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Liang C, Li X, Song G, Schmidt SF, Sun L, Chen J, Pan X, Zhao H, Yan Y. Adipose Kiss1 controls aerobic exercise-related adaptive responses in adipose tissue energy homeostasis. FASEB J 2024; 38:e23743. [PMID: 38877852 DOI: 10.1096/fj.202302598rr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 05/13/2024] [Accepted: 05/31/2024] [Indexed: 06/29/2024]
Abstract
Kisspeptin signaling regulates energy homeostasis. Adiposity is the principal source and receiver of peripheral Kisspeptin, and adipose Kiss1 metastasis suppressor (Kiss1) gene expression is stimulated by exercise. However, whether the adipose Kiss1 gene regulates energy homeostasis and plays a role in adaptive alterations during prolonged exercise remains unknown. Here, we investigated the role of Kiss1 role in mice and adipose tissues and the adaptive changes it induces after exercise, using adipose-specific Kiss1 knockout (Kiss1adipoq-/-) and adeno-associated virus-induced adipose tissue Kiss1-overexpressing (Kiss1adipoq over) mice. We found that adipose-derived kisspeptin signal regulates lipid and glucose homeostasis to maintain systemic energy homeostasis, but in a sex-dependent manner, with more pronounced metabolic changes in female mice. Kiss1 regulated adaptive alterations of genes and proteins in tricarboxylic acid (TCA) cycle and oxidative phosphorylation (OxPhos) pathways in female gWAT following prolonged aerobic exercise. We could further show that adipose Kiss1 deficiency leads to reduced peroxisome proliferator-activated receptor gamma co-activator 1 alpha (PGC-1α) protein content of soleus muscle and maximum oxygen uptake (VO2 max) of female mice after prolonged exercise. Therefore, adipose Kisspeptin may be a novel adipokine that increases organ sensitivity to glucose, lipids, and oxygen following exercise.
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Affiliation(s)
- Chunyu Liang
- Department of Sport Biochemistry, School of Sport Science, Beijing Sport University (BSU), Beijing, China
- Laboratory of Sports Stress and Adaptation, General Administration of Sport of China, Beijing, China
- Department of Biochemistry and Molecular Biology, Center for Functional Genomics and Tissue Plasticity (ATLAS), University of Southern Denmark (SDU), Odense, Denmark
- School of Physical Education, Guangxi University (GXU), Nanning, China
| | - Xuehan Li
- Department of Sport Biochemistry, School of Sport Science, Beijing Sport University (BSU), Beijing, China
- Laboratory of Sports Stress and Adaptation, General Administration of Sport of China, Beijing, China
| | - Ge Song
- Department of Sport Biochemistry, School of Sport Science, Beijing Sport University (BSU), Beijing, China
- Laboratory of Sports Stress and Adaptation, General Administration of Sport of China, Beijing, China
| | - Søren Fisker Schmidt
- Department of Biochemistry and Molecular Biology, Center for Functional Genomics and Tissue Plasticity (ATLAS), University of Southern Denmark (SDU), Odense, Denmark
| | - Lingyu Sun
- Department of Sport Biochemistry, School of Sport Science, Beijing Sport University (BSU), Beijing, China
- Laboratory of Sports Stress and Adaptation, General Administration of Sport of China, Beijing, China
| | - Jianhao Chen
- Department of Sport Biochemistry, School of Sport Science, Beijing Sport University (BSU), Beijing, China
- Laboratory of Sports Stress and Adaptation, General Administration of Sport of China, Beijing, China
| | - Xinliang Pan
- Department of Sport Biochemistry, School of Sport Science, Beijing Sport University (BSU), Beijing, China
- Laboratory of Sports Stress and Adaptation, General Administration of Sport of China, Beijing, China
| | - Haotian Zhao
- Department of Sport Biochemistry, School of Sport Science, Beijing Sport University (BSU), Beijing, China
- Laboratory of Sports Stress and Adaptation, General Administration of Sport of China, Beijing, China
| | - Yi Yan
- Department of Sport Biochemistry, School of Sport Science, Beijing Sport University (BSU), Beijing, China
- Laboratory of Sports Stress and Adaptation, General Administration of Sport of China, Beijing, China
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2
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Chomiuk T, Niezgoda N, Mamcarz A, Śliż D. Physical activity in metabolic syndrome. Front Physiol 2024; 15:1365761. [PMID: 38440349 PMCID: PMC10910017 DOI: 10.3389/fphys.2024.1365761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 02/07/2024] [Indexed: 03/06/2024] Open
Abstract
Obesity has become one of the global epidemics, contributing to the burden of disease in society, increasing the risk of diabetes, cardiovascular and liver diseases. Inadequate energy balance resulting from excessive energy intake and insufficient physical activity (PA) is one of the main factors contributing to the incidence of obesity and the development of metabolic syndrome (MetS). Treatment options for obesity include lifestyle modifications, pharmacotherapy and bariatric surgery, with the latter being the most effective treatment. Lifestyle interventions involving increased PA and reduced caloric intake improve metabolic outcomes. Early implementation of exercise leads to improved physical fitness, better glycemic control and lipid profile. Undertaking systematic PA is associated with better quality of life, improves insulin sensitivity, causes additional weight loss, reduces its adverse effects on bone mass and results in better body composition. In this narrative review we summarized the current state of knowledge on the impact of PA on the components of MetS and the latest recommendations for PA in patients with MetS.
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Affiliation(s)
| | - Natalia Niezgoda
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
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3
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Almuraikhy S, Doudin A, Domling A, Althani AAJF, Elrayess MA. Molecular regulators of exercise-mediated insulin sensitivity in non-obese individuals. J Cell Mol Med 2024; 28:e18015. [PMID: 37938877 PMCID: PMC10805515 DOI: 10.1111/jcmm.18015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 11/10/2023] Open
Abstract
Insulin resistance is a significant contributor to the development of type 2 diabetes (T2D) and is associated with obesity, physical inactivity, and low maximal oxygen uptake. While intense and prolonged exercise may have negative effects, physical activity can have a positive influence on cellular metabolism and the immune system. Moderate exercise has been shown to reduce oxidative stress and improve antioxidant status, whereas intense exercise can increase oxidative stress in the short term. The impact of exercise on pro-inflammatory cytokine production is complex and varies depending on intensity and duration. Exercise can also counteract the harmful effects of ageing and inflamm-ageing. This review aims to examine the molecular pathways altered by exercise in non-obese individuals at higher risk of developing T2D, including glucose utilization, lipid metabolism, mitochondrial function, inflammation and oxidative stress, with the potential to improve insulin sensitivity. The focus is on understanding the potential benefits of exercise for improving insulin sensitivity and providing insights for future targeted interventions before onset of disease.
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Affiliation(s)
- Shamma Almuraikhy
- Biomedical Research CenterQatar UniversityDohaQatar
- Groningen Research Institute of Pharmacy, Drug DesignGroningen UniversityGroningenThe Netherlands
| | - Asmaa Doudin
- Biomedical Research CenterQatar UniversityDohaQatar
| | - Alexander Domling
- Groningen Research Institute of Pharmacy, Drug DesignGroningen UniversityGroningenThe Netherlands
| | - Asmaa Ali J. F. Althani
- Biomedical Research CenterQatar UniversityDohaQatar
- Department of Biomedical Sciences, College of Health Science, QU HealthQatar UniversityDohaQatar
| | - Mohamed A. Elrayess
- Biomedical Research CenterQatar UniversityDohaQatar
- College of Pharmacy, QU HealthQatar UniversityDohaQatar
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Guo Y, Zhang Q, Zheng L, Shou J, Zhuang S, Xiao W, Chen P. Depot-specific adaption of adipose tissue for different exercise approaches in high-fat diet/streptozocin-induced diabetic mice. Front Physiol 2023; 14:1189528. [PMID: 37485056 PMCID: PMC10358987 DOI: 10.3389/fphys.2023.1189528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 06/29/2023] [Indexed: 07/25/2023] Open
Abstract
Background: Adipose tissue pathology plays a crucial role in the pathogenesis of type 2 diabetes mellitus. Understanding the impact of exercise training on adipose tissue adaptation is of paramount importance in enhancing metabolic health. In this study, we aimed to investigate the effects of various exercise modalities on three distinct adipose tissue depots, namely, interscapular brown adipose tissue (iBAT), subcutaneous white adipose tissue (sWAT), and epididymal white adipose tissue (eWAT), in a murine model of diabetes. Methods: Male C57BL/6J mice received a 12-week high-fat diet and a single injection of streptozotocin, followed by an 8-week exercise intervention. The exercise intervention included swimming, resistance training, aerobic exercise, and high-intensity interval training (HIIT). Results: We found that exercise training reduced body weight and body fat percentage, diminished adipocyte size and increased the expression of mitochondria-related genes (PGC1, COX4, and COX8B) in three adipose tissue depots. The effects of exercise on inflammatory status include a reduction in crown-like structures and the expression of inflammatory factors, mainly in eWAT. Besides, exercise only induces the browning of sWAT, which may be related to the expression of the sympathetic marker tyrosine hydroxylase. Among the four forms of exercise, HIIT was the most effective in reducing body fat percentage, increasing muscle mass and reducing eWAT adipocyte size. The expression of oxidative phosphorylation and thermogenesis-related genes in sWAT and eWAT was highest in the HIIT group. Conclusion: When targeting adipose tissue to improve diabetes, HIIT may offer superior benefits and thus represents a more advantageous choice.
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Affiliation(s)
- Yifan Guo
- Shanghai Key Lab of Human Performance, Shanghai University of Sport, Shanghai, China
- The Key Lab of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Qilong Zhang
- Shanghai Key Lab of Human Performance, Shanghai University of Sport, Shanghai, China
- The Key Lab of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Lifang Zheng
- College of Physical Education, Shanghai University, Shanghai, China
| | - Jian Shou
- School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| | - Shuzhao Zhuang
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Weihua Xiao
- Shanghai Key Lab of Human Performance, Shanghai University of Sport, Shanghai, China
- The Key Lab of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Peijie Chen
- Shanghai Key Lab of Human Performance, Shanghai University of Sport, Shanghai, China
- The Key Lab of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
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Kostić M, Korićanac G, Tepavčević S, Stanišić J, Romić S, Ćulafić T, Ivković T, Stojiljković M. Low-Intensity Exercise Affects Cardiac Fatty Acid Oxidation by Increasing the Nuclear Content of PPARα, FOXO1, and Lipin1 in Fructose-Fed Rats. Metab Syndr Relat Disord 2023; 21:122-131. [PMID: 36625880 DOI: 10.1089/met.2022.0078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background and Aim: Excessive fructose consumption along with a sedentary lifestyle provokes metabolic disorders and cardiovascular diseases. Fructose overload causes cardiac insulin resistance and increases reliance on fatty acid (FA) uptake and catabolism. The cardiometabolic benefits of exercise training have long been appreciated. The goal of the presented study is to shed a new light to the preventive role of exercise training on cardiac lipid metabolism in fructose-fed rats. Methods: Male Wistar rats were divided into control (C), sedentary fructose (F), and exercised fructose (EF) groups. Fructose was given as a 10% fructose solution in drinking water for 9 weeks. Low-intensity exercise training was applied for 9 weeks. The protein expression and subcellular localization of Lipin1, peroxisome proliferator-activated receptor α (PPARα), and peroxisome proliferator-activated receptor-γ coactivator 1 α (PGC1) were analyzed in the heart using Western blot. Cardiac forkhead box transcription factor 1 (FOXO1) and sirtuin 1 (SIRT1) protein levels were also evaluated. Gene expression of long-chain acyl-CoA dehydrogenase was analyzed by quantitative polymerase chain reaction. Results: Exercise training has augmented the expression of main regulators of FA oxidation in the heart and achieves its effect by increasing the nuclear content of PPARα, Lipin1, and FOXO1 compared with the fructose group (P = 0.0422, P = 0.000045, P = 0.00958, respectively). In addition, Lipin1, FOXO1, and SIRT1 were increased in nuclear extract after exercise compared with the control group (P = 0.000043, P = 0.0417, P = 0.0329, respectively). In cardiac lysate, low-intensity exercise caused significantly increased protein level of PPARα, PGC1, FOXO1, and SIRT1 compared with control (P = 0.0377, P = 0.0275, P = 0.0096, P = 0.0282, respectively) and PGC1 level compared with the fructose group (P = 0.0417). Conclusion: The obtained results imply that the heart with a metabolic burden additionally relies on FA as an energy substrate after low-intensity running.
