Short-term aerobic exercise training in obese humans with type 2 diabetes mellitus improves whole-body insulin sensitivity through gains in peripheral, not hepatic insulin sensitivity.
BACKGROUND
Short-term aerobic exercise training can improve whole-body insulin sensitivity in humans with type 2 diabetes mellitus; however, the contributions of peripheral and hepatic tissues to these improvements are not known.


OBJECTIVE
Our objective was to determine the effect of 7-d aerobic exercise training on peripheral and hepatic insulin sensitivity during isoglycemic/hyperinsulinemic clamp conditions.


METHODS
Subjects were randomly assigned to one of two groups. The energy balance group consumed an isocaloric diet consisting of 50% carbohydrate, 30% fat, and 20% protein for 15 d. The energy balance plus exercise group consumed a similar diet over the 15 d and performed 50-min of treadmill walking at 70% of maximum oxygen consumption maximum during the second 7 d of the 15-d study period. Each subject underwent an initial isoglycemic/hyperinsulinemic clamp after 1-wk dietary control and a second clamp after completing the study.


METHODS
The study was performed at Ohio State University's General Clinical Research Center.


METHODS
There were 18 obese, mildly diabetic humans included in the study.


METHODS
Aerobic exercise training was performed for 7 d.


METHODS
Whole-body, peripheral, and hepatic insulin sensitivity were measured.


RESULTS
Exercise training did not have an impact on peripheral glucose uptake or endogenous glucose production during the basal state or low-dose insulin. Likewise, it did not alter endogenous glucose production during high-dose insulin. However, 1-wk of exercise training increased both whole-body (P<0.05) and peripheral insulin sensitivity (P<0.0001) during high-dose insulin.


CONCLUSIONS
Improvements to whole body insulin sensitivity after short-term aerobic exercise training are due to gains in peripheral, not heptic insulin sensitivity.
Winnick
Jason J
JJ
School of Physical Activity and Educational Services, Department of Internal Medicine, The Ohio State University, Columbus 43210, USA. jason.winnick@vanderbilt.edu
Sherman
W Michael
WM
Habash
Diane L
DL
Stout
Michael B
MB
Failla
Mark L
ML
Belury
Martha A
MA
Schuster
Dara P
DP
D000328:Adult; D001481:Basal Metabolism; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D015444:Exercise; D005260:Female; D005947:Glucose / Q000378:metabolism; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance; D008099:Liver / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000378:metabolism*; D010101:Oxygen Consumption
D005947:Glucose