Aerobic Endurance Exercise or Circuit-Type Resistance Training for Individuals with Impaired Glucose Tolerance?

Eriksson, Johan G.; Tuominen, J. A.; Valle, Timo T.; Sundberg, S.; Sovijärvi, A.; Lindholm, Harri; Tuomilehto, J; Koivisto, Veikko A.

doi:10.1055/s-2007-978828

Cited by 127 publications

(84 citation statements)

References 24 publications

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“…In this study, there was not a significant decrease in insulin concentration in the exercise group compared to the control. It is consistent with the results of Erikson et al and Engdahl et al 20,21) . Insulin concentration increases following exercise because exercise suppresses the secretion of insulin from the pancreas by stimulating the sympathetic nervous system 9) , and by restricting the synthesis of cholesterol by increasing the permeability of the cell membrane to insulin receptors.…”

Section: Discussionsupporting

confidence: 94%

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Effect of Exercise Therapy on the Body Composition and Blood Components of Obese Men

Lee

2011

J Phys Ther Sci

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Abstract.[Purpose] The purpose of this study was to examine the effects of an eight-week exercise program on body composition, blood lipids, and hormone levels of 16 obese adult males. [Subjects and Methods] After an experimental group (n=8) and a control group (n=8) were organized, subject were examined: then, the experimental group performed endurance exercises for 8 weeks. At the end of the eight weeks, the two groups were examined again for weight, % body fat, and body fat mass via a bioelectrical impedance analysis (BIA). A blood sample was collected the day before the exercise program. Right after the exercise program, 5 ml of blood was collected and then centrifuged for 10 min at 3000 rpm. The centrifuged samples were stored at -73°C and sent to Green Cross for analysis; TC, TG, leptin, and insulin were analyzed.[Results] The experimental group showed a statistically significant decrease in % body fat and body fat mass as well as significant reductions in TC and TG and leptin concentrations. There was also a decrease in the exercise group's insulin concentration but is was not significant. [Conclusion] Eight weeks of exercise therapy increased energy consumption resulting in favorable changes in the body composition, blood lipid metabolism, and hormone levels in obese adult males.

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Section: Discussionsupporting

confidence: 94%

“…Moderate exercise intensity for 12 weeks has been shown to decrease insulin levels by 8.2% 20) , and a 60% lower insulin level was shown in the people who have exercised regularly 21) . In this study, there was not a significant decrease in insulin concentration in the exercise group compared to the control.…”

Section: Discussionmentioning

confidence: 98%

Effect of Exercise Therapy on the Body Composition and Blood Components of Obese Men

Lee

2011

J Phys Ther Sci

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“…Strength training has previously been used in prospective studies in healthy subjects (26), subjects with impaired glucose tolerance (19), and subjects with type 2 diabetes (17), and in these studies 22-48% improvement in the M-value was found, generally attributable to increases in nonoxidative glucose metabolism. Data in two (17,26) of these studies were expressed relative to the fat-free mass, thus attempting to correct for the effect of a larger muscle mass in resistance-trained individuals.…”

Section: Discussionmentioning

confidence: 99%

Strength Training Increases Insulin-Mediated Glucose Uptake, GLUT4 Content, and Insulin Signaling in Skeletal Muscle in Patients With Type 2 Diabetes

et al. 2004

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Strength training represents an alternative to endurance training for patients with type 2 diabetes. Little is known about the effect on insulin action and key proteins in skeletal muscle, and the necessary volume of strength training is unknown. A total of 10 type 2 diabetic subjects and 7 healthy men (control subjects) strength-trained one leg three times per week for 6 weeks while the other leg remained untrained. Each session lasted no more than 30 min. After strength training, muscle biopsies were obtained, and an isoglycemic-hyperinsulinemic clamp combined with arteriofemoral venous catheterization of both legs was carried out. In general, qualitatively similar responses were obtained in both groups. During the clamp, leg blood flow was higher (P < 0.05) in trained versus untrained legs, but despite this, arterio-venous extraction glucose did not decrease in trained legs. Thus, leg glucose clearance was increased in trained legs (P < 0.05) and more than explained by increases in muscle mass. Strength training increased protein content of GLUT4, insulin receptor, protein kinase B-␣/␤, glycogen synthase (GS), and GS total activity. In conclusion, we found that strength training for 30 min three times per week increases insulin action in skeletal muscle in both groups. The adaptation is attributable to local contraction-mediated mechanisms involving key proteins in the insulin signaling cascade. Diabetes 53: 294 -305, 2004 I t is an established finding that aerobic endurance training increases insulin action in patients with type 2 diabetes (1-9), and also that the effect of training is predominantly located to the skeletal muscle (10). Glycemic control also improves along with training (11). Furthermore, with the increased insulin action, the need for insulin to mediate the clearance of a given amount of glucose is lessened. Thus, the need for exogenous insulin or oral hypoglycemic agents is decreased (12). Apart from the beneficial effects on glucose metabolism, physical training also exerts marked improvement on most of the components of the metabolic syndrome (13).Despite the scientific evidence of the therapeutic effect of exercise training, it is a well-known clinical experience that it is often very difficult to engage the patients into taking exercise on a regular basis, and even if one succeeds, the adherence is disappointing. The majority of patients with type 2 diabetes are overweight and have usually been sedentary for the major part of their lives. For many reasons, both psychological and sociological, they are not likely to take up endurance training. Obesity may even be a physical problem in the performance of exercise, especially endurance-type exercises.For patients with type 2 diabetes, resistance training probably represents an attractive exercise modality, but little is known about the overall effect, and the effect in muscle has not been studied. Furthermore, dose-response studies on resistance training effects have not been carried out. To provide support for the recommendations about...