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Affiliation(s)
- Milan Kostić
- Department for Molecular Biology and Endocrinology, "Vinča" Institute of Nuclear Sciences-National Institute of the Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Goran Korićanac
- Department for Molecular Biology and Endocrinology, "Vinča" Institute of Nuclear Sciences-National Institute of the Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Snežana Tepavčević
- Department for Molecular Biology and Endocrinology, "Vinča" Institute of Nuclear Sciences-National Institute of the Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Jelena Stanišić
- Department for Molecular Biology and Endocrinology, "Vinča" Institute of Nuclear Sciences-National Institute of the Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Snježana Romić
- Department for Molecular Biology and Endocrinology, "Vinča" Institute of Nuclear Sciences-National Institute of the Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Tijana Ćulafić
- Department for Molecular Biology and Endocrinology, "Vinča" Institute of Nuclear Sciences-National Institute of the Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Tamara Ivković
- Department for Molecular Biology and Endocrinology, "Vinča" Institute of Nuclear Sciences-National Institute of the Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Mojca Stojiljković
- Department for Molecular Biology and Endocrinology, "Vinča" Institute of Nuclear Sciences-National Institute of the Republic of Serbia, University of Belgrade, Belgrade, Serbia
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Lee YJ, Hong JH, Hur MH, Seo EY. Effects of Virtual Reality Exercise Program on Blood Glucose, Body Composition, and Exercise Immersion in Patients with Type 2 Diabetes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4178. [PMID: 36901191 PMCID: PMC10002193 DOI: 10.3390/ijerph20054178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND This study is a preliminary study to examine the effect of a virtual reality exercise program (VREP) on type 2 diabetes patients. METHOD This is a randomized controlled trial for patients with type 2 diabetes (glycated hemoglobin ≥ 6.5%), diagnosed by a specialist. The virtual reality environment was set up by attaching an IoT sensor to an indoor bicycle and linking it with a smartphone, enabling exercise in an immersive virtual reality through a head-mounted display. The VREP was implemented three times a week, for two weeks. The blood glucose, body composition, and exercise immersion were analyzed at baseline, and two weeks before and after the experimental intervention. RESULT After VREP application, the mean blood glucose (F = 12.001 p < 0.001) and serum fructosamine (F = 3.274, p = 0.016) were significantly lower in the virtual reality therapy (VRT) and indoor bicycle exercise (IBE) groups than in the control group. There was no significant difference in the body mass index between the three groups; however, the muscle mass of participants in the VRT and IBE groups significantly increased compared with that of the control (F = 4.445, p = 0.003). Additionally, exercise immersion was significantly increased in the VRT group compared with that in the IBE and control groups. CONCLUSION A two week VREP had a positive effect on blood glucose, muscle mass, and exercise immersion in patients with type 2 diabetes, and is highly recommended as an effective intervention for blood glucose control in type 2 diabetes.
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Affiliation(s)
- Yu-jin Lee
- College of Nursing, University of Eulji, Uijeongbu 11759, Republic of Korea
| | - Jun-hwa Hong
- Division of Endocrinology, Department of Internal Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon 35233, Republic of Korea
| | - Myung-haeng Hur
- College of Nursing, University of Eulji, Uijeongbu 11759, Republic of Korea
| | - Eun-young Seo
- Department of Nursing, Gyeongbuk College of Health, Gimcheon 39525, Republic of Korea
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7
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Handy RM, Holloway GP. Insights into the development of insulin resistance: Unraveling the interaction of physical inactivity, lipid metabolism and mitochondrial biology. Front Physiol 2023; 14:1151389. [PMID: 37153211 PMCID: PMC10157178 DOI: 10.3389/fphys.2023.1151389] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 04/07/2023] [Indexed: 05/09/2023] Open
Abstract
While impairments in peripheral tissue insulin signalling have a well-characterized role in the development of insulin resistance and type 2 diabetes (T2D), the specific mechanisms that contribute to these impairments remain debatable. Nonetheless, a prominent hypothesis implicates the presence of a high-lipid environment, resulting in both reactive lipid accumulation and increased mitochondrial reactive oxygen species (ROS) production in the induction of peripheral tissue insulin resistance. While the etiology of insulin resistance in a high lipid environment is rapid and well documented, physical inactivity promotes insulin resistance in the absence of redox stress/lipid-mediated mechanisms, suggesting alternative mechanisms-of-action. One possible mechanism is a reduction in protein synthesis and the resultant decrease in key metabolic proteins, including canonical insulin signaling and mitochondrial proteins. While reductions in mitochondrial content associated with physical inactivity are not required for the induction of insulin resistance, this could predispose individuals to the detrimental effects of a high-lipid environment. Conversely, exercise-training induced mitochondrial biogenesis has been implicated in the protective effects of exercise. Given mitochondrial biology may represent a point of convergence linking impaired insulin sensitivity in both scenarios of chronic overfeeding and physical inactivity, this review aims to describe the interaction between mitochondrial biology, physical (in)activity and lipid metabolism within the context of insulin signalling.
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8
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Zańko A, Siewko K, Krętowski AJ, Milewski R. Lifestyle, Insulin Resistance and Semen Quality as Co-Dependent Factors of Male Infertility. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010732. [PMID: 36613051 PMCID: PMC9819053 DOI: 10.3390/ijerph20010732] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 05/11/2023]
Abstract
Infertility is a problem that affects millions of couples around the world. It is known as a disease of couples, not individuals, which makes diagnosis difficult and treatment unclear. Male infertility can have many causes, from mechanical ones to abnormal spermatogenesis or spermiogenesis. Semen quality is determined by a number of factors, including those dependent on men themselves, with the number of infertile men growing every year. These include, e.g., diet, physical activity, sleep quality, stress, among many others. As these factors co-exist with insulin resistance, which is a disease closely related to lifestyle, it has been singled out in the study due to its role in affecting semen quality. In order to examine connections between lifestyle, insulin resistance, and semen quality, a review of literature published from 1989 to 2020 in the following databases PubMed/Medline, EMBASE (Elsevier), Scopus, Web of Science, and Google Scholar was performed. Hence, semen quality, environment, and insulin resistance are interrelated, thus it is difficult to indicate which aspect is the cause and which is the effect in a particular relationship and the nature of possible correlations. Since the influence of lifestyle on semen quality has been extensively studied, it is recommended that more thorough research be done on the relationship between insulin resistance and semen quality, comparing the semen quality of men with and without insulin resistance.
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Affiliation(s)
- Adrianna Zańko
- Doctoral School, Medical University of Białystok, 15-089 Białystok, Poland
| | - Katarzyna Siewko
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Białystok, 15-276 Białystok, Poland
| | - Adam Jacek Krętowski
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Białystok, 15-276 Białystok, Poland
| | - Robert Milewski
- Department of Biostatistics and Medical Informatics, Medical University of Białystok, 15-295 Białystok, Poland
- Correspondence:
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Palermi S, Iacono O, Sirico F, Modestino M, Ruosi C, Spera R, De Luca M. The complex relationship between physical activity and diabetes: an overview. J Basic Clin Physiol Pharmacol 2022; 33:535-547. [PMID: 34592073 DOI: 10.1515/jbcpp-2021-0279] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 09/19/2021] [Indexed: 06/13/2023]
Abstract
Diabetes mellitus (DM) is a widespread condition, representing a challenging disease to manage. Exercise is being increasingly recommended as part of the therapeutic regimen for DM but the management of different forms of physical activity is difficult for individuals with diabetes, trainers, and physicians. Regular exercise can improve health and well-being, helping individuals to achieve their target lipid profile, body composition, cardio-respiratory fitness, and glycemic goals. People with diabetes tend to be as inactive as the general population, with a large percentage of individuals not achieving the minimum amount of recommended physical activity levels. Indeed, several barriers to exercise exist for persons with diabetes, including sports eligibility, multi-modality management of diabetic athletes, and inadequate knowledge about adequate type and intensity of exercise. The aim of the present review is to provide the current understanding of mechanisms, recommendations, and beneficial effects of different modalities of exercise for the treatment of DM.
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Affiliation(s)
- Stefano Palermi
- Public Health Department, University Federico II, Naples, Italy
| | - Olimpia Iacono
- Department of Translational Medical Sciences, University Federico II, Naples, Italy
| | - Felice Sirico
- Public Health Department, University Federico II, Naples, Italy
| | - Michele Modestino
- Department of Translational Medical Sciences, University Federico II, Naples, Italy
| | - Carlo Ruosi
- Public Health Department, University Federico II, Naples, Italy
| | - Rocco Spera
- Public Health Department, University Federico II, Naples, Italy
| | - Mariarosaria De Luca
- Department of Translational Medical Sciences, University Federico II, Naples, Italy
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Dhait SR, Vardhan V, Walke RR. A Review on Glycemic Control in Type 2 Diabetes Mellitus by Arm Ergometer Exercise. Cureus 2022; 14:e27476. [PMID: 36060389 PMCID: PMC9421095 DOI: 10.7759/cureus.27476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 07/30/2022] [Indexed: 11/05/2022] Open
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11
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Pooni R, Edgell H, Tamim H, Kuk JL. The association of objectively and subjectively measured physical activity and sedentary time with prediabetes and type 2 diabetes in adults: A cross-sectional study in Framingham Heart Study cohorts. Appl Physiol Nutr Metab 2022; 47:1023-1030. [PMID: 35878413 DOI: 10.1139/apnm-2022-0232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to examine whether using both objectively (accelerometer) and subjectively (questionnaire) measured moderate- to vigorous-intensity physical activity (MVPA) and sedentary time (SED) improves the prediction of prediabetes and type 2 diabetes (pre/T2D) using data from the Framingham Heart Study (n=4200). Logistic regression was used to examine the odds ratio of pre/T2D in groups cross-classified by subjective and objective MVPA and SED. Less than half of participants fell into concordant categories of MVPA and SED using subjective and objective measures, with 7.0-9.4% of participants in the extreme discordant categories of high-low or low-high subjective-objective MVPA or SED. Low objective MVPA, regardless of subjective MVPA status, was associated with a higher prevalence of pre/T2D (P<0.05). When cross-classifying by MVPA and SED, the majority of participants fell into concordant categories of MVPA-SED, with <4% of participants in the extreme discordant categories of MVPA-SED. Low objective MVPA, regardless of objective SED, was associated with a higher prevalence of pre/T2D (P<0.05). These findings suggest that low objectively measured MVPA appears more closely associated with pre/T2D risk compared to subjective measures, and there does not appear to be an additive effect of SED on pre/T2D risk after accounting for MVPA.
