Abnormal glucoregulation during exercise in type II (non-insulin-dependent) diabetes.
We studied the effects of exercise on the levels of plasma glucose and glucoregulatory hormones before and after 6 weeks of thrice-weekly physical training in 20 sedentary type II (non-insulin-dependent) diabetic patients and 11 control subjects matched for previous physical activity. Parameters were measured at rest, after 30 minutes of bicycle exercise at 70% to 75% of maximal oxygen uptake, and after 30 minutes of recovery. In the untrained state exercise resulted in a decrease in plasma glucose levels in diabetics but not in controls (-12 +/- 5 v + 4 +/- 2 mg/dL, P less than .01) and the expected drop in plasma insulin level was absent in diabetics. These differences in glucose and insulin response persisted after physical training. There was a tendency for patients with diabetes to have a smaller R-R interval variation during deep breathing, an abnormal resting heart rate response to physical training, and a lesser increment in plasma epinephrine levels following exercise, findings consistent with autonomic dysfunction. Physical training resulted in a blunting of the exercise-induced increment of plasma epinephrine, growth hormone, and lactate levels in control subjects, but not in diabetics. Our data demonstrate a hypoglycemic effect of exercise in mildly hyperglycemic nonobese type II diabetics. Possible causative factors include: hyperglycemia per se, a lack of physiologic suppression of plasma insulin, and abnormalities of autonomic or hypothalamic regulatory function.
Schneider
S H
SH
Division of Endocrinology, Metabolism and Nutrition, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick 08903-0019.
Khachadurian
A K
AK
Amorosa
L F
LF
Gavras
H
H
Fineberg
S E
SE
Ruderman
N B
NB
D001786:Blood Glucose / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D004837:Epinephrine / Q000097:blood*; D005230:Fatty Acids, Nonesterified / Q000097:blood; D013006:Growth Hormone / Q000097:blood*; D006801:Humans; D007328:Insulin / Q000097:blood*; D007773:Lactates / Q000097:blood; D019344:Lactic Acid; D008297:Male; D009638:Norepinephrine / Q000097:blood*; D010100:Oxygen / Q000378:metabolism; D005082:Physical Exertion
D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D007773:Lactates; D019344:Lactic Acid; D013006:Growth Hormone; D010100:Oxygen; D009638:Norepinephrine; D004837:Epinephrine