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This Article Full Text Full Text (PDF) All Versions of this Article: 297/1/E151    most recent 00210.2009v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Google Scholar Articles by Kirwan, J. P. Articles by Holloszy, J. O. PubMed PubMed Citation Articles by Kirwan, J. P. Articles by Holloszy, J. O.

Effects of 7 days of exercise training on insulin sensitivity and responsiveness in type 2 diabetes mellitus

¹Department of Pathobiology, Lerner Research Institute; ²Department of Gastroenterology/Hepatology, Cleveland Clinic; ³Department of Physiology, Case Western Reserve University School of Medicine, Cleveland, Ohio; and ⁴Division of Geriatrics and Nutritional Sciences, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri

Submitted 31 March 2009 ; accepted in final form 19 April 2009

The objectives of this study were to determine whether 1) the improvement in insulin action induced by short-term exercise training in patients with type 2 diabetes is due to an improvement in insulin sensitivity, an improvement in insulin responsiveness, or a combination of improved insulin sensitivity and responsiveness and 2) short-term exercise training results in improved suppression of hepatic glucose production by insulin. Fourteen obese patients with type 2 diabetes, age 64 ± 2 yr, underwent a two-stage hyperinsulinemic euglycemic clamp procedure, first stage 40 mU·m^–2·min^–1 insulin infusion, second stage 1,000 mU·m^–2·min^–1 insulin infusion, together with a [3-³H]glucose infusion, before and after 7 days of exercise. The training consisted of 30 min of cycling and 30 min of treadmill walking at 70% of maximal aerobic capacity daily for 7 days. The exercise program resulted in improvements in insulin action in the absence of weight loss. Glucose disposal rates during the euglycemic clamp were significantly increased at both hyperinsulinemic stages after training (40 mU: 1.84 ± 0.32 to 2.67 ± 0.37 mg·kg^–1·min^–1, P < 0.0001; 1,000 mU: 7.57 ± 0.61 to 8.84 ± 0.56 mg·kg^–1·min^–1, P = 0.008). Hepatic glucose production, both in the basal state (3.17 ± 0.43 vs. 2.54 ± 0.26 mg·kg^–1·min^–1, P = 0.05) and during the 40-mU clamp stage (1.15 ± 0.41 vs. 0.46 ± 0.20 mg·kg^–1·min^–1, P = 0.03), was significantly reduced after training. One week of vigorous exercise training can induce significant improvements in insulin action in type 2 diabetes. These improvements include increased peripheral insulin sensitivity and responsiveness as well as enhanced suppression of hepatic glucose production.

hyperinsulinemic euglycemic clamp; insulin resistance; hepatic glucose production

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