Increased insulin‐stimulated glucose uptake in both leg and arm muscles after sprint interval and moderate‐intensity training in subjects with type 2 diabetes or prediabetes

Abstract

We investigated the effects of sprint interval training (SIT) and moderate-intensity continuous training (MICT) on glucose uptake (GU) during hyperinsulinemic euglycemic clamp and fatty acid uptake (FAU) at fasting state in thigh and arm muscles in subjects with type 2 diabetes (T2D) or prediabetes.Twenty-six patients (age 49, SD 4; 10 women) were randomly assigned into two groups: SIT (n=13) and MICT (n=13). The exercise in the SIT group consisted of 4-6×30 s of all-out cycling with 4-minute recovery and in the MICT group 40-to 60-minute cycling at 60% of VO 2peak . Both groups completed six training sessions within two weeks. GU and FAU were measured before and after the intervention with positron emission tomography in thigh (quadriceps femoris, QF; and hamstrings) and upper arm (biceps and triceps brachii) muscles.Whole-body insulin-stimulated GU increased significantly by 25% in both groups, and this was accompanied with significantly increased insulin-stimulated GU in all thigh and upper arm muscles and significantly increased FAU in QF. Within QF, insulin-stimulated GU improved more by SIT than MICT in rectus femoris (P = .01), but not differently between the training modes in the other QF muscles.In individuals with T2D or prediabetes, both SIT and MICT rapidly improve insulinstimulated GU in whole body and in the thigh and arm muscles as well as FAU in the main working muscle QF. These findings highlight the underused potential of exercise in rapidly restoring the impaired skeletal muscle metabolism in subjects with impaired glucose metabolism. K E Y W O R D Sexercise, insulin resistance, muscle metabolism

Exercise training decreases pancreatic fat content and improves beta cell function regardless of baseline glucose tolerance: a randomised controlled trial

“…With regards to prediabetic or type 2 diabetic men and women in the present study, SIT and MICT had a different effect only on , which increased only after SIT, as discussed in our previous report [25]. The changes observed in all the other variables investigated in the present study, including increased whole-body insulin sensitivity, decreased pancreatic fat content, improved potentiation and decreased ΔISR 0-30 /ΔG 0-30 , were similar for both training modes.…”

Effects of one‐legged high‐intensity interval training on insulin‐mediated skeletal muscle glucose homeostasis in patients with type 2 diabetes

“…The literature on the effect of HIIT training or a single HIIT exercise bout on glycaemic control (fasting plasma glucose and HbA1C concentrations, post‐prandial glucose homeostasis, time spent in hyperglycaemia, feasibility of the intervention) in type 2 diabetes is abundant, for example Very few studies have mechanistically explored the effects of HIIT on insulin action in patients with type 2 diabetes, and the present study extends the previous findings by demonstrating the effect of HIIT directly in skeletal muscle (metabolically speaking the leg consists predominantly of skeletal muscle) and provides further mechanistic observations.…”

“…The one-legged training model used here has previously been used in similar studies on the effect of endurance training 2,32 and strength training. 3 With one-legged endurance training for 10 weeks, the patients with type 2 mechanistically explored the effects of HIIT on insulin action in patients with type 2 diabetes, 22,25 and the present study extends the previous findings by demonstrating the effect of HIIT directly in skeletal muscle (metabolically speaking the leg consists predominantly of skeletal muscle) and provides further mechanistic observations.…”

“…One previous study used the glucose clamp technique combined with positron emission tomography and combined with a glucose tracer and found that six sessions of sprint training improved glucose uptake in muscle. However, muscle biopsies or arteriovenous balances across muscle were not performed, and therefore, no mechanism could be described and only one very low clamp step (plasma insulin ~90 pmol/L) was used . Other studies have addressed the molecular effects of high‐intensity interval training in skeletal muscle, but only one study included patients with type 2 diabetes .…”

“…However, muscle biopsies or arteriovenous balances across muscle were not performed, and therefore, no mechanism could be described and only one very low clamp step (plasma insulin~90 pmol/L) was used. 25 Other studies have addressed the molecular effects of high-intensity interval training in skeletal muscle, [26][27][28][29][30] but only one study included patients with type 2 diabetes. 22 In general, these studies have showed that HIIT leads to increases in proteins (activity and/or content) related to mitochondrial biogenesis, such as citrate synthase (CS), complexes in the mitochondrial respiratory chain, silent mating-type information regulator 2 homolog 1 (SIRT1), peroxisome proliferator-activated receptor γ coactivator-1α (PGC1α) and mitofusin (Mfn) 2.…”