8.6 ± 0.4 and 8.1 ± 0.5 mmol/l (resistance-type exercise) and 6.8 ± 0.2, 8.6 ± 0.5 and 8.5 ± 0.5 mmol/l (endurance-type exercise) over the 24 h period following a single bout of exercise in the IGT, OGLM and INS groups, respectively (p < 0.001 for both treatments). The prevalence of hyperglycaemia (blood glucose >10 mmol/l) was reduced by 35 ± 7 and 33 ± 11% over the 24 h period following a single session of resistance- and endurance-type exercise, respectively (p < 0.001 for both treatments).Conclusions/interpretationA single session of resistance- or endurance-type exercise substantially reduces the prevalence of hyperglycaemia during the subsequent 24 h period in individuals with IGT, and in insulin-treated and non-insulin-treated type 2 diabetic patients. Both resistance- and endurance-type exercise can be integrated in exercise intervention programmes designed to improve glycaemic control.Trial registration:Clinicaltrials.gov NCT00945165Funding:The Netherlands Organization for Health Research and Development (ZonMw, the Netherlands).

Strength Capacity and Cardiometabolic Risk Clustering in Adolescents

“…[2][3][4][5] Indeed, among adults with and without existing risk factors, numerous studies have reported significantly improved insulin sensitivity and glucose tolerance with structured RE interventions. 6,7 There is also compelling evidence to support the efficacy of progressive RE for glycemic control among children and adolescents, 8 even in the absence of weight loss. 9,10 However, because RE is known to elicit a potent insulin-sensitizing affect for hours after a single bout of training, [11][12][13] there is some speculation about whether it is merely the repeated acute responses to habitual RE that drive benefits for metabolic health, rather than any adaptive-response per se.…”

Effects of Postmeal Walking on Postprandial Glucose Control and Oxidative Stress

“…While many studies indicate that acute exercise lowers postprandial glucose (Gillen et al, 2012;Heden et al, 2015;Larsen, Dela, Kjaer, & Galbo, 1997;Larsen, Dela, Madsbad, & Galbo, 1999;Poirier et al, 2000;van Dijk et al, 2012;Rynders et al, 2014), others show either mixed effects (Ho, Dhaliwal, Hills, & Pal, 2010;Manders, Van Dijk, & Van Loon, 2010;Oberlin et al, 2014) or no effect (Baynard, Franklin, Goulopoulou, Carhart Jr, & Kanaley, 2005;Gonzalez, Veasey, Rumbold, & Stevenson, 2013;Knudsen, Karstoft, Pedersen, van Hall, & Solomon, 2014;Morishima, Mori, Sasaki, & Goto, 2014;Rose, Howlett, King, & Hargreaves, 2001). The four studies that have investigated the effects of acute aerobic (Larsen et al, 1997;Larsen et al, 1999;Poirier et al, 2001) or resistance (Heden et al, 2015) postmeal exercise on glucose control have all indicated a decrease in glucose and insulin in the postprandial period.…”

“…For example, studies using continuous glucose monitors (CGM) to assess glucose kinetics over a 24-hour period have shown beneficial effects following both moderate (Manders et al, 2010;Oberlin et al, 2013;van Dijk et al, 2012) and high-intensity (Gillen et al, 2012;Manders et al, 2010) exercise before a meal. Of these, no study indicated an attenuation of blood glucose in the initial two-hour postprandial period.…”

High Intensity Interval Training Vs Moderate Intensity Continuous Training in the Management of Metabolic Type Disease

“…37 As the effect of physical activity on glycemic control and body composition is well documented, 34,38 exercise training could be used as a first line of treatment for type 2 diabetes, and numerous studies have also showed the efficacy of HIIT [39][40][41]43 with regards to the effective management of the condition. For instance, decreases in average 24h blood glucose concentrations (~1mmol/l), postprandial excursions for breakfast, lunch and dinner, the prevalence of hyperglycemia (~33%), and increases in GLUT4 activity as well as reduced body fat levels, have previously been reported by studies examining the use of either HIIT or MICT in patients with type 2 diabetes.…”

“…For instance, decreases in average 24h blood glucose concentrations (~1mmol/l), postprandial excursions for breakfast, lunch and dinner, the prevalence of hyperglycemia (~33%), and increases in GLUT4 activity as well as reduced body fat levels, have previously been reported by studies examining the use of either HIIT or MICT in patients with type 2 diabetes. [39][40][41][42][43] This enhanced GLUT4 activity and/or glycogen synthesis/utilisation may be in part due to the up regulation of the transcription factor E3 (TFE3), which in mice has been shown to increase glycogen storage is and associated with up regulation of genes related to proteins related to glucose metabolism (glycogen synthase, GLUT4, Hexokinase II), 44 The lack of 'action' of insulin in type 2 diabetics has been linked to defects in the ability of insulin to phosphorylate the insulin receptor IRS-1, a molecule responsible for downstream regulation of insulin action in skeletal muscle. 45 Indeed it has been shown that regular exercise leads to up regulation of IRS-1 in humans.…”