The effect of exercise on postprandial lipidemia in type 2 diabetic patients

Abstract

To elucidate if postprandial exercise can reduce the exaggerated lipidemia seen in type 2 diabetic patients after a high-fat meal. Two mornings eight type 2 diabetic patients (males) (58 +/- 1.2 years, BMI 28.0 +/- 0.9 kg m(-2)) and seven non-diabetic controls ate a high-fat breakfast (680 kcal m(-2), 84% fat). On one morning, 90 min later subjects cycled 60 min at 57% VO(2max). Biopsies from quadriceps muscle and abdominal subcutaneous adipose tissue were sampled after exercise or equivalent period of rest and arterialized blood for 615 min. Postprandial increases in serum total-triglyceride (TG) (incremental AUC: 1,702 +/- 576 vs. 341 +/- 117 mmol l(-1) 600 min), chylomicron-TG (incremental AUC: 1,331 +/- 495 vs. 184 +/- 55 mmol l(-1) 600 min) and VLDL-TG as well as in insulin (incremental AUC: 33,946 +/- 7,414 vs. 13,670 +/- 3,250 pmol l(-1) 600 min), C-peptide and glucose were higher in diabetic patients than in non-diabetic controls (P < 0.05). In diabetic patients these variables were reduced (P < 0.05) by exercise (total-TG incremental AUC being 1,110 +/- 444, chylomicron-TG incremental AUC 1,043 +/- 474 mmol l(-1) 600 min and insulin incremental AUC 18,668 +/- 4,412 pmol l(-1) 600 min). Lipoprotein lipase activity in muscle (11.0 +/- 2.0 vs. 24.1 +/- 3.4 mU g per wet weight, P < 0.05) and post-heparin plasma at 615 min were lower in diabetic patients than in non-diabetic controls, but did not differ in adipose tissue and did not change with exercise. In diabetic patients, 210 min after exercise oxygen uptake (P < 0.05) and fat oxidation (P < 0.1) were still higher than on non-exercise days. In type 2 diabetic patients, after a high-fat meal exercise reduces the plasma concentrations of triglyceride contained in both chylomicrons and VLDL as well as insulin secretion. This suggests protection against progression of atherosclerosis and diabetes.

Exercising for Metabolic Control: Is Timing Important?

“…Zhang et al [35] and Tobin et al [53] found no effect of postmeal moderate-intensity aerobic exercise after a high-fat meal in healthy individuals. Conversely, two other studies found a beneficial effect of postmeal exercise on the lipemic response to a high-fat meal [32,41].…”

“…Accordingly, diabetic patients, compared to a healthy control group, show higher basal levels of plasmatic TG and glucose, and these levels increase twice as much after a high-fat meal [53]. Alssema et al [58] reported that a high-carbohydrate meal elicits greater TG, glucose, and insulin responses in T2D postmenopausal women when compared to age-matched healthy counterparts.…”

“…The remaining 18 studies investigated the effect of exercise on postprandial events, modulating some parameters related to meals and exercise (i.e. exercise intensity and duration, meal size and composition) [36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53]. …”

Percutaneous Electrical Muscle Stimulation Attenuates Postprandial Hyperglycemia in Obese and Pre-obese Japanese Men

“…The experimental breakfast used in this study was very rich in lipids as well as in carbohydrates. This was because it had been reported that a single bout of voluntary exercise also attenuated postprandial lipidemia (Tobin, et al, 2008). Therefore, we also determined the eŠect of EMS on blood lipids as a reference.…”

Postprandial dysmetabolism: Too early or too late?

“…As far as postprandial lipid metabolism is concerned, it seems that exercise improves postprandial triglyceride levels in overweight young women and men with metabolic syndrome and in type 2 diabetic patients. [137][138][139] Moreover, there are data indicating that weight loss after bariatric surgery may result in lower postprandial plasma glucose values in both obese and non-obese type 2 diabetic patients.…”