Exercise as A Potential Therapeutic Target for Diabetic Cardiomyopathy: Insight into the Underlying Mechanisms

Seo, Dae Yun; Ko, Jeong Rim; Jang, Jung Eun; Kim, Tae Nyun; Youm, Jae Boum; Kwak, Hyo‐Bum; Bae, Joonsoo; Kim, Amy Hyein; Ko, Kyung Soo; Rhee, Byoung Doo; Han, Jin

doi:10.3390/ijms20246284

Cited by 28 publications

(25 citation statements)

References 144 publications

(186 reference statements)

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“…Exercise reduces the production of ROS, and reduces oxidative stress damage, additionally exercise upregulates the expression and function of anti-oxidants enzymes superoxide dismutase, glutathione peroxidase and catalase ( Seo et al, 2019 ), and “exerkines” ( Yu et al, 2017 ). As a result of the above, exercise in diabetic patients; reduces overall cardiovascular disease burden, improves endothelial function, improves indices of cardiac dysfunction, reduces overall hyperglycemic time and reduces the long term index of poor glucose control (glycated hemoglobin, HbA1C) ( Seo et al, 2019 ). Exercise is simple intervention, which reduces cardiovascular morbidity and mortality and positively correlates with beneficial health outcomes as they pertain to diabetes and other chronic illnesses.…”

Section: Exercisementioning

confidence: 99%

The Endothelium as a Therapeutic Target in Diabetes: A Narrative Review and Perspective

et al. 2021

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Diabetes has reached worldwide epidemic proportions, and threatens to be a significant economic burden to both patients and healthcare systems, and an important driver of cardiovascular mortality and morbidity. Improvement in lifestyle interventions (which includes increase in physical activity via exercise) can reduce diabetes and cardiovascular disease mortality and morbidity. Encouraging a population to increase physical activity and exercise is not a simple feat particularly in individuals with co-morbidities (obesity, heart disease, stroke, peripheral vascular disease, and those with cognitive and physical limitations). Translation of the physiological benefits of exercise within that vulnerable population would be an important step for improving physical activity goals and a stopgap measure to exercise. In large part many of the beneficial effects of exercise are due to the introduction of pulsatile shear stress (PSS) to the vascular endothelium. PSS is a well-known stimulus for endothelial homeostasis, and induction of a myriad of pathways which include vasoreactivity, paracrine/endocrine function, fibrinolysis, inflammation, barrier function, and vessel growth and formation. The endothelial cell mediates the balance between vasoconstriction and relaxation via the major vasodilator endothelial derived nitric oxide (eNO). eNO is critical for vasorelaxation, increasing blood flow, and an important signaling molecule that downregulates the inflammatory cascade. A salient feature of diabetes, is endothelial dysfunction which is characterized by a reduction of the bioavailability of vasodilators, particularly nitric oxide (NO). Cellular derangements in diabetes are also related to dysregulation in Ca2+ handling with increased intracellular Ca2+overload, and oxidative stress. PSS increases eNO bioavailability, reduces inflammatory phenotype, decreases intracellular Ca2+ overload, and increases antioxidant capacity. This narrative review and perspective will outline four methods to non-invasively increase PSS; Exercise (the prototype for increasing PSS), Enhanced External Counterpulsation (EECP), Whole Body Vibration (WBV), Passive Simulated Jogging and its predicate device Whole Body Periodic Acceleration, and will discuss current knowledge on their use in diabetes.