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Affiliation(s)
- Rubin Pooni
- York University, 7991, School of Kinesiology and Health Science, Toronto, Ontario, Canada;
| | - Heather Edgell
- York University, 7991, School of Kinesiology and Health Science, Toronto, Ontario, Canada;
| | - Hala Tamim
- York University, 7991, School of Kinesiology and Health Science, Toronto, Ontario, Canada;
| | - Jennifer L Kuk
- York University, 7991, School of Kinesiology and Health Science, Toronto, Ontario, Canada;
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12
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Association between physical activity and insulin resistance using the homeostatic model assessment for insulin resistance independent of waist circumference. Sci Rep 2022; 12:6002. [PMID: 35397649 PMCID: PMC8994755 DOI: 10.1038/s41598-022-10032-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 03/31/2022] [Indexed: 11/08/2022] Open
Abstract
Only a few studies have evaluated the relationship between physical activity (PA) and Homeostatic model assessment for insulin resistance (HOMA-IR). Therefore, we aimed to analyze the association between HOMA-IR and PA. We included 280,194 Korean without diabetes who underwent health examinations. The short form of the International Physical Activity Questionnaire was completed. PA level was divided into sedentary, mild PA, and health-enhancing PA (HEPA). The HOMA-IR levels were calculated. Confounding factors including waist circumference were adjusted. The median follow-up duration was 4.13 years. A significant inverse relationship was observed between PA level and HOMA-IR (p < 0.001). Compared with the sedentary group, HOMA-IR was lower in the HEPA group (p < 0.001), even when HEPA group decreased PA level over time (p < 0.001). Mild PA (p < 0.001) or HEPA showed a lower risk of HOMA-IR progression (p < 0.001). Increasing PA or maintaining HEPA was significantly associated with a lower HOMA-IR (p < 0.001), HOMA-IR improvement (p < 0.001), and a lower risk of HOMA-IR progression (p < 0.001). Our findings support the inverse relationship between PA and HOMA-IR in a population without diabetes. PA might improve IR and prevent its progression among populations without diabetes, independent of the waist circumference.
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13
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The 10-week of aerobic-functional training improves fasting blood sugar, insulin resistance, and lipid profile in patients with diabetic peripheral neuropathy: A randomized controlled trial. BIOMEDICAL HUMAN KINETICS 2022. [DOI: 10.2478/bhk-2022-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Study aim: This study aimed to investigate the effect of a 10-week of combined training course on concentrations of blood sugar, Insulin Resistance (HOMA-IR), and lipid profile in patients with diabetic peripheral neuropathy.
Materials and methods: This clinical trial was performed in diabetic neuropathy women and men (30–60 years old). Participants were randomly assigned to two groups: exercise (EG; n = 10) and control (CG; n = 10). The EG performed 10-week programme with one session of aerobic exercises (40% to 70% of HRReserve) and one session of functional exercises (60–90 min/ day) at the same day for four days/week and the CG performed their daily activities. The Blood glucose, IR, and lipid profile were measured initially and after the intervention.
Results: Repeated-measures ANOVA showed significant decrease in fasting blood sugar (p < 0.01) and HOMA-IR (p < 0.01), and greater improvements in TG (p < 0.05) and LDL (p < 0.05) in EG than CG, but. HDL concentration did not show significant changes.
Conclusion: The 10-week of aerobic-functional training improves fasting blood sugar, IR, and lipid profile in patients with diabetic neuropathy.
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Mohammadi A, Bijeh N, Moazzami M, Kazem Khodaei, Rahimi N. Effect of Exercise Training on Spexin Level, Appetite, Lipid Accumulation Product, Visceral Adiposity Index, and Body Composition in Adults With Type 2 Diabetes. Biol Res Nurs 2021; 24:152-162. [PMID: 34719994 DOI: 10.1177/10998004211050596] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
ObjectiveTo compare the effects of resistance and aerobic training (RT and AT) on spexin (SPX), appetite, lipid accumulation product (LAP), visceral adiposity index (VAI), and body composition in type 2 diabetes mellitus (T2DM) patients. Materials and Methods: Thirty-six T2DM men were randomized to receive RT (n = 12), AT (n = 12), or to act as a non-exercise control (CON, n = 12) 3 days a week for 12 weeks. Results: SPX was increased after both RT and AT (66.2% and 46.5%, respectively). VAI, LAP, and homeostasis model assessment-insulin resistance (HOMA-IR) were reduced in both groups, while quantitative insulin sensitivity check index (Quicki) and McAuley's indexes were increased following both interventions. However, the increases of both hunger and PFC in the RT group were greater than those of the AT. Moreover, the improvement of upper-body strength (41% vs. 10.3%) and lower-body strength (42.2% vs. 20.5%) in the RT group was greater than those of the AT. Conclusion: Our investigation shows that regardless of the modes of the regimen, a 12-week exercise intervention with RT and AT can effectively induce a significant improvement in SPX levels, appetite, LAP, VAI, and body composition in adults with T2DM.
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Affiliation(s)
- Arash Mohammadi
- Department of Exercise Physiology, Faculty of Sport Sciences, 48440Ferdowsi University of Mashhad, Mashhad, Iran
| | - Nahid Bijeh
- Department of Exercise Physiology, Faculty of Sport Sciences, 48440Ferdowsi University of Mashhad, Mashhad, Iran
| | - Mahtab Moazzami
- Department of Exercise Physiology, Faculty of Sport Sciences, 48440Ferdowsi University of Mashhad, Mashhad, Iran
| | - Kazem Khodaei
- Department of Sport Physiology and Corrective Exercise, Faculty of Sport Sciences, 117045Urmia University, Urmia, Iran
| | - Najmeh Rahimi
- Department of Internal Medicine, Vasei Hospital, 56941Sabzevar University of Medical Sciences, Sabzevar, Iran
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15
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Samudera WS, Efendi F, Indarwati R. Effect of community and peer support based healthy lifestyle program (CP-HELP) on self care behavior and fasting blood glucose in patient with type 2 Diabetes Mellitus. J Diabetes Metab Disord 2021; 20:193-199. [PMID: 34178831 PMCID: PMC8212258 DOI: 10.1007/s40200-021-00729-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 01/01/2021] [Indexed: 10/22/2022]
Abstract
Type 2 diabetes mellitus (T2DM) was one of chronic disease that remain global concern including in Indonesia. Healthy lifestyle is a part of diabetes mellitus treatment to achieve the highest health status and to prevent diabetes complication. PURPOSE This study aimed to examine the effect of community and peer support based healthy lifestyle program (CP-HELP) on self-care behavior and fasting blood glucose in patient with T2DM. METHODS The research design was used quasi experimental pre and post-test design. 163 participants with T2DM were divided into two groups, 83 participants as intervention group were given CP-HELP intervention and 80 participants as control group were given usual care. Measurement of self-care behavior used Diabetes Self-Management Questionnaire (DSMQ). Furthermore, measurement of fasting blood glucose was measured by capillary blood test. This study was used paired t test and multivariate analysis of variance. RESULTS An increase of mean value of self-care behavior was occurred in both of group intervention and control. A significant different between pre-test and post-test in intervention group (p = 0.000). Results of statistical test used paired t test in control group, was not showed significantly different (p = 0.249). Improved of fasting blood glucose only occurred in intervention group (p = 0.020). Results of multivariate statistic test was showed in both outcomes obtained significant value less than 0.05, self-care behavior (p = 0.010), fasting blood glucose (p = 0.042). CONCLUSION CP-HELP may be a promising interventional strategy to improve self-care behavior and improving of fasting blood glucose in patient with T2DM. The research results can be used as an important reference for improving self care behavior and fasting blood glucose in patient with type 2 Diabetes Mellitus.
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Affiliation(s)
- Wahyu Sukma Samudera
- Master of Nursing Study Program, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Ferry Efendi
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Retno Indarwati
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
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16
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Targets identified from exercised heart: killing multiple birds with one stone. NPJ Regen Med 2021; 6:23. [PMID: 33837221 PMCID: PMC8035363 DOI: 10.1038/s41536-021-00128-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 02/26/2021] [Indexed: 02/07/2023] Open
Abstract
Cardiovascular diseases (CVDs) are a major cause of mortality worldwide, which are mainly driven by factors such as aging, sedentary lifestyle, and excess alcohol use. Exercise targets several molecules and protects hearts against many of these physiological and pathological stimuli. Accordingly, it is widely recognized as an effective therapeutic strategy for CVD. To investigate the molecular mechanism of exercise in cardiac protection, we identify and describe several crucial targets identified from exercised hearts. These targets include insulin-like growth factor 1 (IGF1)-phosphatidylinositol 3 phosphate kinase (PI3K)/protein kinase B (AKT), transcription factor CCAAT/enhancer-binding protein β (C/EBPβ), cardiac microRNAs (miRNAs, miR-222 and miR-17-3p etc.), exosomal-miRNAs (miR-342, miR-29, etc.), Sirtuin 1 (SIRT1), and nuclear factor erythroid 2‑related factor/metallothioneins (Nrf2/Mts). Targets identified from exercised hearts can alleviate injury via multiple avenues, including: (1) promoting cardiomyocyte proliferation; (2) facilitating cardiomyocyte growth and physiologic hypertrophy; (3) elevating the anti-apoptotic capacity of cardiomyocytes; (4) improving vascular endothelial function; (5) inhibiting pathological remodeling and fibrosis; (6) promoting extracellular vesicles (EVs) production and exosomal-molecules transfer. Exercise is one treatment (‘stone’), which is cardioprotective via multiple avenues (‘birds’), and is considered ‘killing multiple birds with one stone’ in this review. Further, we discuss the potential application of EV cargos in CVD treatment. We provide an outline of targets identified from the exercised heart and their mechanisms, as well as novel ideas for CVD treatment, which may provide novel direction for preclinical trials in cardiac rehabilitation.
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17
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Zhang Q, Ding Y, Zhang J, Wang L. EFFECTS OF ACUTE EXERCISE WITH DIFFERENT INTENSITIES ON GLYCEMIC CONTROL IN PATIENTS WITH TYPE 2 DIABETES MELLITUS. ACTA ENDOCRINOLOGICA (BUCHAREST, ROMANIA : 2005) 2021; 17:212-218. [PMID: 34925570 PMCID: PMC8665237 DOI: 10.4183/aeb.2021.212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Exercise intensity is one of the most important factors that determines the effects of exercise; however, there is little known about the acute glycemic control of different exercise intensities on patients with Type 2 Diabetes Mellitus (T2DM). Here we aimed at exploring the influence of a single bout of exercise with different intensities on blood glucose levels in T2DM patients. METHODS Fifteen subjects (54.7 ± 5.8 years old) participated in a session of walking (WG), jogging (JG), or sedentary control (CG) in a randomized order on three different days. Distances in both WG and JG were set as 2 Km with a speed set as 4~4.5 Km/h for walking and 5~6 Km/h for jogging based on pretrial test. Blood glucose levels at fasting (~6:30am), pre-exercise (~8:30am), post-exercise (~9am), 11am and 4pm were detected. RESULTS Walking and jogging reached approximately moderate and high intensity based on the immediate post-exercise heart rate and RPE scores. Blood glucose levels at fasting, pre-exercise and 4pm were not substantially different among all groups (p > 0.05). JG had a significantly lower post-exercise blood glucose level (p < 0.05) when compared with CG and WG. The blood glucose level at 11am was notably lower in WG and JG than in CG (p < 0.05). CONCLUSIONS Both a single bout of jogging and walking can lower postprandial blood glucose levels in T2DM patients. When matched for exercise distance, jogging represents a more effective strategy to immediately lower postprandial glucose levels than walking.
