Increased Insulin Sensitivity and Insulin Binding to Monocytes after Physical Training

Soman, Vijay; Koivisto, Veikko A.; Deibert, David; Felig, Philip; DeFronzo, Ralph A.

doi:10.1056/nejm197911293012203

Cited by 181 publications

(85 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Insulin secretion is inhibited by increased sympathetic nervous system activity via a-adrenergic receptors, and plasma insulin concentrations decline to low levels (6,(23)(24)(25). This results in increased lipolysis in adipose tissue and increased hepatic glucose production (26,27).…”

Section: Ls Hortonmentioning

confidence: 99%

“…The low insulin concentration during exercise also promotes lipolysis, making FFAs available for oxidation by exercising muscle and glycerol available to the liver for gluconeogenesis. In the insulin-treated diabetic patients, plasma insulin concentrations do not decrease during exercise and may even increase substantially if exercise is undertaken within an hour or so of an insulin injection (6,(61)(62)(63). This effect is due to increased absorption of insulin from the subcutaneous tissue, particularly if the injection site is in an exercising part of the body (64).…”

Section: Metabolic Fuel Homeostasis During Exercise In Type I Diabetesmentioning

confidence: 99%

“…In addition to lowering blood glucose (4,5) and increasing insulin sensitivity (6)(7)(8), regular exercise improves several of the recognized risk factors for cardiovascular disease. Both low-density and very-low-density lipoprotein concentrations in serum decrease with physical training (9,10), whereas high-density lipoprotein cholesterol increases (11)(12)(13)(14).…”

mentioning

confidence: 99%

See 2 more Smart Citations

Role and Management of Exercise in Diabetes Mellitus

Horton

1988

Diabetes Care

111

View full text Add to dashboard Cite

As more is understood about the physiology of exercise, in both normal and diabetic subjects, its role in the treatment of diabetes is becoming better defined. Whereas people with diabetes may derive many benefits from regular physical exercise, there are also several hazards that make exercise difficult to manage. In type I (insulin-dependent) diabetes, there are risks of hypoglycemia during or after exercise or of worsening metabolic control if insulin deficiency is present. Type II (non-insulin-dependent) diabetic patients treated with sulfonylureas are also at some increased risk of developing hypoglycemia during or after exercise, although this poses less of a problem than with insulin treatment. In individuals treated by diet alone, regulation of blood glucose during exercise is usually not a significant problem and exercise can be used as an adjunct to diet to achieve weight loss and improved insulin sensitivity. When obese type II diabetic patients are treated with very low calorie diets, adequate amounts of carbohydrate must be provided to ensure maintenance of normal muscle glycogen content, particularly if individuals wish to participate in highintensity exercise that places a heavy workload on specific muscle groups. On the other hand, moderateintensity exercise such as vigorous walking can be tolerated by individuals on very low calorie, carbohydrate-restricted diets after an appropriate period of adaptation. A number of strategies can be employed to avoid hypoglycemia in type I diabetic patients, and both type I and II diabetic patients should be examined carefully for long-term complications of their disease, which may be made worse by exercise. These considerations have led many diabetologists to consider exercise beneficial in the management of diabetes for

show abstract

Section: Ls Hortonmentioning

confidence: 99%

Section: Metabolic Fuel Homeostasis During Exercise In Type I Diabetesmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Role and Management of Exercise in Diabetes Mellitus

Horton

1988

Diabetes Care

111

View full text Add to dashboard Cite

show abstract

“…Many studies have shown positive health benefits with low-intensity exercise (Dunstan et al 1997;Poirier et al 2002;Soman et al 1979;Tessier et al 2000). Greater intensities of exercise tend to yield even greater benefits (1996), particularly changes in hemoglobin HbA 1c levels and aerobic capacity (Mourier et al 1997).…”

mentioning

confidence: 99%

Duration of Exercise as a Key Determinant of Improvement in Insulin Sensitivity in Type 2 Diabetes Patients

