The Effect of Exercise on Insulin Action in Diabetes

Lawrence, R. D.

doi:10.1136/bmj.1.3406.648

Cited by 129 publications

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“…A possible interpretation would be that insulin acts essentially to permit (or cause) accelerated transport of glucose across the cell membrane (29,30) in a process that is dependent in part on the intracellular utilization of glucose such that an increased oxidation of glucose would enhance the transport process (31,32). An analogous situation would be muscular exercise, which has long been known to have a hypoglycemic effect in diabetes (33,34), increasing glucose utilization in the presence of insulin presumably by activating glycolysis (35). Indeed, it is attractive to speculate that the failure to demonstrate a synergistic effect of (+)-decanoylcarnitine on the insulin-induced fall in plasma glucose in nonanesthetized animals was due to their increased muscular activity, since even the animals placed in restraining cages were continually moving their limbs.…”

Section: Discussionmentioning

confidence: 99%

Acute Reversal of Experimental Diabetic Ketoacidosis in the Rat with (+)-Decanoylcarnitine

McGarry¹,

Foster²

1973

J. Clin. Invest.

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A B S T R A C T The effect of (+) -decanoylcarnitine, a potent inhibitor of long-chain acylcarnitine transferase, was tested for its ability to inhibit hepatic ketogenesis both in the isolated perfused liver and in vivo in severely ketotic alloxan diabetic rats. In vitro the inhibitor caused an almost complete block in ketone body production. In vivo (+) -decanoylcarnitine caused a rapid reversal of ketosis under conditions where large doses of insulin had little effect. A combination of the two agents produced an even more striking fall in plasma ketone levels.While (+) -decanoylcarnitine alone had no effect on plasma glucose levels it enhanced the hypoglycemic effect of insulin in anesthetized animals. Loss of this effect was noted in nonanesthetized animals, possibly as a result of increased muscle activity.Studies in the isolated perfused liver indicated that the blockade of fatty acid oxidation and ketogenesis produced by (+) -decanoylcarnitine was rapidly reversible upon removal of the inhibitor.

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Section: Discussionmentioning

confidence: 99%

Acute Reversal of Experimental Diabetic Ketoacidosis in the Rat with (+)-Decanoylcarnitine

McGarry¹,

Foster²

1973

J. Clin. Invest.

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“…Exercise can play an integral role in the management of type 1 diabetes because of its blood glucose-lowering effect [1]. Adjustments to insulin dose and carbohydrate (CHO) intake are generally necessary to reduce the risk of exerciseinduced hypoglycaemia [2], and patients need to be proactive with their diabetes management to accommodate planned exercise [3].…”

Section: Introductionmentioning

confidence: 99%

Exercise under hyperinsulinaemic conditions increases whole-body glucose disposal without affecting muscle glycogen utilisation in type 1 diabetes

et al. 2006

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Aims/hypothesis We examined whole-body and muscle metabolism in patients with type 1 diabetes during moderate exercise at differing circulating insulin concentrations. Methods Eight men (mean±SEM age 36.4±1.5 years; diabetes duration 11.3±1.4 years; BMI 24.6±0.7 kg/m 2 ; HbA 1c 7.9±0.2% and VO 2 peak 44.5±1.2 ml kg −1 min −1 ) with type 1 diabetes were studied on two occasions at rest (2 h) and during 45 min of cycling at 60% maximum VO 2 with insulin infused at the rate of either 15 (LO study) or 50 (HI) mU m −2 min −1 and blood glucose clamped at 8 mmol/l. Indirect calorimetry, insulin-glucose clamps and thigh muscle biopsies were employed to measure wholebody energy and muscle metabolism. Results Fat oxidation contributed 15 and 23% to total energy expenditure during exercise in the HI and LO studies, respectively. The respective carbohydrate (CHO) oxidation rates were 31.7±2.7 and 27.8±1.9 mg kg −1 min −1 (p<0.05). Exogenous glucose utilisation rate during exercise was substantially greater (p<0.001) in the HI study (18.4± 2.1 mg kg −1 min −1 ) than in the LO study (6.9±1.2 mg kg −1 min −1 ). Muscle glycogen content fell by ∼40% during exercise in both trials. Muscle glycogen utilisation, muscle intermediary metabolism, and phosphorylation of protein kinase B/Akt, glycogen synthase kinase 3α/β and extracellular signal-regulated protein kinase 1 and 2 proteins were no different between interventions. Conclusions/interpretation In patients with type 1 diabetes, exercise under peak therapeutic insulin concentrations increases exogenous glucose utilisation but does not spare muscle glycogen utilisation. A disproportionate increase in exogenous glucose utilisation relative to the increase in CHO oxidation suggests an increase in glucose flux through non-oxidative pathways.