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Affiliation(s)
- Q.Q. Zhang
- First Affiliated Hospital of Anhui Medical University - Department of Pediatrics, Hefei, Anhui, China
- Soochow University - Medical College, School of Nursing, Suzhou, Jiangsu, China
| | - Y.J. Ding
- Soochow University - Medical College, School of Nursing, Suzhou, Jiangsu, China
- Changshu No.2 People’s Hospital - Department of Endocrinology, Changshu, Jiangsu, China
| | - J.J. Zhang
- Soochow University - Medical College, School of Nursing, Suzhou, Jiangsu, China
- Zhejiang University School of Medicine Sir Run Run Shaw Hospital - Intensive Care Unit, Hangzhou, Zhejiang China
| | - L. Wang
- Soochow University - Medical College, School of Nursing, Suzhou, Jiangsu, China
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18
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Moghetti P, Balducci S, Guidetti L, Mazzuca P, Rossi E, Schena F, Moghetti P, Balducci S, Guidetti L, Schena F, Mazzuca P, Rossi E. Walking for subjects with type 2 diabetes: a systematic review and joint AMD/SID/SISMES evidence-based practical guideline. SPORT SCIENCES FOR HEALTH 2021. [DOI: 10.1007/s11332-020-00690-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Abstract
Aims
Regular exercise is considered a cornerstone in the management of type 2 diabetes mellitus (T2DM). It improves glucose control and cardiovascular risk factors, contributes to weight loss, and also improves general well-being, likely playing a role in the prevention of chronic complications of diabetes. However, compliance to exercise recommendations is generally inadequate in subjects with T2DM. Walking is the most ancestral form of physical activity in humans, easily applicable in daily life. It may represent, in many patients, a first simple step towards lifestyle changes. Nevertheless, while most diabetic patients do not engage in any weekly walking, exercise guidelines do not generally detail how to improve its use. The aims of this document are to conduct a systematic review of available literature on walking as a therapeutic tool for people with T2DM, and to provide practical, evidence-based clinical recommendations regarding its utilization in these subjects.
Data synthesis
Analysis of available RCTs proved that regular walking training, especially when supervised, improves glucose control in subjects with T2DM, with favorable effects also on cardiorespiratory fitness, body weight, and blood pressure. Moreover, some recent studies have shown that even short bouts of walking, used for breaking prolonged sitting, can ameliorate glucose profiles in diabetic patients with sedentary behavior.
Conclusions
There is sufficient evidence to recognize that walking is a useful therapeutic tool for people with T2DM. This document discusses theoretical and practical issues for improving its use.
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19
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Kostić M, Korićanac G, Tepavčević S, Stanišić J, Romić S, Ćulafić T, Ivković T, Stojiljković M. Low-intensity exercise diverts cardiac fatty acid metabolism from triacylglycerol synthesis to beta oxidation in fructose-fed rats. Arch Physiol Biochem 2021:1-11. [PMID: 33612014 DOI: 10.1080/13813455.2021.1886118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
CONTEXT Excessive fructose consumption causes ectopic lipid storage leading to metabolic disorders and cardiovascular diseases associated with defective substrate utilisation in the heart. OBJECTIVE Examining the preventive impact of low-intensity exercise on alterations related to fructose-rich diet (FRD) on cardiac fatty acid (FA) transport and metabolism. MATERIALS AND METHODS Male Wistar rats were divided into control and two groups that received 10% fructose for 9 weeks, one of which was additionally exposed to exercise. RESULTS FRD elevated plasma and cardiac TAG, FATP1 in plasma membrane, Lipin 1 in microsomes and HSL mRNA, while mitochondrial CPT1 was decreased. Exercise decreased plasma free FA level, raised CD36 in plasma membrane and FATP1 in lysate, mitochondrial CPT1 and decreased microsomal Lipin 1 in fructose-fed rats. CONCLUSIONS FRD changed plasma lipids and augmented partitioning of FA to TAG storage in the heart, whereas exercise in FRD rats switched metabolism of FA towards β-oxidation.
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Affiliation(s)
- Milan Kostić
- Department for Molecular Biology and Endocrinology, "Vinča" Institute of Nuclear Sciences - National Institute of thе Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Goran Korićanac
- Department for Molecular Biology and Endocrinology, "Vinča" Institute of Nuclear Sciences - National Institute of thе Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Snežana Tepavčević
- Department for Molecular Biology and Endocrinology, "Vinča" Institute of Nuclear Sciences - National Institute of thе Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Jelena Stanišić
- Department for Molecular Biology and Endocrinology, "Vinča" Institute of Nuclear Sciences - National Institute of thе Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Snježana Romić
- Department for Molecular Biology and Endocrinology, "Vinča" Institute of Nuclear Sciences - National Institute of thе Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Tijana Ćulafić
- Department for Molecular Biology and Endocrinology, "Vinča" Institute of Nuclear Sciences - National Institute of thе Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Tamara Ivković
- Department for Molecular Biology and Endocrinology, "Vinča" Institute of Nuclear Sciences - National Institute of thе Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Mojca Stojiljković
- Department for Molecular Biology and Endocrinology, "Vinča" Institute of Nuclear Sciences - National Institute of thе Republic of Serbia, University of Belgrade, Belgrade, Serbia
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20
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Barber TM, Kyrou I, Randeva HS, Weickert MO. Mechanisms of Insulin Resistance at the Crossroad of Obesity with Associated Metabolic Abnormalities and Cognitive Dysfunction. Int J Mol Sci 2021; 22:ijms22020546. [PMID: 33430419 PMCID: PMC7827338 DOI: 10.3390/ijms22020546] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/04/2021] [Accepted: 01/06/2021] [Indexed: 12/19/2022] Open
Abstract
Obesity mediates most of its direct medical sequelae through the development of insulin resistance (IR). The cellular effects of insulin occur through two main postreceptor pathways that are the phosphatidylinositol 3-kinase (PI3-K) and the mitogen-activated protein kinase (MAP-K) pathways. Obesity-related IR implicates the PI3-K pathway that confers the metabolic effects of insulin. Numerous and complex pathogenic pathways link obesity with the development of IR, including chronic inflammation, mitochondrial dysfunction (with the associated production of reactive oxygen species and endoplasmic reticulum stress), gut microbiota dysbiosis and adipose extracellular matrix remodelling. IR itself plays a key role in the development of metabolic dysfunction, including hypertension, dyslipidaemia and dysglycaemia. Furthermore, IR promotes weight gain related to secondary hyperinsulinaemia, with a resulting vicious cycle of worsening IR and its metabolic sequelae. Ultimately, IR underlies obesity-related conditions such as type 2 diabetes mellitus (T2D) and polycystic ovary syndrome (PCOS). IR also underlies many obesity-related malignancies, through the effects of compensatory hyperinsulinaemia on the relatively intact MAP-K insulin pathway, which controls cellular growth processes and mitoses. Furthermore, the emergent data over recent decades support an important role of obesity- and T2D-related central IR in the development of cognitive dysfunction, including effects on hippocampal synaptic plasticity. Importantly, IR is largely reversible through the optimisation of lifestyle factors that include regular engagement in physical activity with the avoidance of sedentariness, improved diet including increased fibre intake and sleep sufficiency. IR lies at the key crossroad between obesity and both metabolic and cognitive dysfunction. Given the importance of IR in the pathogenesis of many 21st century chronic diseases and its eminent reversibility, it is important that we all embrace and facilitate optimised lifestyles to improve the future health and wellbeing of the populace.
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Affiliation(s)
- Thomas M. Barber
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; (T.M.B.); (I.K.); (H.S.R.)
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry CV2 2DX, UK
| | - Ioannis Kyrou
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; (T.M.B.); (I.K.); (H.S.R.)
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry CV2 2DX, UK
- Aston Medical Research Institute, Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
| | - Harpal S. Randeva
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; (T.M.B.); (I.K.); (H.S.R.)
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry CV2 2DX, UK
- Aston Medical Research Institute, Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
| | - Martin O. Weickert
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; (T.M.B.); (I.K.); (H.S.R.)
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry CV2 2DX, UK
- Centre for Sport, Exercise and Life Sciences, Faculty of Health & Life Sciences, Coventry University, Coventry CV1 5FB, UK
- Correspondence:
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21
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Sun Y, Ding S. ER-Mitochondria Contacts and Insulin Resistance Modulation through Exercise Intervention. Int J Mol Sci 2020; 21:ijms21249587. [PMID: 33339212 PMCID: PMC7765572 DOI: 10.3390/ijms21249587] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 12/11/2020] [Accepted: 12/14/2020] [Indexed: 12/16/2022] Open
Abstract
The endoplasmic reticulum (ER) makes physical contacts with mitochondria at specific sites, and the hubs between the two organelles are called mitochondria-associated ER membranes (MAMs). MAMs are known to play key roles in biological processes, such as intracellular Ca2+ regulation, lipid trafficking, and metabolism, as well as cell death, etc. Studies demonstrated that dysregulation of MAMs significantly contributed to insulin resistance. Alterations of MAMs’ juxtaposition and integrity, impaired expressions of insulin signaling molecules, disruption of Ca2+ homeostasis, and compromised metabolic flexibility are all actively involved in the above processes. In addition, exercise training is considered as an effective stimulus to ameliorate insulin resistance. Although the underlying mechanisms for exercise-induced improvement in insulin resistance are not fully understood, MAMs may be critical for the beneficial effects of exercise.
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Affiliation(s)
- Yi Sun
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministry of Education, East China Normal University, Shanghai 200241, China;
- College of Physical Education and Health, East China Normal University, Shanghai 200241, China
| | - Shuzhe Ding
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministry of Education, East China Normal University, Shanghai 200241, China;
- College of Physical Education and Health, East China Normal University, Shanghai 200241, China
- Correspondence:
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22
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Li J, Ding X, Jian T, Lü H, Zhao L, Li J, Liu Y, Ren B, Chen J. Four sesquiterpene glycosides from loquat ( Eriobotrya japonica) leaf ameliorates palmitic acid-induced insulin resistance and lipid accumulation in HepG2 Cells via AMPK signaling pathway. PeerJ 2020; 8:e10413. [PMID: 33240683 PMCID: PMC7680621 DOI: 10.7717/peerj.10413] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/02/2020] [Indexed: 12/14/2022] Open
Abstract
Insulin resistance (IR), caused by impaired insulin signal and decreased insulin sensitivity, is generally responsible for the pathophysiology of type 2 diabetes mellitus (T2DM). Sesquiterpene glycosides (SGs), the exclusive natural products from loquat leaf, have been regarded as potential lead compounds owing to their high efficacy in hypoglycemia and hypolipidemia. Here, we evaluated the beneficial effects of four single SGs isolated from loquat leaf, including SG1, SG2, SG3 and one novel compound SG4 against palmitic acid-induced insulin resistance in HepG2 cells. SG1, SG3 and SG4 could significantly enhance glucose uptake of insulin-resistant HepG2 cells at non-cytotoxic concentration. Meanwhile, Oil Red O staining showed the decrease of both total cholesterol and triglyceride content, suggesting the amelioration of lipid accumulation by SGs in insulin-resistant HepG2 cells. Further investigations found that the expression levels of phosphorylated AMPK, ACC, IRS-1, and Akt were significantly up-regulated after SGs treatment, on the contrary, the expression levels of SREBP-1 and FAS were significantly down-regulated. Notably, AMPK inhibitor Compound C (CC) blocked the regulative effects, while AMPK activator AICAR mimicked the effects of SGs in PA-treated insulin-resistant HepG2 cells. In conclusion, SGs (SG4>SG1≈SG3>SG2) improved lipid accumulation in insulin-resistant HepG2 cells through the AMPK signaling pathway.