Zhang

Guo

et al. 2012

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

Exercise duration and intensity are important parameters in exercise prescription and play a major role in improving insulin sensitivity (including transient and persistent improvement effects following cessation of training) in patients with type 2 diabetes mellitus (T2DM). However, whether duration or intensity of exercise is the more important factor has yet to be established. Therefore, we aimed to determine whether exercise prescriptions differing in duration and intensity differ in their ability to aid T2DM patients to retain insulin sensitivity following the conclusion of a period of training. Sedentary T2DM patients (age 51.2 ± 1.3 years) were assigned to either a low-intensity (50% V 4 O 2peak , n = 27) or a high-intensity exercise group (75% V 4 O 2peak , n = 28), and followed a 12-week exercise program of 5 sessions/week and 240 kcal/session. Insulin sensitivity (oral glucose tolerance test, ISI) was measured when subjects were sedentary and at 16-24 h and 15 days after the final training bout. The low-intensity group spent more training time to training per exercise session than the high-intensity group (56.1 ± 3.0 min/session vs. 34.3 ± 2.4 min/ session) (P < 0.01), but the total amount of energy expended was the same. ISI was increased in both groups 16-24 h after the final training session, but only the low-intensity group still had elevated ISI 15 days after the cessation of training. These findings suggest that in T2DM patients, the persistent traininginduced improvements in insulin sensitivity may be more dependent on exercise duration than exercise intensity in regimens with the same level of energy expenditure.

show abstract

“…3 Current management is controversial and not adequate. In obese patients, loss of weight, 2,15 as well as exercise, 16 helps in reducing the insulin resistance. Gonadotropin suppression by the combined pills has been reported by many to help in reduction of ovarian hyperandrogenism.…”

Section: Discussionmentioning

confidence: 99%

The Hair-An Syndrome: A Report of a Misdiagnosed Case with Unfortunate Outcome

Fouda

1998

Ann Saudi Med

View full text Add to dashboard Cite

The HAIR-AN syndrome, which consists of hyperandrogenism (HA), insulin resistance (IR) and acanthosis nigricans (AN), is an underdiagnosed endocrinopathy.2 Hyperandrogenic women are seen frequently in clinical practice, the challenge being to identify a cause and source of the problem. Many such patients are classified, after thorough investigations, as polycystic ovary syndrome (PCOS). The problem with this identification is that the PCOS encompasses a wide range of clinical and laboratory presentations and, therefore, classification into subgroups may help in understanding the process and thereby targeting the management in a more appropriate way. 2The HAIR-AN syndrome is an example of a unique entity with a specific molecular basis. It was thought to be a rare syndrome, but recent experience suggests that as many as 5% of hyperandrogenic women have this syndrome. 3Here we report a classical case of HAIR-AN which had an unfortunate outcome because of initial misdiagnosis. Case ReportA 20-year-old girl presented to the Endocrinology clinic with a history of being healthy until the age of 11 years, when she started experiencing right iliac fossa pain, followed by progressive change in voice, increased body and facial hair, increased pigmentation of skin, increased sweating, with heat intolerance and persistent bitemporal headache. She also noticed enlargement of hands and feet in the six years before presentation, prompting her to change shoes and watches frequently. For the previous three years, she had been experiencing polyuria and polydipsia, was told to have diabetes mellitus, and put on a diet. She had primary amenorrhea, and was put on a combination of pills which resulted in oligomenorrhea with dysmenorrhoea. She later stopped the medication.In 1990, the patient had been seen in another hospital, had been diagnosed with appendicitis, and appendectomy was performed to remove a mass found in the right iliac fossa (there was no report on the nature of the mass). In 1993, an ultrasound scan revealed a well-defined solid mass in the pelvis, suggestive of a left ovarian tumor, and the right ovary was visualized. The ovarian mass was subsequently excised. A frozen section done at the time was inconclusive. Paraffin sections did, however, show histological features consistent with a right polycystic ovary and mild hyperthecosis (Figure 1).Upon presentation to the Endocrine clinic, examination of the patient revealed a depressed girl who was not very communicative. She was about 162 cm tall, weighed 62.2 kg and had a BP of 140/80. She had a large face with big nose and macroglossia. Her hands and feet were large and bulky, with mainly soft tissue enlargement and nonpitting edema of the lower limbs. She had significant facial hirsutism with hypertrichosis over the rest of the body and coarse terminal hair over the limbs.Acanthosis nigricans was positive at the flexor surfaces, neck, axillae, cubital fossae and the base of the neck. Abdominal examination revealed the scars of the previous two operations, with no or...

show abstract

Increased Insulin Sensitivity and Insulin Binding to Monocytes after Physical Training

Cited by 181 publications

References 28 publications

Role and Management of Exercise in Diabetes Mellitus

Role and Management of Exercise in Diabetes Mellitus

Duration of Exercise as a Key Determinant of Improvement in Insulin Sensitivity in Type 2 Diabetes Patients

The Hair-An Syndrome: A Report of a Misdiagnosed Case with Unfortunate Outcome

Contact Info

Product

Resources

About