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

Abstract

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.

Exercise medicine for cancer cachexia: targeted exercise to counteract mechanisms and treatment side effects

“…Moreover, 6 weeks of concentric RET (loaded ladder climbing) increased GLUT4 expression in diabetic mice (Dehghan et al 2016 ). Several studies demonstrated that LICET also increases GLUT4 expression in both skeletal and cardiac muscle (Bowman et al 2021 ). Additionally, 6 weeks (3 week −1 ) of 4–6 sets of 30-s maximal bicycling increased muscle GLUT4 content by ~ 20% compared to baseline in healthy men (Burgomaster et al 2007 ).…”

Impact of cancer cachexia on respiratory muscle function and the therapeutic potential of exercise

“…Insulin sensitivity has been increased in elderly men following a single session of eccentric RET per-week for 12 weeks, whereas concentric RET did not produce equivalent results (Chen et al, 2017). Further research conducted in alternative populations, including diabetic and healthy adults, implies that exercise reliant on high muscle glucose metabolism may be more efficacious in elevating GLUT4 expression, supporting the implementation of both high-intensity interval (Burgomaster et al, 2007) and low-intensity continuous (Bowman et al, 2021) endurance exercise, in addition to concentric RET (Dehghan et al, 2016). The obvious issue in implementing an intervention aimed at maximising glucose metabolism is a higher energy yield is undesirable in the cachectic individual.…”