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Affiliation(s)
- Jiawei Li
- Institute of Botany, Jiangsu Province and Chinese Academy of Sciences, Nanjing, China
| | - Xiaoqin Ding
- Institute of Botany, Jiangsu Province and Chinese Academy of Sciences, Nanjing, China
| | - Tunyu Jian
- Institute of Botany, Jiangsu Province and Chinese Academy of Sciences, Nanjing, China
| | - Han Lü
- Institute of Botany, Jiangsu Province and Chinese Academy of Sciences, Nanjing, China
| | - Lei Zhao
- Institute of Botany, Jiangsu Province and Chinese Academy of Sciences, Nanjing, China
| | - Jing Li
- Department of Food Science and Technology, College of Light Industry and Food Engineering, Nanjing Forestry University, Nanjing, China
| | - Yan Liu
- Institute of Botany, Jiangsu Province and Chinese Academy of Sciences, Nanjing, China
| | - Bingru Ren
- Institute of Botany, Jiangsu Province and Chinese Academy of Sciences, Nanjing, China
| | - Jian Chen
- Institute of Botany, Jiangsu Province and Chinese Academy of Sciences, Nanjing, China.,Department of Food Science and Technology, College of Light Industry and Food Engineering, Nanjing Forestry University, Nanjing, China
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23
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Moghetti P, Balducci S, Guidetti L, Mazzuca P, Rossi E, Schena F. Walking for subjects with type 2 diabetes: A systematic review and joint AMD/SID/SISMES evidence-based practical guideline. Nutr Metab Cardiovasc Dis 2020; 30:1882-1898. [PMID: 32998820 DOI: 10.1016/j.numecd.2020.08.021] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 12/19/2022]
Abstract
AIMS Regular exercise is considered a cornerstone in the management of type 2 diabetes mellitus (T2DM). It improves glucose control and cardiovascular risk factors, contributes to weight loss, and also improves general well-being, likely playing a role in the prevention of chronic complications of diabetes. However, compliance to exercise recommendations is generally inadequate in subjects with T2DM. Walking is the most ancestral form of physical activity in humans, easily applicable in daily life. It may represent, in many patients, a first simple step towards lifestyle changes. Nevertheless, while most diabetic patients do not engage in any weekly walking, exercise guidelines do not generally detail how to improve its use. The aims of this document are to conduct a systematic review of available literature on walking as a therapeutic tool for people with T2DM, and to provide practical, evidence-based clinical recommendations regarding its utilization in these subjects. DATA SYNTHESIS Analysis of available RCTs proved that regular walking training, especially when supervised, improves glucose control in subjects with T2DM, with favorable effects also on cardiorespiratory fitness, body weight and blood pressure. Moreover, some recent studies have shown that even short bouts of walking, used for breaking prolonged sitting, can ameliorate glucose profiles in diabetic patients with sedentary behavior. CONCLUSIONS There is sufficient evidence to recognize that walking is a useful therapeutic tool for people with T2DM. This document discusses theoretical and practical issues for improving its use. This article is co-published in the journals Sport Sciences for Health and Nutrition, Metabolism and Cardiovascular Diseases.
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Affiliation(s)
- P Moghetti
- Unit of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Verona, Italy; Hospital Trust of Verona, Verona, Italy.
| | - S Balducci
- Department of Clinical and Molecular Medicine, La Sapienza University, Rome, Italy; Diabetes Unit, Sant'Andrea University Hospital, Rome, Italy; Metabolic Fitness Association, Monterotondo, Rome, Italy
| | - L Guidetti
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - P Mazzuca
- Unit of Internal Medicine, Diabetes and Metabolic Disease Center, Romagna Health District, Rimini, Italy; Department for Life Quality Studies, University of Bologna, Rimini, Italy
| | - E Rossi
- Diabetes Unit, ASL of Benevento, Benevento, Italy
| | - F Schena
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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24
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Rozanska O, Uruska A, Zozulinska-Ziolkiewicz D. Brain-Derived Neurotrophic Factor and Diabetes. Int J Mol Sci 2020; 21:ijms21030841. [PMID: 32012942 PMCID: PMC7037992 DOI: 10.3390/ijms21030841] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 01/21/2020] [Accepted: 01/27/2020] [Indexed: 01/22/2023] Open
Abstract
Diabetes and its chronic complications still represent a great clinical problem, despite improvements made in the diagnosis and treatment of the disease. People with diabetes have a much higher risk of impaired brain function and psychiatric disorders. Neurotrophins are factors that protect neuronal tissue and improve the function of the central nervous system, and among them is brain-derived neurotrophic factor (BDNF). The level and function of BDNF in diabetes seems to be disturbed by and connected with the presence of insulin resistance. On the other hand, there is evidence for the highly beneficial impact of physical activity on brain function and BDNF level. However, it is not clear if this protective phenomenon works in the presence of diabetes. In this review, we summarize the current available research on this topic and find that the results of published studies are ambiguous.
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Peláez-Jaramillo MJ, Valencia-Enciso N, Cárdenas-Mojica AA, Gaete PV, Scher-Nemirovsky EA, Gómez-Arango LF, Colmenares-Araque D, Castro-López CA, Betancourt-Villamizar E, Jaimes-Madrigal J, Alvarez CA, Jiménez-Mora MA, Quiroga-Padilla PJ, Puerto-Baracaldo DK, Mendivil CO. Impact of a Formulation Containing Unusual Polyunsaturated Fatty Acids, Trace Elements, Polyphenols and Plant Sterols on Insulin Resistance and Associated Disturbances. Diabetes Ther 2020; 11:229-245. [PMID: 31691133 PMCID: PMC6965541 DOI: 10.1007/s13300-019-00721-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION To evaluate the effect of a lipid-based formulation containing unusual polyunsaturated fatty acids, trace elements, polyphenols and plant sterols on insulin resistance and its associated disturbances among adults at risk of diabetes. METHODS This was an 8-week, three-arm, open-label randomized clinical trial. We studied individuals aged ≥ 18 years old with diabetes risk given by a body mass index ≥ 25 kg/m2 or a FinnRisc score ≥ 13/20. Participants were randomly assigned to receive: 7 ml sunflower oil (control group), 3.5 ml of the study formulation + 3.5 ml of sunflower oil (low-dose group) or 7 ml of study formulation (high-dose group). RESULTS We randomized 25 individuals. After one withdrawal in the high-dose group, the study sample comprised nine patients in the control, nine in the low-dose and six in the high-dose groups. The insulin sensitivity increased significantly and in a dose-dependent fashion, up to 10% in the high-dose group. At week 8 the low-dose group exhibited lower glycemic excursions during the oral glucose tolerance test (OGTT), especially 1 h after the glucose challenge (32 mg/dl or 23% lower vs. control group). The incremental area under the glucose curve in the OGTT was 17.1% lower in the low-dose group vs. the control group. Waist circumference increased in the control group, remained constant in the low-dose group and decreased in the high-dose group. C-reactive protein decreased in both formulation groups, up to 50% in the high-dose group. Participants in the formulation groups exhibited increased secretion of GLP-1 and plasma irisin at week 8 vs. the control group. CONCLUSION The formulation induced favorable changes in insulin sensitivity, glucose tolerance, abdominal obesity and inflammation. These effects and their durability will need to be assessed in larger studies. TRIAL REGISTRATION NCT03512665. FUNDING Team Foods Colombia.
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Affiliation(s)
| | | | | | - Paula V Gaete
- School of Medicine, Universidad de los Andes, Bogotá, Colombia
| | | | | | | | | | | | | | | | | | | | | | - Carlos O Mendivil
- School of Medicine, Universidad de los Andes, Bogotá, Colombia.
- Section of Endocrinology, Department of Internal Medicine, Fundación Santa Fe de Bogotá, Bogotá, Colombia.
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Niemann MJ, Tucker LA, Bailey BW, Davidson LE. Strength Training and Insulin Resistance: The Mediating Role of Body Composition. J Diabetes Res 2020; 2020:7694825. [PMID: 32455135 PMCID: PMC7235686 DOI: 10.1155/2020/7694825] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/14/2020] [Accepted: 04/21/2020] [Indexed: 12/25/2022] Open
Abstract
The main objective of the present study was to assess the association between participation in strength training and insulin resistance. Another goal was to assess the influence of several potential confounding variables on the strength training and insulin resistance relationship. Lastly, the influence of waist circumference, fat-free mass (kg), body fat percentage, and the fat-free mass index on the association between strength training and insulin resistance was assessed. This cross-sectional study included 6,561 randomly selected men and women in the U.S. Data were collected using the precise protocol established by NHANES. HOMA-IR was used as the outcome variable to index insulin resistance. Both time spent strength training and frequency of strength training bouts were used as exposure variables. There was not a statistically significant relationship between strength training and insulin resistance in women. However, before and after controlling for 11 potential confounding variables, men who reported no strength training had significantly higher levels of HOMA-IR compared to men who reported moderate or high levels of strength training (F = 9.87, P < 0.0001). Odds ratios were also assessed. Men reporting no strength training had 2.42 times the odds of having insulin resistance compared to men reporting moderate levels of strength training (95% CI: 1.19-4.93). Similarly, men reporting no strength training had 2.50 times the odds of having insulin resistance compared to men reporting high levels of strength training (95% CI: 1.25-5.00). In conclusion, there was a strong relationship between strength training and insulin resistance in U.S. men, but not in U.S. women. Differences in waist circumference, fat-free mass (kg), body fat percentage, and the fat-free mass index, as well as demographic and lifestyle measures, do not appear to mediate the relationship. The present study was not a clinical trial.
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Affiliation(s)
- McKayla J. Niemann
- Department of Exercise Sciences, Brigham Young University, Provo, Utah 84602, USA
| | - Larry A. Tucker
- Department of Exercise Sciences, Brigham Young University, Provo, Utah 84602, USA
| | - Bruce W. Bailey
- Department of Exercise Sciences, Brigham Young University, Provo, Utah 84602, USA
| | - Lance E. Davidson
- Department of Exercise Sciences, Brigham Young University, Provo, Utah 84602, USA
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Tang Y, Gong L, Chen X, Du Z, Hu J, Xu Z, Wu J, Li Q, Wang Z. Age-Related Changes in Body Composition and Bone Mineral Density and Their Relationship with the Duration of Diabetes and Glycaemic Control in Type 2 Diabetes. Diabetes Metab Syndr Obes 2020; 13:4699-4710. [PMID: 33293843 PMCID: PMC7719045 DOI: 10.2147/dmso.s278425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 11/09/2020] [Indexed: 12/25/2022] Open
Abstract
PURPOSE To investigate age-related changes in body composition (BC) and bone mineral density (BMD) in type 2 diabetes (T2D) and analyse whether diabetes duration or glycaemic control affects these factors. PATIENTS AND METHODS We enrolled 1474 hospitalized T2D patients (817 males and 657 females; 45-85 years). BC and BMD were assessed by dual-energy X-ray absorptiometry (DEXA). Patients were stratified into age groups: 45-54, 55-64, 65-74, and ≥75 years. Continuous variables were compared using t-tests or one-way analysis of variance (ANOVA), and categorical variables were compared using chi-square tests. Effects of age, diabetes duration, and haemoglobin A1C (HbA1c) on BC and BMD were assessed with multiple linear regression models. RESULTS In T2D, in females, changes in fat mass index (FMI) were positively correlated with age, while changes in lean mass index (LMI) were unrelated to age. Changes in FMI or LMI in males were unrelated to age. For regional BC distribution, changes in visceral adipose tissue (VAT) were positively correlated with age for both males and females, while changes in appendage lean mass (ALM) were negatively correlated with age. For BMD, changes in total BMD (TBMD) in males were not correlated with age, while changes in lumbar spine BMD (LBMD) were positively correlated with age, and femoral neck BMD (FNBMD) was negatively correlated with age. Changes in BMD in all parts of females were negatively correlated with age. In addition, changes in BC and BMD were unrelated to diabetes duration, and HbA1c was mainly associated with decreases in lean mass but had little effect on other BC and BMD parameters. CONCLUSION In T2D, changes in BC and BMD were associated with age but not diabetes duration. A higher HbA1c is associated with lower lean mass.