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Section: Exercisementioning

confidence: 99%

The Endothelium as a Therapeutic Target in Diabetes: A Narrative Review and Perspective

et al. 2021

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“…42 It is broadly recognized as an effective strategy for the prevention and management of many chronic diseases. 43 Moderate exercise following Roux-en-Y gastric bypass surgery was found to provide additional improvements in insulin sensitivity, glucose effectiveness, and cardiorespiratory fitness for obese individuals. 44 The effects of exercise and leisure time PA have been extended from prevention to management of several components of metabolic syndrome and also for the mood and quality-of-life.…”

Section: Physical Activitymentioning

confidence: 99%

“…70 Exercise is used for the prevention, 71 and treatment of T2DM [72][73][74][75][76][77][78] by improving glycemic control. 43,[79][80][81][82][83][84][85][86] It is a comprehensive element of diabetes management. 87,88 A randomized trial has reported that exercise performed for 30 minutes after meal eating may provide better improvements in glycemic control for people with T2DM.…”

Section: Management Of T2dmmentioning

confidence: 99%

<p>Antidiabetic Effects of Physical Activity: How It Helps to Control Type 2 Diabetes</p>

Wake¹

2020

DMSO

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Despite the improvements in clinical care of the patients, research updates, and public health interventions, there is still an increase in the prevalence, incidence, and mortality because of diabetes mellitus (DM). DM is a public health problem in both developed and developing countries. It has increased alarmingly, putting this disease in the dimension of an epidemic. Diabetes is associated with several complications which increase the risk of many serious health problems on the other side. Therefore, this review was aimed to discuss the antidiabetic effects of physical activity (PA) on type 2 DM (T2DM) by summarizing the significant studies on this topic. This review found that several studies have recommended the utilization of PA for the effective management of T2DM. PA is a non-pharmacologic therapy which is a significant strategy for the management of T2DM and is an appropriate lifestyle modification approach to be practiced by these patients. The studies showed that PA has antidiabetic effects which are evidenced by its substantial role in improving the blood glucose (BG) levels of the individuals with T2DM where it helps them to control their levels of glucose in the blood. It plays a significant role in glycemic control of this disease by lowering the BG levels through possible mechanisms such as decreasing insulin resistance, increasing production of glucose transporter type 4 (GLUT-4), lowering visceral adipose tissue (VAT), increasing pancreatic β-cell functions, using glucose for energy, and so on. In turn, the controlled glycemia helps to prevent the complications associated with uncontrolled T2DM and this would further improve the overall health of the patients and the burden on the health professionals as well. Finally, this review concludes that PA is the cornerstone in the management of T2DM. It also suggests that more attention is needed to its significance in the prevention, glycemic control, and its role in the management of the morbidity and mortality associated with T2DM. Practical PA recommendations and suggestions for the future direction of research in this area are also provided.

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“…Exercise has been proposed to elicit beneficial effects through multiple mechanisms, as recently reviewed ( Hafstad, Boardman & Aasum, 2015 ; Seo et al, 2019 ) and indicated in Fig. 4 .…”

Section: Resultsmentioning

confidence: 99%

Run for your life: can exercise be used to effectively target GLUT4 in diabetic cardiac disease?

Bowman

Smith

Gould

2021

PeerJ

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The global incidence, associated mortality rates and economic burden of diabetes are now such that it is considered one of the most pressing worldwide public health challenges. Considerable research is now devoted to better understanding the mechanisms underlying the onset and progression of this disease, with an ultimate aim of improving the array of available preventive and therapeutic interventions. One area of particular unmet clinical need is the significantly elevated rate of cardiomyopathy in diabetic patients, which in part contributes to cardiovascular disease being the primary cause of premature death in this population. This review will first consider the role of metabolism and more specifically the insulin sensitive glucose transporter GLUT4 in diabetic cardiac disease, before addressing how we may use exercise to intervene in order to beneficially impact key functional clinical outcomes.

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Exercise as A Potential Therapeutic Target for Diabetic Cardiomyopathy: Insight into the Underlying Mechanisms

Cited by 28 publications

References 144 publications

The Endothelium as a Therapeutic Target in Diabetes: A Narrative Review and Perspective

The Endothelium as a Therapeutic Target in Diabetes: A Narrative Review and Perspective

<p>Antidiabetic Effects of Physical Activity: How It Helps to Control Type 2 Diabetes</p>

Run for your life: can exercise be used to effectively target GLUT4 in diabetic cardiac disease?

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