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Am J Physiol Endocrinol Metab (July 13, 2004). doi:10.1152/ajpendo.00056.2004
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Submitted on February 4, 2004
Accepted on July 2, 2004

Physical training may enhance {beta}-cell function in Type 2 Diabetes

Flemming Dela1*, Michael E. von Linstow2, Kari Joensen Mikines3, and Henrik Galbo4

1 Copenhagen Muscle Research Centre, University of Copenhagen, Copenhagen, Denmark; The Panum Institute, Department of Medical Physiology, University of Copenhagen, Copenhagen, Denmark
2 Center for Spinal Injury, Rigshospitalet, Copenhagen, Denmark; Department of Orthopedic Medicine T, Rigshospitalet, Copenhagen, Denmark
3 Copenhagen Muscle Research Centre, University of Copenhagen, Copenhagen, Denmark; Department of Urology, Herlev University Hospital, Herlev, Denmark
4 Copenhagen Muscle Research Centre, University of Copenhagen, Copenhagen, Denmark; Department of Rheumatology, Bispebjerg Hospital, Bispebjerg, Denmark

* To whom correspondence should be addressed. E-mail: fdela{at}mfi.ku.dk.

In healthy young subjects training increases insulin sensitivity but decreases the capacity to secrete insulin. We studied if training changes {beta}-cell function in type 2 diabetic patients. Patients, stratified into "moderate" and "low" secretors according to individual C-peptide response to an i.v. glucagon test, were randomly assigned to a training programme (ergometer cycling 30-40 min/day including at least 20 min at 75% Vo2max, 5 days/wk for 3 months) or a sedentary schedule. Before and after the intervention (16 hrs after last training bout), a sequential hyperglycemic (90 min at both 11, 18 and 25 mM) clamp was performed. An i.v. bolus of 5 g arginine was given at the end. Training increased Vo2max 17 ± 13% and decreased heart rate during submaximal exercise (p<0.05). During the 3 months of sedentary lifestyle insulin and C-peptide responses to the clamp procedures were unchanged in both moderate and low secretors. Likewise, no change in {beta}-cell response was seen after training in the low secretors (n=5). In contrast, moderate secretors (n=9) showed significant increases in {beta}-cell response to 18 and 25 mM hyperglycemia and to arginine stimulation. Glucagon responses to arginine as well as measures of insulin sensitivity and HbA1C levels were not altered by training. In conclusion, in type 2 diabetic patients training may enhance {beta}-cell function if the remaining secretory capacity is moderate, but not if it is low. The improved {beta}-cell function does not require changes in insulin sensitivity and HbA1C concentration.




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