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Affiliation(s)
- Ying Tang
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Department of Endocrinology, West China-Guang’an Hospital, Sichuan University, Sichuan, People’s Republic of China
| | - Lilin Gong
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Xiangjun Chen
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Zhipeng Du
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Jinbo Hu
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Zhixin Xu
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Jinshan Wu
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Qifu Li
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Zhihong Wang
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Correspondence: Zhihong Wang The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, People’s Republic of ChinaTel/Fax +86-23-89011552 Email
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Akimoto H, Tezuka K, Nishida Y, Nakayama T, Takahashi Y, Asai S. Association between use of oral hypoglycemic agents in Japanese patients with type 2 diabetes mellitus and risk of depression: A retrospective cohort study. Pharmacol Res Perspect 2019; 7:e00536. [PMID: 31768258 PMCID: PMC6868652 DOI: 10.1002/prp2.536] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/29/2019] [Accepted: 10/10/2019] [Indexed: 12/18/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a risk factor for depression. Since brain insulin resistance plays a potential role in depression, the future risk of depression in patients with T2DM may be altered depending on the class of oral hypoglycemic agent (OHA) used for T2DM therapy. The aim of the present study was to determine if specific classes of OHAs are associated with a risk for comorbid depression in T2DM. Japanese adult patients with T2DM (n = 40 214) were divided into a case group (with depression; n = 1979) and control group (without depression; n = 38 235). After adjustment for age [adjusted odds ratio (AOR) for 10 years: 1.03; 95% confidence interval (CI): 0.99-1.07; P = .1211], sex [AOR for female: 1.39; 95% CI: 1.26-1.53; P < .0001], hemoglobin A1c [AOR for 1.0%: 1.18; 95% CI: 1.11-1.26; P < .0001], duration of T2DM [AOR for 1 year: 1.00; 95% CI: 0.99-1.01; P = .4089], and history of seven medical conditions, the odds ratios for the development of depression was significantly lower for dipeptidyl peptidase-4 (DPP-4) inhibitors [AOR: 0.31; 95% CI: 0.24-0.42; P < .0001]. However, there was no significant association for the other classes of OHAs. Therefore, this study finds that there is less risk of depression associated with the use of DPP-4 inhibitors for the treatment of T2DM.
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Affiliation(s)
- Hayato Akimoto
- Department of Biomedical SciencesNihon University School of MedicineTokyoJapan
| | - Kotoe Tezuka
- Clinical Trials Research CenterNihon University School of MedicineTokyoJapan
| | - Yayoi Nishida
- Department of Biomedical SciencesNihon University School of MedicineTokyoJapan
| | - Tomohiro Nakayama
- Department of Pathology and MicrobiologyNihon University School of MedicineTokyoJapan
| | - Yasuo Takahashi
- Clinical Trials Research CenterNihon University School of MedicineTokyoJapan
| | - Satoshi Asai
- Department of Biomedical SciencesNihon University School of MedicineTokyoJapan
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Exercise training attenuates insulin resistance and improves β-cell function in patients with systemic autoimmune myopathies: a pilot study. Clin Rheumatol 2019; 38:3435-3442. [PMID: 31401791 DOI: 10.1007/s10067-019-04738-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 07/29/2019] [Accepted: 08/04/2019] [Indexed: 01/07/2023]
Abstract
INTRODUCTION/OBJECTIVES To assess the effects of exercise training on insulin resistance and β-cell function in patients with systemic autoimmune myopathies (SAMs). METHOD This quasi-experimental, prospective study includes 9 patients with SAMs (six with dermatomyositis, two with antisynthetase syndrome, and one with polymyositis). Patients were submitted to a 12-week, twice a week, exercise training program comprising aerobic and resistance exercises. Baseline and after the intervention, we evaluated disease status, aerobic capacity, muscle strength, body composition, insulin resistance, and β-cell function parameters. RESULTS The patients have a mean age of 46.7 years and stable disease. No clinical or laboratory parameter impairment was observed after the intervention. Compared with baseline, aerobic capacity, muscle strength, and function increased after 12 weeks (P < 0.05), while no changes were observed for body composition. Data from the oral glucose tolerance test showed that exercise did not change glucose area under the curve (AUC), whereas insulin and C-peptide AUC decreased significantly (P < 0.05). Furthermore, Matsuda index and HOMA2 percentage (both surrogates of insulin resistance) also improved (P < 0.05). CONCLUSION Exercise training improved aerobic capacity, muscle strength, and muscle function in patients with SAMs. In addition, exercise training led to an attenuation of insulin resistance and improvements in β-cell function parameters. These data indicate that exercise training can mitigate metabolic impairments, attenuating the cardiovascular risk in SAMs.Key Points• Exercise training improved aerobic capacity, muscle strength, and function without disease impairment• Exercise training was capable of improve insulin resistance and β-cell function in patients with SAM• These results suggest that exercise can mitigate metabolic impairments in patients with SAM, attenuating the cardiovascular risk.
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Zhu HT, Yu M, Hu H, He QF, Pan J, Hu RY. Factors associated with glycemic control in community-dwelling elderly individuals with type 2 diabetes mellitus in Zhejiang, China: a cross-sectional study. BMC Endocr Disord 2019; 19:57. [PMID: 31170961 PMCID: PMC6555723 DOI: 10.1186/s12902-019-0384-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 05/24/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Although exercise seems to be beneficial for type 2 diabetes mellitus (T2DM) patients, there is limited research elucidating the optimal accessible indices of adiposity and insulin resistance for identifying elderly T2DM patients with poor glycemic control, which could be improved by performing regular exercise. METHODS A community-based, cross-sectional study was conducted with 918 Chinese elderly individuals with T2DM in Zhejiang. Relevant risk factors for poor glycemic control, as determined using glycated haemoglobin A1c (HbA1c) > 7%, were explored using logistic regression analyses and included body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR), fasting blood glucose (FBG), triglycerides (TGs), total cholesterol (TC), the product of fasting triglycerides and glucose (TyG), visceral adiposity index (VAI), lipid accumulation product (LAP), TyG-BMI, and TyG-WC. Comparisons of the risk factors' ability to discriminate poor glycemic control as well as their optimal cutoff values were determined using receiver operating characteristic (ROC) analyses, and then the extent of poor glycemic control risk reduction through regular exercise was examined using multivariate logistic regression analyses. RESULTS The overall poor glycemic control rate was 49.3%. The factors associated with poor glycemic control included FBG > 3.869, TyG > 8.73, TyG-BMI > 222.45, and TyG-WC > 713.48 in logistic regression analyses. The optimal cutoff points of FBG, TyG, TyG-WC, and TyG-BMI in discriminating poor glycemic control were 7.38, 9.22, 813.33, and 227.77, and their corresponding areas under the ROC curves were 0.864(0.840-0.886), 0.684(0.653-0.714), 0.604(0.571-0.635), and 0.574(0.541-0.606), respectively. Occasional and regular exercise reduced the odds ratios (95% confidence interval) of poor glycemic control to 0.187 (0.063-0.557) and 0.183 (0.059-0.571) for subjects with TyG-WC > 813.33 (p = 0.008), to 0.349 (0.156-0.782) and 0.284 (0.123-0.652) for subjects with TyG > 9.22 (p = 0.011), and to 0.390 (0.175-0.869) and 0.300(0.130-0.688) for subjects with TyG-BMI > 227.77 (p = 0.017), respectively, after adjusting for multiple confounding factors. CONCLUSION Among elderly individuals with T2DM, poor glycemic control risk might be identified using indices calculated from FBG, TG, BMI, and WC measurements, which are indicative of adiposity and insulin resistance. TyG-WC seems to be an accessible and useful indicator to identify which elderly T2DM patients would benefit from performing regular exercise to achieve good glycemic control.
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Affiliation(s)
- Hong-Ting Zhu
- Yongkang Municipal Center for Disease Control and Prevention, Jinghua, Zhejiang, 321300 China
| | - Min Yu
- Department of Occupational Diseases, Zhejiang Academy of Medical Sciences, Zhejiang, 310013 Hangzhou China
| | - Hao Hu
- Yongkang Municipal Center for Disease Control and Prevention, Jinghua, Zhejiang, 321300 China
| | - Qing-Fang He
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, No. 3399, Binsheng Road, Zhejiang, 310051 Hangzhou China
| | - Jin Pan
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, No. 3399, Binsheng Road, Zhejiang, 310051 Hangzhou China
| | - Ru-Ying Hu
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, No. 3399, Binsheng Road, Zhejiang, 310051 Hangzhou China
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Liu JX, Zhu L, Li PJ, Li N, Xu YB. Effectiveness of high-intensity interval training on glycemic control and cardiorespiratory fitness in patients with type 2 diabetes: a systematic review and meta-analysis. Aging Clin Exp Res 2019; 31:575-593. [PMID: 30097811 PMCID: PMC6491404 DOI: 10.1007/s40520-018-1012-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 07/14/2018] [Indexed: 12/25/2022]
Abstract
Aims The aim of this systematic review and meta-analysis was to quantify the effect of high-intensity interval training (HIIT) on glycemic control and cardiorespiratory fitness compared with moderate-intensity training (MICT) and no training at all in patients with type 2 diabetes (T2D). Methods Relevant articles were sourced from PubMed, Embase, the Web of Science, EBSCO, and the Cochrane Library. Randomized-controlled trials were included based upon the following criteria: participants were clinically diagnosed with T2D, outcomes that included glycemic control (e.g., hemoglobin A1c); body composition (e.g., body weight); cardiorespiratory fitness (e.g., VO2peak) are measured at baseline and post-intervention and compared with either a MICT or control group. Results Thirteen trials involving 345 patients were finally identified. HIIT elicited a significant reduction in BMI, body fat, HbA1c, fasting insulin, and VO2peak in patients with type 2 diabetes. Regarding changes in the body composition of patients, HIIT showed a great improvement in body weight (mean difference: − 1.22 kg, 95% confidence interval [CI] − 2.23 to − 0.18, P = 0.02) and body mass index (mean difference: − 0.40 kg/m2, 95% CI − 0.78 to − 0.02, P = 0.04) than MICT did. Similar results were also found with respect to HbA1c (mean difference: − 0.37, 95% CI − 0.55 to − 0.19, P < 0.0001); relative VO2peak (mean difference: 3.37 ml/kg/min, 95% CI 1.88 to 4.87, P < 0.0001); absolute VO2peak (mean difference: 0.37 L/min, 95% CI 0.28 to 0.45, P < 0.00001). Conclusions HIIT may induce more positive effects in cardiopulmonary fitness than MICT in T2D patients.