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“…These findings strongly suggest that resistance exercise may be an effective alternative to aerobic exercise in the management of GDM. Resistance training has previously been shown to be effective in improving insulin sensitivity and glycemic control in individuals with abnormal glucose tolerance and T2DM [54,55]. Importantly, for some women, resistance exercises may be performed more comfortably than aerobic exercise in late pregnancy and could assist with posture and reduce general discomforts of pregnancy.…”

Section: Diet Plus Insulinmentioning

confidence: 99%

The Role of Exercise in Reducing the Risks of Gestational Diabetes Mellitus

Hopkins

Artal

2013

Womens Health (Lond Engl)

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Women's Health (2013) 9(6), [569][570][571][572][573][574][575][576][577][578][579][580][581] support the demands of fetal growth. A progressive and marked insulin resistance develops in maternal skeletal muscle, beginning around mid-pregnancy and progressing during the third trimester to levels that approximate the insulin resistance seen in T2DM [9]. Hormones and adipo kines secreted from the placenta, including TNF-a, placental lactogen, placental growth hormone, cortisol and progesterone, are probable triggers of insulin resistance in pregnancy, owing to rapid reversal at delivery [10].Normal pregnancy is characterized by increased insulin secretion from pancreatic b cells to compensate for peripheral insulin resistance. This can be displayed as a hyperbolic relationship between insulin sensitivity (the inverse of insulin resistance) and insulin secretion from pancreatic b cells (Figure 2). The development of GDM occurs when a mother does not secrete enough insulin in order to be able to meet the metabolic stress of peripheral insulin resistance. The reciprocal relation ship is preserved in most GDM women, but occurs at much lower level of insulin secretion. That is, women with GDM secrete 40-70% less insulin for any degree of insulin resistance [11,12]. Therefore, pregnancy-induced insulin resistance may unmask the b-cell dysfunction characteristic of GDM [13].Serial assessments of insulin sensitivity starting before pregnancy have also demonstrated slightly greater insulin resistance persisting into the third trimester in women with GDM compared with normal pregnant women [11]. This resistance applies to both the action of insulin Gestational diabetes mellitus & maternal obesityGestational diabetes mellitus (GDM) is the most common medical complication of pregnancy and is defined as glucose intolerance or high blood glucose concentrations (hyperglycemia), with onset or first recognition during pregnancy. The prevalence of GDM varies from 1 to 20% and is rising worldwide in line with increasing trends of maternal obesity and Type 2 diabetes mellitus (T2DM) [1,2]. The incidence of GDM rises disproportionately with increasing obesity. A recent meta-analysis of 20 population-based studies estimated that the risk of developing GDM is 2.14-fold higher for overweight (BMI: 25.0-29.9), 3.56-fold higher for obese (BMI: ≥30.0) and 8.56-fold higher for severely obese women (BMI: ≥40.0) compared with normal weight pregnant women (BMI: <25.0) [3]. Obesity and GDM have been recognized as independent risk factors for a number of adverse maternal and fetal outcomes, including diabetes, hypertension, operative deliveries, macrosomia and neonatal complications [4][5][6]. More recently, we have begun to understand that maternal obesity and GDM are also associated with significant lifelong consequences for the next generation [7,8]. As obesity and GDM share many of the same health consequences, obese women and their offspring are at a greater risk for adverse outcomes (Figure 1). Pathophysiology of GDMDuring normal pregnancy,...

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Aerobic Endurance Exercise or Circuit-Type Resistance Training for Individuals with Impaired Glucose Tolerance?

Cited by 127 publications

References 24 publications

Effect of Exercise Therapy on the Body Composition and Blood Components of Obese Men

Effect of Exercise Therapy on the Body Composition and Blood Components of Obese Men

Strength Training Increases Insulin-Mediated Glucose Uptake, GLUT4 Content, and Insulin Signaling in Skeletal Muscle in Patients With Type 2 Diabetes

The Role of Exercise in Reducing the Risks of Gestational Diabetes Mellitus

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