Physical Activity and Exercise

Exercise and Insulin Resistance

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Acute Exercise and Insulin Resistance
A single exercise session has been shown to significantly reduce plasma glucose (36, 37) and insulin (37) levels in type 2 diabetic subjects. Significant improvements in glucose clearance, as assessed through a euglycemic-hyperinsulinemic clamp, have been achieved in obese diabetics and normoglycemics after one hour of moderate-intensity treadmill exercise (38), insulin-resistant subjects after 50 minutes of moderate-intensity stair climbing exercise (39), diabetic subjects after glycogen-depleting cycle exercise (40), and healthy subjects after 60 minutes of moderate-intensity ergometer exercise (41). Not only is insulin sensitivity enhanced immediately after the acute exercise bout (38), it appears to last 20 hours after exercise (40) and even up to 48 hours post exercise (39, 41), finally dissipating five days post exercise (41). The degree of improvement in insulin-stimulated whole-body glucose disposal after a single exercise bout ranges from 15 (41) to 24% (38). These improvements are equal to those achieved through chronic pharmacological intervention (42, 43).

Reference

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36. Larsen JJ, Dela F, Kjaer M, et al. The effect of moderate exercise on postprandial glucose homeostasis in NIDDM patients. Diabetologia 1997; 40: 447-53.

37. Musi N, Fujii N, Hirshman MF, et al. AMP-activated protein kinase (AMPK) is activated in muscle of subjects with type 2 diabetes during exercise. Diabetes 2001; 50: 921-7.

38. Burstein R, Epstein Y, Shapiro Y, et al. Effect of an acute bout of exercise on glucose disposal in human obesity. J Appl Physiol 1990; 69: 299-304.

39. Perseghin G, Price TB, Petersen KF, et al. Increased glucose transport-phosphorylation and muscle glycogen synthesis after exercise training in insulin-resistant subjects. N Engl J Med 1996; 335: 1357-62.

40. Devlin JT, Hirshman M, Horton ED, et al. Enhanced peripheral and splanchnic insulin sensitivity in NIDDM men after single bout of exercise. Diabetes 1987; 36: 434-9.

41. Mikines KJ, Sonne B, Farrell PA, et al. Effect of physical exercise on sensitivity and responsiveness to insulin in humans. Am J Physiol 1988; 254: E248-59.

42. Widen EI, Eriksson JG and Groop LC. Metformin normalizes nonoxidative glucose metabolism in insulin-resistant normoglycemic first-degree relatives of patients with NIDDM. Diabetes 1992; 41: 354-8.

43. Nolan JJ, Ludvik B, Beerdsen P, et al. Improvement in glucose tolerance and insulin resistance in obese subjects treated with troglitazone. N Engl J Med 1994; 331: 1188-93.

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