Glucose effectiveness, but not insulin sensitivity, is improved after short-term interval training in individuals with type 2 diabetes mellitus: a controlled, randomised, crossover trial

Karstoft, Kristian; Clark, Margaret A; Jakobsen, Ida Hovdenak; Knudsen, Sine H.; Hall, Gerrit van; Pedersen, Bente Klarlund; Solomon, Thomas P. J.

doi:10.1007/s00125-017-4406-0

Cited by 14 publications

(13 citation statements)

References 50 publications

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“…Male athletes have lower fasting glucose, lower insulin secretion, increased insulin sensitivity, and increased insulin clearance determined by the insulin/c-peptide ratio following a hyperinsulinemic-euglycemic clamp and arginine stimulation test compared with age- and BMI-matched sedentary males [110]. Consistent with this, exercise training has been shown to acutely lower insulin and gradually increase insulin sensitivity and glucose effectiveness [174, 175]. Compared with untrained subjects, endurance trained subjects had similar nonpulsatile basal insulin secretion, but significantly reduced insulin secreted per secretory burst [176].…”

Section: Therapeutic Implicationsmentioning

confidence: 97%

Hyperinsulinemia: An Early Indicator of Metabolic Dysfunction

Thomas

Corkey

Istfan

2019

Journal of the Endocrine Society

167

116

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Hyperinsulinemia is strongly associated with type 2 diabetes. Racial and ethnic minority populations are disproportionately affected by diabetes and obesity-related complications. This mini-review provides an overview of the genetic and environmental factors associated with hyperinsulinemia with a focus on racial and ethnic differences and its metabolic consequences. The data used in this narrative review were collected through research in PubMed and reference review of relevant retrieved articles. Insulin secretion and clearance are regulated processes that influence the development and progression of hyperinsulinemia. Environmental, genetic, and dietary factors are associated with hyperinsulinemia. Certain pharmacotherapies for obesity and bariatric surgery are effective at mitigating hyperinsulinemia and are associated with improved metabolic health. Hyperinsulinemia is associated with many environmental and genetic factors that interact with a wide network of hormones. Recent studies have advanced our understanding of the factors affecting insulin secretion and clearance. Further basic and translational work on hyperinsulinemia may allow for earlier and more personalized treatments for obesity and metabolic diseases.

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Section: Therapeutic Implicationsmentioning

confidence: 97%

Hyperinsulinemia: An Early Indicator of Metabolic Dysfunction

Thomas

Corkey

Istfan

2019

Journal of the Endocrine Society

167

116

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“…Interestingly, glucose kinetics in the 4 h following a standardized mixed meal with glucose isotopic tracers, as well as glucose profiles in the 32 h following this test, were better after a single interval walking session than after a continuous walking session [60]. Moreover, glucose effectiveness, measured during a hyperglycemic clamp, increased after two weeks of interval walking, but not continuous walking, before any improvement in insulin sensitivity had occurred [61]. This change was associated with reductions in mean and maximum glucose levels in the 24 h glucose monitoring, suggesting that the increase in glucose effectiveness may represent an additional mechanism by which exercise training improves glycemic control in subjects with T2DM.…”

Section: Evidence Supporting Walking As a Therapy For Type 2 Diabetesmentioning

confidence: 99%

Walking for subjects with type 2 diabetes: A systematic review and joint AMD/SID/SISMES evidence-based practical guideline

Moghetti

Balducci

Guidetti

et al. 2020

Nutrition, Metabolism and Cardiovascular Diseases

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Regular exercise is considered a cornerstone in the management of type 2 diabetes mellitus (T2DM). It improves glucose control and cardiovascular risk factors, contributes to weight loss, and also improves general well-being, likely playing a role in the prevention of chronic complications of diabetes. However, compliance to exercise recommendations is generally inadequate in subjects with T2DM. Walking is the most ancestral form of physical activity in humans, easily applicable in daily life. It may represent, in many patients, a first simple step towards lifestyle changes. Nevertheless, while most diabetic patients do not engage in any weekly walking, exercise guidelines do not generally detail how to improve its use. The aims of this document are to conduct a systematic review of available literature on walking as a therapeutic tool for people with T2DM, and to provide practical, evidence-based clinical recommendations regarding its utilization in these subjects. Data synthesis: Analysis of available RCTs proved that regular walking training, especially when supervised, improves glucose control in subjects with T2DM, with favorable effects also on cardiorespiratory fitness, body weight and blood pressure. Moreover, some recent studies have shown that even short bouts of walking, used for breaking prolonged sitting, can ameliorate glucose profiles in diabetic patients with sedentary behavior. Conclusions: There is sufficient evidence to recognize that walking is a useful therapeutic tool for people with T2DM. This document discusses theoretical and practical issues for improving its use. This article is co-published in the journals Sport Sciences for Health and Nutrition, Metabolism and Cardiovascular Diseases. * Systematic Review registration: PROSPERO (CRD42020171515).

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“…• Outcomes. Some studies did not have usable CGM data (31,32) or presented data which was available from the same population as another included study (33)(34)(35)(36)(37). For example, Little et al (34) included the same participants as the study by Gillen et al (38).…”

Section: Description Of Studiesmentioning

confidence: 99%

Acute and Chronic Effects of Exercise on Continuous Glucose Monitoring Outcomes in Type 2 Diabetes: A Meta-Analysis

et al. 2020

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Objective: To examine the acute and chronic effects of structured exercise on glucose outcomes assessed by continuous glucose monitors in adults with type 2 diabetes. Methods: PubMed, Medline, EMBASE were searched up to January 2020 to identify studies prescribing structured exercise interventions with continuous glucose monitoring outcomes in adults with type 2 diabetes. Randomized controlled trials, crossover trials, and studies with pre-and post-designs were eligible. Short-term studies were defined as having exercise interventions lasting ≤2 weeks. Longer-term studies were defined as >2 weeks. Results: A total of 28 studies were included. Of these, 23 studies were short-term exercise interventions. For all short-term studies, the same participants completed a control condition as well as at least one exercise condition. Compared to the control condition, exercise decreased the primary outcome of mean 24-h glucose concentrations in short-term studies (−0.5 mmol/L, [−0.7, −0.3]; p < 0.001). In longer-term studies, mean 24-h glucose was not significantly reduced compared to control (−0.9 mmol/L [−2.2, 0.3], p = 0.14) but was reduced compared to pre-exercise values (−0.5 mmol/L, [−0.7 to −0.2] p < 0.001). The amount of time spent in hyperglycemia and indices of glycemic variability, but not fasting glucose, also improved following short-term exercise. Among the shorter-term studies, subgroup, and regression analyses suggested that the timing of exercise and sex of participants explained some of the heterogeneity among trials. Conclusion: Both acute and chronic exercise can improve 24-h glucose profiles in adults with type 2 diabetes. The timing of exercise and sex of participants are among the factors that may explain part of the heterogeneity in acute glycemic improvements following exercise.

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Glucose effectiveness, but not insulin sensitivity, is improved after short-term interval training in individuals with type 2 diabetes mellitus: a controlled, randomised, crossover trial

Cited by 14 publications

References 50 publications

Hyperinsulinemia: An Early Indicator of Metabolic Dysfunction

Hyperinsulinemia: An Early Indicator of Metabolic Dysfunction

Walking for subjects with type 2 diabetes: A systematic review and joint AMD/SID/SISMES evidence-based practical guideline

Acute and Chronic Effects of Exercise on Continuous Glucose Monitoring Outcomes in Type 2 Diabetes: A Meta-Analysis

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