Intermittent exercise with and without hypoxia improves insulin sensitivity in individuals with type 2 diabetes

J Clin Endocrinol Metab. 2012 Apr;97(4):E546-55. doi: 10.1210/jc.2011-2829. Epub 2012 Jan 25.

Abstract

Context: Hypoxia and muscle contraction stimulate glucose transport activity in vitro. Exercise and hypoxia have additive effects on insulin sensitivity in type 2 diabetics (T2D).

Objective: The objective of the study was to examine the effectiveness of intermittent exercise with and without hypoxia on acute- and moderate-term glucose kinetics and insulin sensitivity in T2D.

Setting: The study was conducted at a university research center.

Design, participants, and interventions: Eight male T2D patients completed the following: 1) 60 min of continuous exercise at 90% lactate threshold in hypoxia (HyEx60); 2) intermittent exercise at 120% lactate threshold, separated by periods of passive recovery (5:5 min) in hypoxia [Hy5:5; O₂ ∼ 14.7 (0.2)%]; and 3) intermittent exercise (5:5 min) at 120% lactate threshold in normoxia (O₂ ∼ 20.93%).

Main outcome measures: Glucose appearance and glucose disappearance, using an adapted non-steady-state one-compartment model were measured. Homeostasis models of insulin resistance (HOMA(IR)), fasting insulin resistance index (FIRI), and β-cell function were calculated 24 and 48 h after exercise conditions.

Results: Glucose disappearance increased from baseline (1.85 mg/kg · min⁻¹) compared with 24 h (2.01 min/kg · min⁻¹) after HyEx60 (P = 0.031). No difference was noted for both Hy5:5 (P = 0.064) and normoxia (P = 0.385). Hy5:5 demonstrated improvements in HOMA(IR) from baseline [d 1, 6.20 (0.40)] when comparisons were made with d 2 [4.83 (0.41)] (P = 0.0013). HOMA(IR) and FIRI improved in the 24 h (HOMA(IR), P = 0.002; FIRI, P = 0.003), remaining reduced 48 h after HyEx60 (HOMA(IR), P = 0.028; and FIRI, P = 0.034).

Conclusion: HyEx60 offered the greatest improvements in acute and moderate-term glucose control in T2D. Intermittent exercise stimulated glucose disposal and improved post-exercise insulin resistance, which was enhanced when exercise was combined with hypoxia (Hy5:5). The data suggest a use of hypoxic exercise in treatment of T2D.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Algorithms
  • Blood Glucose / analysis
  • Cross-Over Studies
  • Deuterium
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetes Mellitus, Type 2 / therapy*
  • Exercise*
  • Glucose / metabolism
  • Humans
  • Hyperglycemia / prevention & control
  • Hyperinsulinism / prevention & control
  • Hypoxia / etiology*
  • Insulin Resistance*
  • Insulin-Secreting Cells / metabolism
  • Kinetics
  • Lactic Acid / blood*
  • Male
  • Middle Aged
  • Models, Biological
  • Oxygen / blood*
  • Sedentary Behavior

Substances

  • Blood Glucose
  • Lactic Acid
  • Deuterium
  • Glucose
  • Oxygen