Diabetes, Vol 36, Issue 12 1379-1385, Copyright © 1987 by American Diabetes Association

ARTICLES

Effect of physical training on insulin action in obesity

RA DeFronzo, RS Sherwin and N Kraemer
Division of Diabetes/Endocrinology, Yale University School of Medicine, New Haven, Connecticut.

We evaluated insulin secretion and insulin action with the hyperglycemic (125 mg/dl above basal) and euglycemic insulin (40 mU.m-2.min-1) clamps in seven moderately obese subjects before and after a 6-wk exercise training program. Thirty-nine normal-weight, age-matched subjects served as controls. Both fasting plasma insulin concentration and glucose-stimulated (hyperglycemic clamp) insulin secretion were significantly (P less than .001) increased in the obese subjects. After the training program fasting insulin levels decreased by 26% (P less than .01). Insulin secretion in response to hyperglycemia decreased by a similar percentage (P less than .01). Nonetheless, total-body glucose metabolism increased significantly (P less than .05) during the hyperglycemic clamp. With the euglycemic insulin clamp, obese subjects were shown to be significantly (P less than .001) insulin resistant compared with controls. The decrease in total-body glucose uptake resulted from defects in both peripheral glucose disposal and suppression of hepatic glucose production. After the 6-wk training program, insulin-mediated total-body glucose metabolism increased due to significant improvements in peripheral glucose uptake (P less than .01) and more effective suppression of hepatic glucose production (P less than .05). These results indicate that a moderate-intensity physical conditioning program is capable of ameliorating the insulin resistance and reducing glucose-stimulated hyperinsulinemia observed in obese subjects with normal glucose tolerance.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				F. M. Ivey, A. S. Ryan, C. E. Hafer-Macko, A. P. Goldberg, and R. F. Macko Treadmill Aerobic Training Improves Glucose Tolerance and Indices of Insulin Sensitivity in Disabled Stroke Survivors: A Preliminary Report Stroke, October 1, 2007; 38(10): 2752 - 2758. [Abstract] [Full Text] [PDF]

				S. Shadid, J. A. Kanaley, M. T. Sheehan, and M. D. Jensen Basal and insulin-regulated free fatty acid and glucose metabolism in humans Am J Physiol Endocrinol Metab, June 1, 2007; 292(6): E1770 - E1774. [Abstract] [Full Text] [PDF]

				K. McAuley and J. Mann Thematic review series: Patient-Oriented Research. Nutritional determinants of insulin resistance J. Lipid Res., August 1, 2006; 47(8): 1668 - 1676. [Abstract] [Full Text] [PDF]

				K. J. Nadeau, L. B. Ehlers, L. E. Aguirre, R. L. Moore, K. N. Jew, H. K. Ortmeyer, B. C. Hansen, J. E. B. Reusch, and B. Draznin Exercise training and calorie restriction increase SREBP-1 expression and intramuscular triglyceride in skeletal muscle Am J Physiol Endocrinol Metab, July 1, 2006; 291(1): E90 - E98. [Abstract] [Full Text] [PDF]

				A. Balasubramanyam, D. Hinnen, and W. Polonsky Cardiovascular Event Prevention in the Person With Type 2 Diabetes: Case Examples for Identifying and Treating Multiple Risks The Diabetes Educator, July 1, 2006; 32(Supplement_5): 163S - 173S. [Full Text] [PDF]

				N. G. Boule, S. J. Weisnagel, T. A. Lakka, A. Tremblay, R. N. Bergman, T. Rankinen, A. S. Leon, J. S. Skinner, J. H. Wilmore, D.C. Rao, et al. Effects of Exercise Training on Glucose Homeostasis: The HERITAGE Family Study Diabetes Care, January 1, 2005; 28(1): 108 - 114. [Abstract] [Full Text] [PDF]

				T. B. Price, S. Krishnan-Sarin, and D. L. Rothman Smoking impairs muscle recovery from exercise Am J Physiol Endocrinol Metab, July 1, 2003; 285(1): E116 - E122. [Abstract] [Full Text] [PDF]

				R. Ross Does Exercise Without Weight Loss Improve Insulin Sensitivity? Diabetes Care, March 1, 2003; 26(3): 944 - 945. [Full Text] [PDF]

				C. W. Cortes, P. D. Thompson, N. M. Moyna, M. D. Schluter, M. J. Leskiw, M. R. Donaldson, B. H. Duncan, and T. P. Stein Protein kinetics in stable heart failure patients J Appl Physiol, January 1, 2003; 94(1): 295 - 300. [Abstract] [Full Text] [PDF]

				I. Janssen, A. Fortier, R. Hudson, and R. Ross Effects of an Energy-Restrictive Diet With or Without Exercise on Abdominal Fat, Intermuscular Fat, and Metabolic Risk Factors in Obese Women Diabetes Care, March 1, 2002; 25(3): 431 - 438. [Abstract] [Full Text] [PDF]

				B. H. Goodpaster, J. He, S. Watkins, and D. E. Kelley Skeletal Muscle Lipid Content and Insulin Resistance: Evidence for a Paradox in Endurance-Trained Athletes J. Clin. Endocrinol. Metab., December 1, 2001; 86(12): 5755 - 5761. [Abstract] [Full Text] [PDF]

				S. Matthaei, M. Stumvoll, M. Kellerer, and H.-U. Häring Pathophysiology and Pharmacological Treatment of Insulin Resistance Endocr. Rev., December 1, 2000; 21(6): 585 - 618. [Abstract] [Full Text]

				E. T. Poehlman, R. V. Dvorak, W. F. DeNino, M. Brochu, and P. A. Ades Effects of Resistance Training and Endurance Training on Insulin Sensitivity in Nonobese, Young Women: A Controlled Randomized Trial J. Clin. Endocrinol. Metab., July 1, 2000; 85(7): 2463 - 2468. [Abstract] [Full Text]

				K. L. D. De Angelis, A. R. Oliveira, A. Werner, P. Bock, A. Bello-Klein, T. G. Fernandes, A. A. Bello, and M. C. Irigoyen Exercise Training in Aging : Hemodynamic, Metabolic, and Oxidative Stress Evaluations Hypertension, September 1, 1997; 30(3): 767 - 771. [Abstract] [Full Text]

				G. Perseghin, T. B. Price, K. F. Petersen, M. Roden, G. W. Cline, K. Gerow, D. L. Rothman, and G. I. Shulman Increased Glucose Transport-Phosphorylation and Muscle Glycogen Synthesis after Exercise Training in Insulin-Resistant Subjects N. Engl. J. Med., October 31, 1996; 335(18): 1357 - 1362. [Abstract] [Full Text] [PDF]