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Li J, Liu B, Cai M, Lin X, Lou S. Glucose metabolic alterations in hippocampus of diabetes mellitus rats and the regulation of aerobic exercise. Behav Brain Res 2019; 364:447-456. [DOI: 10.1016/j.bbr.2017.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 11/02/2017] [Accepted: 11/02/2017] [Indexed: 12/17/2022]
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Lundqvist MH, Almby K, Abrahamsson N, Eriksson JW. Is the Brain a Key Player in Glucose Regulation and Development of Type 2 Diabetes? Front Physiol 2019; 10:457. [PMID: 31133864 PMCID: PMC6524713 DOI: 10.3389/fphys.2019.00457] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 04/01/2019] [Indexed: 01/08/2023] Open
Abstract
Ever since Claude Bernards discovery in the mid 19th-century that a lesion in the floor of the third ventricle in dogs led to altered systemic glucose levels, a role of the CNS in whole-body glucose regulation has been acknowledged. However, this finding was later overshadowed by the isolation of pancreatic hormones in the 20th century. Since then, the understanding of glucose homeostasis and pathology has primarily evolved around peripheral mechanism. Due to scientific advances over these last few decades, however, increasing attention has been given to the possibility of the brain as a key player in glucose regulation and the pathogenesis of metabolic disorders such as type 2 diabetes. Studies of animals have enabled detailed neuroanatomical mapping of CNS structures involved in glucose regulation and key neuronal circuits and intracellular pathways have been identified. Furthermore, the development of neuroimaging techniques has provided methods to measure changes of activity in specific CNS regions upon diverse metabolic challenges in humans. In this narrative review, we discuss the available evidence on the topic. We conclude that there is much evidence in favor of active CNS involvement in glucose homeostasis but the relative importance of central vs. peripheral mechanisms remains to be elucidated. An increased understanding of this field may lead to new CNS-focusing pharmacologic strategies in the treatment of type 2 diabetes.
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Affiliation(s)
| | - Kristina Almby
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | | | - Jan W Eriksson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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Sampath Kumar A, Maiya AG, Shastry B, Vaishali K, Ravishankar N, Hazari A, Gundmi S, Jadhav R. Exercise and insulin resistance in type 2 diabetes mellitus: A systematic review and meta-analysis. Ann Phys Rehabil Med 2019; 62:98-103. [DOI: 10.1016/j.rehab.2018.11.001] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 11/15/2018] [Accepted: 11/16/2018] [Indexed: 12/11/2022]
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Mechanisms of Aerobic Exercise Upregulating the Expression of Hippocampal Synaptic Plasticity-Associated Proteins in Diabetic Rats. Neural Plast 2019; 2019:7920540. [PMID: 30911292 PMCID: PMC6398012 DOI: 10.1155/2019/7920540] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 11/21/2018] [Accepted: 11/28/2018] [Indexed: 12/15/2022] Open
Abstract
We investigated the effects of aerobic exercise on the expression of hippocampal synaptic plasticity-associated proteins in rats with type 2 diabetes and their possible mechanisms. A type 2 diabetes rat model was established with 8 weeks of high-fat diet combined with a single intraperitoneal injection of streptozotocin (STZ). Then, a 4-week aerobic exercise intervention was conducted. Memory performance was measured with Y maze tests. The expression and activity of synaptic plasticity-associated proteins and of proteins involved in the PI3K/Akt/mTOR, AMPK/Sirt1, and NFκB/NLRP3/IL-1β signaling pathways were evaluated by western blot. Our results show that aerobic exercise promotes the expression of synaptic plasticity-associated proteins in the hippocampus of diabetic rats. Aerobic exercise also activates the PI3K/Akt/mTOR and AMPK/Sirt1 signaling pathways and inhibits the NFκB/NLRP3/IL-1β signaling pathway in the hippocampus of diabetic rats. Therefore, modulating the PI3K/Akt/mTOR, AMPK/Sirt1, and NFκB/NLRP3/IL-1β signaling pathways is probably the mechanism of aerobic exercise upregulating the expression of hippocampal synaptic plasticity-associated proteins in diabetic rats.
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Nasiri-Amiri F, Sepidarkish M, Shirvani MA, Habibipour P, Tabari NSM. The effect of exercise on the prevention of gestational diabetes in obese and overweight pregnant women: a systematic review and meta-analysis. Diabetol Metab Syndr 2019; 11:72. [PMID: 31467594 PMCID: PMC6712661 DOI: 10.1186/s13098-019-0470-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 08/21/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy and its prevalence worldwide is increasing along with enhancing type two of diabetes. Contrary results have been found in some review articles that examine the effect of exercise activities on preventing GDM, regardless of obesity. Therefore, the aim of this study was to systematically review the articles on the effect of exercise activities on the prevention of GDM in obese and overweight pregnant women. MAIN TEXT Literature was retrieved by formally searching PubMed, Embase, Cochrane library, Web of Science, Scopus, Proquest and by hand searching of reference lists of related articles. Finally, a total of eight literatures included, and Review manager 5.3 and STATA 14.0 statistical software were utilized for processing. In order to investigate the effect of sports activities on the incidence of GDM, the risk ratio (RR), and for quantitative indices, the standardized mean difference (SMD) with 95% confidence interval (CI) for each study was calculated. Out of 5107 papers identified, eight papers with 1441 participants included in meta-analysis (intervention group 727, control group 714). In the intervention group, 143 (19.66%, 95% CI 76.83 to 22.74) and in the control group, 196 (27.45%, 95% CI 20.24 to 30.88%), pregnant women had diabetes. The RR of gestational diabetes was 0.76 (95% CI 0.56 to 1.03, I2 = 50%, P = 0.05). In studies that the time for the intervention was three times a week or less, effect of intervention was significant in reducing the incidence of diabetes (RR: 0.59, 95% CI 0.46 to 0.76, I2 = 0%, P = 0.47). However, in studies with repeat of intervention was more than three times a week, the effect of intervention between two intervention and control groups was not different (RR: 1.03, 95% CI 0.78 to 1.35, I2 = 0%, P = 0.46). CONCLUSIONS The exercise activities, alone, in obese or overweight pregnant women did not have a significant effect on the overall incidence of GDM, but considering the effect measure, the incidence of GDM was 24% lower in the intervention group than control group. This difference is considerable in the two groups. As the systematic review literatures both represent the information gap on the research subject and pave the way for further studies so it seems that there is a need for more randomized controlled trials so that we can make a complete conclusion on the type, intensity and duration of exercise in preventing GDM.
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Affiliation(s)
- Fatemeh Nasiri-Amiri
- Fateme Zahra Fertility & Infertility Research Health Center, Health Research Institute, Babol University of Medical Sciences, Babol, P.O.Box: 4717647745, Iran
| | - Mahdi Sepidarkish
- Department of Biostatistics and Epidemiology, Babol University of Medical Sciences, Ganjafroze Street, Babol, P.O.Box: 4717647745, Iran
| | - Marjan Ahmad Shirvani
- Department of Midwifery, School of Nursing & Midwifery, Mazandaran University of Medical Sciences, Vesal Street, Sari, P.O.Box: 4816715793, Iran
| | - Payam Habibipour
- Islamic Azad University of Medical Science Sari Branch, Sari, P.O.Box: 194-48164, Iran
| | - Narges Sadat Motahari Tabari
- Department of Midwifery, School of Nursing & Midwifery, Mazandaran University of Medical Sciences, Vesal Street, Sari, P.O.Box: 4816715793, Iran
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Motalebi SA, Iranagh JA, Mohammadi F. Effect of a Physical Activity Program on Serum Biochemical Parameters among the Elderly Women. Rev Recent Clin Trials 2019; 14:209-216. [PMID: 30706792 DOI: 10.2174/1574887114666190201113809] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 01/24/2019] [Accepted: 01/25/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND The present study examined the efficacy of the walking program on biochemical parameters among the elderly women. METHODS A total of one hundred elderly women participated in this randomized clinical trial study. The intervention group attended a 24-week walking exercise meeting five times per week. The control group continued with their routine activities. The subjects were assessed in Fasting blood glucose (FBS) and lipid profile before and after 12 and 24 weeks of the program. RESULTS The mean age of the elderly participants in the study was 68.33 ± 4.55 years. The results of repeated measures ANOVA showed a significant difference between the intervention and the control group in FBS, total cholesterol, triglyceride, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol after completing the program (for all p < 0.001). CONCLUSION The low-cost physical activity intervention could be effective for reducing chronic vascular disease risk factors among community-dwelling elderly women.
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Affiliation(s)
- Seyedeh Ameneh Motalebi
- Social Determinants of Health Research Center (SDH), Qazvin University of Medical Sciences, Qazvin, Iran
| | - Jamileh Amirzadeh Iranagh
- Social Determinants of Health Research Centre (SDH), Urmia University of Medical Sciences, Urmia, Iran
| | - Fatemeh Mohammadi
- Social Determinants of Health Research Center (SDH), Qazvin University of Medical Sciences, Qazvin, Iran
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Barreira E, Novo A, Vaz JA, Pereira AMG. Dietary program and physical activity impact on biochemical markers in patients with type 2 diabetes: A systematic review. Aten Primaria 2018; 50:590-610. [PMID: 29061310 PMCID: PMC6836882 DOI: 10.1016/j.aprim.2017.06.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 05/26/2017] [Accepted: 06/13/2017] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Evaluate the effectiveness of the implementation of independently or combined dietary and physical activity programs on the blood glucose values and lipid profile in patients with type 2 diabetes, including participants aged 60 years and over. DESIGN Systematic review. DATA SOURCE PubMed/Medline database, with language restrictions. Papers published between 2010 and 2016 were included. STUDY SELECTION A total of 30 randomised controlled trials were included that focused on physical activity and dietary interventions in patients with type 2 diabetes mellitus and include participants aged 60 years and over. RESULTS The selected articles have shown that the implementation of physical activity programs (aerobic, resistance, flexibility and combined exercises), and programs based on a higher intake of vegetables, grains, legumes, fruits, unsaturated fatty acids, as well as consumption of foods with low glycaemic index, calorie restriction, intake of probiotics, vitamin D supplementation and educational sessions about diabetes improves blood glucose levels, as well as the lipid profile, in patients with type 2 diabetes. CONCLUSIONS Physical activity and dietary programs are fundamental in the treatment and metabolic control of type 2 diabetes mellitus.
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Affiliation(s)
- Eduarda Barreira
- Health School, Polytechnic Institute of Bragança, Bragança, Portugal.
| | - André Novo
- Health School, Polytechnic Institute of Bragança, Bragança, Portugal; CINTESIS-Research Center on Health Technologies and Services, Porto, Portugal
| | - Josiana A Vaz
- Health School, Polytechnic Institute of Bragança, Bragança, Portugal; CIMO-Mountain Research Centre, Polytechnic Institute of Bragança, Campus de Santa Apolónia, Bragança, Portugal
| | - Ana M G Pereira
- Health School, Polytechnic Institute of Bragança, Bragança, Portugal
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Szilágyi B, Kukla A, Makai A, Ács P, Járomi M. Sports therapy and recreation exercise program in type 2 diabetes: randomized controlled trial, 3-month follow-up. J Sports Med Phys Fitness 2018; 59:676-685. [PMID: 29991214 DOI: 10.23736/s0022-4707.18.08591-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND A sports therapy program in type 2 diabetes helps in glucose control, but little is known how a long-term structured exercise intervention affects the parameters in this disease. Our aim was to measure the impact of a 24-week-long sports therapy program in type 2 diabetes on the concentration of glucose in blood, body composition, and physical fitness level. METHODS In this prospective longitudinal study, 208 type II diabetic patient (80 male, 128 female, aged: 61±6.86 years) were selected and randomly assigned to a control or an intervention group. The intervention group took part in a sports therapy and recreation sports program for 6 months. Taking into account the rules of training theory and physiotherapy, fitness material of exercising (aerobics, resistance training, muscle strengthening, stretching) and outdoor elements were used during the 3-month sports program, after which it became a 3-month recreation exercise program. In the control group, there was no intervention. RESULTS The intervention group showed significant decrease in concentration of glucose in blood (mean differences [MD]:-3.23; Confidence Interval [CI] lowest: -3.50; CI highest: -2.95]; P<0.01), weight (MD: -1.68; [-0.82, -0.52] P=0.01), BMI (MD: -0.37; [-0.82; 0.08]; P=0.01), body fat percentage (MD:-1.74; [-2.15, -1.34]; P=0.05) and visceral fat (MD:-0.37; [-0.67, -0.07; P=0.01); right (MD: 5.33; [4.98, 5.68]; P<0.01) and left arm curl (MD: 5.23; [4.87, 5.60]; P<0.01) test, chair stand test (MD: 2.95; [2.65, 3.25]; P=0.00) and the 6-minute walk test (MD: 111.21; [101.12; 121.31]; P<0.01) showed significant improvement. CONCLUSIONS A 24-week-long sports therapy program is a successful intervention for improving parameters affected by type 2 diabetes.