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“…Studies performed at the beginning of the 20th century already provided information that physical exercise could potentiate the action of insulin, and thus increases the uptake and utilization of glucose [56]. In hepatic tissue, our group demonstrated that with only one exercise session it is possible to reduce the levels of PTP-1B [64], a protein which is able to down-regulate insulin signal transduction [68].…”

Section: Fructose Consumption and Its Complicatons: The Role Of Aerobmentioning

confidence: 99%

“…Studies performed at the beginning of the 20th century already provided information that physical exercise could potentiate the action of insulin, and thus increases the uptake and utilization of glucose [56]. Recently, studies using immunofluorescence staining technique demonstrated that the glucose transporters 4 (GLUT4) are stored in vesicles in the intracellular environment during rest.…”

Section: Fructose Consumption and Its Complicatons: The Role Of Aerobmentioning

confidence: 99%

Fructose Consumption in the Development of Obesity and the Effects of Different Protocols of Physical Exercise on the Hepatic Metabolism

Pereira

Botezelli

Rodrigues

et al. 2017

Preprint

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Fructose consumption has been growing exponentially and, concomitant with this, the increase in the incidence of obesity and associated complications has followed the same behavior.Studies indicate that fructose may be a carbohydrate with greater obesogenic potential than other sugars. In this context, the liver seems to be a key organ for understanding the deleterious health effects promoted by fructose consumption. Fructose promotes complications in glucose metabolism, accumulation of triacylglycerol in the hepatocytes and alterations in the lipid profile, which, associated with an inflammatory response and alterations in the redox state, will imply a systemic picture of insulin resistance. However, physical exercise has been indicated for the treatment of several chronic diseases. In this review, we show how each exercise protocol (aerobic, strength or a combination of both) promote improvements in the obesogenic state created by fructose consumption as an improvement in the serum and liver lipid profile (HDL increase and decrease TG and LDL levels) and a reduction of markers of inflammation caused by an excess of fructose. Therefore, it is concluded that the practice of aerobic physical exercise, strength or a combination of both is essential for attenuating the complications developed by the consumption of fructose.Keywords: fructose; obesity; liver, aerobic exercise, strength exercise, combined exercise. Preprints (www.preprints.org) | NOT PEER-REVIEWED | Posted: 28 February 2017doi:10.20944/preprints201702.0103.v1Peer-reviewed version available at Nutrients 2017, 9, , 405; doi:10.3390/nu90404052 of 20 New story/old enemyThe high consumption of sugary beverages rich in fructose, is directly related to the development of obesity and its consequences, such as metabolic syndrome [1][2][3]. Concomitant with the increased incidence and prevalence of obesity and metabolic syndrome, the consumption of fructose has increased around 30% in the last 40 years [4]. More specifically, because fructose is less able to promote satiety and is more palatable, it will stimulate a higher consumption of food [4], and alter the metabolism of lipids and carbohydrates, thereby favouring the synthesis and accumulation of fat [5]. The accumulation of adipose tissue has come to be considered a global public health problem. The hypertrophy of this tissue generates harmful effects on the organism through the secretion of various types of adipokines, and for this reason obesity happens to be considered one of the major risk factors for the development of metabolic syndrome and, consequently, is listed as one of the most serious problems in relation to quality of life [6]. According to epidemiological data, it is expected that by 2025, approximately 18% of men and 21% of women worldwide will be considered obese [7]. With that in mind, since fructose consumption is strongly associated with the development of obesity, studies aimed at evaluating its role in the development of obesity are of paramount importance for a better und...

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The Effect of Exercise on Insulin Action in Diabetes

Cited by 129 publications

References 0 publications

Acute Reversal of Experimental Diabetic Ketoacidosis in the Rat with (+)-Decanoylcarnitine

Acute Reversal of Experimental Diabetic Ketoacidosis in the Rat with (+)-Decanoylcarnitine

Exercise under hyperinsulinaemic conditions increases whole-body glucose disposal without affecting muscle glycogen utilisation in type 1 diabetes

Fructose Consumption in the Development of Obesity and the Effects of Different Protocols of Physical Exercise on the Hepatic Metabolism

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