Effective Exercise Modality to Reduce Insulin Resistance in Women With Type 2 Diabetes

Abstract

OBJECTIVE -The purpose of this study was to evaluate whether a combined resistance and aerobic training program would improve insulin sensitivity compared with aerobic training alone in postmenopausal women with type 2 diabetes. A second objective was to relate the improved insulin sensitivity to changes in abdominal adipose tissue (AT) and thigh muscle density. RESEARCH DESIGN AND METHODS-A total of 28 obese postmenopausal women with type 2 diabetes were randomly assigned to one of three 16-week treatments: control, aerobic only training (Ae only), or aerobic plus resistance training (AeϩRT). Pre-and posttreatment outcome measures included glucose disposal by hyperinsulinemic-euglycemic clamp and computed tomography scans of abdominal AT and mid-thigh skeletal muscle.RESULTS -Glucose infusion rates increased significantly (P Ͻ 0.05) in the AeϩRT group. Both exercise groups had reduced abdominal subcutaneous and visceral AT and increased muscle density. The AeϩRT training group exhibited a significantly greater increase in muscle density than the Ae only group. Improved glucose disposal was independently associated with changes in subcutaneous AT, visceral AT, and muscle density. Muscle density retained a relationship with glucose disposal after controlling for abdominal AT.CONCLUSIONS -Adding resistance training to aerobic training enhanced glucose disposal in postmenopausal women with type 2 diabetes. The improved insulin sensitivity is related to loss of abdominal subcutaneous and visceral AT and to increased muscle density.

Early-onset type 2 diabetes in obese white subjects is characterised by a marked defect in beta cell insulin secretion, severe insulin resistance and a lack of response to aerobic exercise training

“…In fact, most subjects showed a deterioration in the acute insulin response to glucose. It has been suggested that progressive resistance training confers greater metabolic benefits than aerobic training [31,32]. While the exercise modality may also be relevant, most studies to date, including our own, have examined the effects of aerobic exercise training.…”

Physical Activity and Genitourinary Cancer Survivorship

“…However, there is only limited evidence supporting the effectiveness of physical activity for abdominal fat loss (Lau et al 2007;Ross and Janssen 1999). It remains plausible, however, that postmenopausal women could be amenable to significant abdominal fat loss given the right exercise prescription (e.g., Cuff et al 2003;Giannopoulou et al 2005;Irwin et al 2003). The PATH and ALPHA trials demonstrated a clear exercise effect in a range of body composition measures (Friedenreich et al 2010b;Irwin et al 2003) including abdominal fat, whereas the SHAPE trial found that exercisers decreased body fat and waist circumference, but not weight, in comparison with controls ).…”

“…The effect of exercise may be strongest for those with impaired (versus normal) glucose tolerance (Ivy 1997), when as combined aerobic/resistance exercise versus aerobic exercise alone (Cuff et al 2003), or at higher intensity (Gill 2007). In terms of abdominal fat loss (which correlates with insulin sensitivity), however, one 20-week exercise RCT in postmenopausal women on a calorie-restricted diet showed no difference whether moderate or vigorous aerobic exercise was undertaken (Nicklas et al 2009).…”

Obesity Management in Women with Polycystic Ovary Syndrome

“…While at least 150 min of exercise/week has been shown to produce clinically significant improvements in body composition and insulin sensitivity [104][105][106], physical activity levels up to 60-90 min a day were found to be necessary for weight maintenance [101,102,107]. At the time this review was prepared, there has only been one published study on the effect of physical activity on PCOS women.…”