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J Clin Endocrinol Metab. 2013 Oct;98(10):4176-86. doi: 10.1210/jc.2013-2232. Epub 2013 Aug 21.

Pancreatic β-cell function is a stronger predictor of changes in glycemic control after an aerobic exercise intervention than insulin sensitivity.

Author information

1
PhD, Department of Biomedical Sciences, Panum Institute 4.5.13, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark. thomas.solomon@sund.ku.dk.

Abstract

CONTEXT:

Understanding intersubject variability in glycemic control following exercise training will help individualize treatment.

OBJECTIVE:

Our aim was to determine whether this variability is related to training-induced changes in insulin sensitivity or pancreatic β-cell function.

DESIGN, SETTING, AND PARTICIPANTS:

We conducted an observational clinical study of 105 subjects with impaired glucose tolerance or type 2 diabetes.

INTERVENTIONS AND MAIN OUTCOME MEASURES:

Individual subject changes in fitness (VO2max), glycemia (glycosylated hemoglobin, fasting glucose, oral glucose tolerance test), insulin sensitivity (hyperinsulinemic-euglycemic clamp), oral glucose-stimulated insulin secretion (GSIS), and disposition index (DI) were measured following 12 to 16 weeks of aerobic exercise training. Regression analyses were used to identify relationships between variables.

RESULTS:

After training, 86% of subjects increased VO2max and lost weight. Glycosylated hemoglobin, fasting glucose, and 2-hour oral glucose tolerance test were reduced in 69%, 62%, and 68% of subjects, respectively, while insulin sensitivity improved in 90% of the participants. Changes in glycemic control were congruent with changes in GSIS such that 66% of subjects had a reduction in first-phase GSIS, and 46% had reduced second-phase GSIS. Training increased first- and second-phase DI in 83% and 74% of subjects. Training-induced changes in glycemic control were related to changes in GSIS (P < .05), but not insulin sensitivity or DI, and training-induced improvements in glycemic control were largest in subjects with greater pretraining GSIS.

CONCLUSIONS:

Intersubject variability in restoring glycemic control following exercise is explained primarily by changes in insulin secretion. Thus, baseline and training-induced changes in β-cell function may be a key determinant of training-induced improvements in glycemic control.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01234155.

PMID:
23966244
PMCID:
PMC3790622
DOI:
10.1210/jc.2013-2232
[Indexed for MEDLINE]
Free PMC Article

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