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Affiliation(s)
- Brigitta Szilágyi
- Faculty of Health Sciences, Institute of Physiotherapy and Sport Sciences, University of Pécs, Pécs, Hungary -
| | - Aniko Kukla
- Veterans Administration Hospital Cleveland, FPB School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Alexandra Makai
- Faculty of Health Sciences, Institute of Physiotherapy and Sport Sciences, University of Pécs, Pécs, Hungary
| | - Pongrác Ács
- Faculty of Health Sciences, Institute of Physiotherapy and Sport Sciences, University of Pécs, Pécs, Hungary
| | - Melinda Járomi
- Faculty of Health Sciences, Institute of Physiotherapy and Sport Sciences, University of Pécs, Pécs, Hungary
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Seib C, Parkinson J, McDonald N, Fujihira H, Zietek S, Anderson D. Lifestyle interventions for improving health and health behaviours in women with type 2 diabetes: A systematic review of the literature 2011-2017. Maturitas 2018; 111:1-14. [PMID: 29673826 DOI: 10.1016/j.maturitas.2018.02.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 02/09/2018] [Indexed: 12/12/2022]
Abstract
The development and maintenance of healthy lifestyle behaviours are among the most promising strategies for reducing complications and premature death among women living with type 2 diabetes mellitus (T2DM). However, despite the potential benefits of these interventions, they have had varying success and the sustained uptake of the recommended lifestyle modifications is limited. This paper reviews research on the impact of lifestyle interventions aimed at improving health and health behaviours in women with T2DM. In a systematic review of the literature, empirical literature from 2011 to 2017 is examined to explore the effects of various lifestyle interventions on a number of objective and subjective health indicators in women with T2DM. A total of 18 intervention studies in women aged between 21 and 75 years were included in this narrative review. Interventions included education/counselling, exercise, diet, or combined components of varying duration. The included studies used a variety of objective indicators, including glycaemic control, lipid profile and anthropometric indices, as well as a number of diabetes-specific and generic subjective scales (for example, the Diabetes Problem Solving Inventory and the Short Form 36). Significant heterogeneity was noted in the interventions and also the study findings, although exercise interventions tended to yield the most consistent benefit in relation to glycaemic control, while exercise/dietary interventions generally improved anthropometric indices. The findings from this review did not consistently suggest the greater value of any one type of intervention. Future research should consider interventions that target multiple health behaviours and emphasize health literacy, self-efficacy, and problem-solving skills.
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Affiliation(s)
- Charrlotte Seib
- Menzies Health Institute of Queensland, Griffith University, Australia; School of Nursing and Midwifery, Griffith University, Australia.
| | - Joy Parkinson
- Menzies Health Institute of Queensland, Griffith University, Australia; School of Business, Griffith University, Australia
| | - Nicole McDonald
- Menzies Health Institute of Queensland, Griffith University, Australia; School of Nursing and Midwifery, Griffith University, Australia
| | | | - Stephanie Zietek
- Menzies Health Institute of Queensland, Griffith University, Australia; School of Nursing and Midwifery, Griffith University, Australia
| | - Debra Anderson
- Menzies Health Institute of Queensland, Griffith University, Australia; School of Nursing and Midwifery, Griffith University, Australia
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Alonso-Domínguez R, Gómez-Marcos MA, Patino-Alonso MC, Sánchez-Aguadero N, Agudo-Conde C, Castaño-Sánchez C, García-Ortiz L, Recio-Rodríguez JI. Effectiveness of a multifactorial intervention based on an application for smartphones, heart-healthy walks and a nutritional workshop in patients with type 2 diabetes mellitus in primary care (EMID): study protocol for a randomised controlled trial. BMJ Open 2017; 7:e016191. [PMID: 28912193 PMCID: PMC5640135 DOI: 10.1136/bmjopen-2017-016191] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION New information and communication technologies (ICTs) may promote lifestyle changes, but no adequate evidence is available on their combined effect of ICTs with multifactorial interventions aimed at improving diet and increasing physical activity in patients with type 2 diabetes mellitus (DM2). The primary objective of this study is to assess the effect of a multifactorial intervention to increase physical activity and adherence to Mediterranean diet in DM2. METHODS AND ANALYSIS: Study scope and population: The study will be conducted at 'La Alamedilla' primary care research unit in Salamanca (Spain). 200 patients with DM2 of both sexes, aged 25-70 years and who meet the inclusion criteria and sign the informed consent will be recruited. Each participant will attend the clinic at baseline and 3 and 12 months after intervention. INTERVENTION Both groups will be given short advice on diet and physical activity. The intervention group will also take five heart-healthy walks and attend a group session on diet education and will be trained on use of an application for smartphone (EVIDENT II) for 3 months. VARIABLES AND MEASUREMENT INSTRUMENTS The main study endpoints will be changes in physical activity, as assessed by a pedometer and the International Physical Activity Questionnaire, and adherence to the Mediterranean diet, as evaluated by an adherence questionnaire and the Diet Quality Index. Anthropometric parameters and laboratory values, lifestyles and quality of life will also be assessed. ETHICS AND DISSEMINATION It was approved by the Clinical Research Ethics Committee of Salamanca on 28/11/2016. TRIAL REGISTRATION NCT02991079; Pre-results.
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Affiliation(s)
- Rosario Alonso-Domínguez
- Primary Care Research Unit, The Alamedilla Health Center, Biomedical Research Institute of Salamanca (IBSAL), Castilla and León Health Service (SACYL), Spanish Network for Preventive Activities and Health Promotion (reIAPP), Salamanca, Spain
| | - Manuel A Gómez-Marcos
- Department of Medicine, Primary Care Research Unit, The Alamedilla Health Center, Biomedical Research Institute of Salamanca (IBSAL), Castilla and León Health Service (SACYL), University of Salamanca. Spanish Network for Preventive Activities and Health Promotion (reIAPP), Salamanca, Spain
| | - Maria C Patino-Alonso
- Department of Statistics, Biomedical Research Institute of Salamanca (IBSAL), Castilla and León Health Service (SACYL), University of Salamanca, Spanish Network for Preventive Activities and Health Promotion (reIAPP), Salamanca, Spain
| | - Natalia Sánchez-Aguadero
- Primary Care Research Unit, The Alamedilla Health Center, Biomedical Research Institute of Salamanca (IBSAL), Castilla and León Health Service (SACYL), Spanish Network for Preventive Activities and Health Promotion (reIAPP), Salamanca, Spain
| | - Cristina Agudo-Conde
- Primary Care Research Unit, The Alamedilla Health Center, Biomedical Research Institute of Salamanca (IBSAL), Castilla and León Health Service (SACYL), Spanish Network for Preventive Activities and Health Promotion (reIAPP), Salamanca, Spain
| | - Carmen Castaño-Sánchez
- Primary Care Research Unit, The Alamedilla Health Center, Biomedical Research Institute of Salamanca (IBSAL), Castilla and León Health Service (SACYL), Spanish Network for Preventive Activities and Health Promotion (reIAPP), Salamanca, Spain
| | - Luis García-Ortiz
- Department of Biomedical and Diagnostic Sciences, Primary Care Research Unit, The Alamedilla Health Center, Biomedical Research Institute of Salamanca (IBSAL), Castilla and León Health Service (SACYL), University of Salamanca, Spanish Network for Preventive Activities and Health Promotion (reIAPP), Salamanca, Spain
| | - José I Recio-Rodríguez
- Department of Nursing and Physiotherapy, Primary Care Research Unit, The Alamedilla Health Center, Biomedical Research Institute of Salamanca (IBSAL), Castilla and León Health Service (SACYL), University of Salamanca. Spanish Network for Preventive Activities and Health Promotion (reIAPP), Salamanca, Spain
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Cognitive impairment in diabetes and poor glucose utilization in the intracellular neural milieu. Med Hypotheses 2017; 104:160-165. [DOI: 10.1016/j.mehy.2017.06.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 05/30/2017] [Accepted: 06/07/2017] [Indexed: 02/01/2023]
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Grace A, Chan E, Giallauria F, Graham PL, Smart NA. Clinical outcomes and glycaemic responses to different aerobic exercise training intensities in type II diabetes: a systematic review and meta-analysis. Cardiovasc Diabetol 2017; 16:37. [PMID: 28292300 PMCID: PMC5351065 DOI: 10.1186/s12933-017-0518-6] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 03/03/2017] [Indexed: 12/13/2022] Open
Abstract
Aims To establish if aerobic exercise training is associated with beneficial effects on clinical outcomes and glycaemic profile in people with type II diabetes. Methods A systematic search was conducted to identify studies through a search of MEDLINE (1985 to Sept 1, 2016, Cochrane Controlled Trials Registry (1966 to Sept 1, 2016), CINAHL, SPORTDiscus and Science Citation Index. The search strategy included a mix of MeSH and free text terms for related key concepts. Searches were limited to prospective randomized or controlled trials of aerobic exercise training in humans with type II diabetes, aged >18 years, lasting >2 weeks. Results Our analysis included 27 studies (38 intervention groups) totalling 1372 participants, 737 exercise and 635 from control groups. The studies contain data from 39,435 patient-hours of exercise training. Our analyses showed improvements with exercise in glycosylated haemoglobin (HbA1C%) MD: −0.71%, 95% CI −1.11, −0.31; p value = 0.0005. There were significant moderator effects; for every additional week of exercise HbA1C% reduces between 0.009 and 0.04%, p = 0.002. For those exercising at vigorous intensity peak oxygen consumption (peak VO2) increased a further 0.64 and 5.98 ml/kg/min compared to those doing low or moderate intensity activity. Homeostatic model assessment of insulin resistance (HOMA-IR) was also improved with exercise MD: −1.02, 95% CI −1.77, −0.28; p value = 0.007; as was fasting serum glucose MD: −12.53 mmol/l, 95% CI −18.94, −6.23; p value <0.0001; and serum MD: −10.39 IU, 95% CI −17.25, −3.53; p value = 0.003. Conclusions Our analysis support existing guidelines that for those who can tolerate it, exercise at higher intensity may offer superior fitness benefits and longer program duration will optimize reductions in HbA1C%. Electronic supplementary material The online version of this article (doi:10.1186/s12933-017-0518-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Aimee Grace
- School of Science and Technology, University of New England, Armidale, NSW, 2351, Australia
| | - Erick Chan
- School of Medicine, Griffith University, Gold Coast, Australia
| | - Francesco Giallauria
- Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | - Petra L Graham
- Department of Statistics, Macquarie University, North Ryde, Sydney, NSW, 2113, Australia
| | - Neil A Smart
- School of Science and Technology, University of New England, Armidale, NSW, 2351, Australia.
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Bird SR, Hawley JA. Update on the effects of physical activity on insulin sensitivity in humans. BMJ Open Sport Exerc Med 2017; 2:e000143. [PMID: 28879026 PMCID: PMC5569266 DOI: 10.1136/bmjsem-2016-000143] [Citation(s) in RCA: 295] [Impact Index Per Article: 42.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2016] [Indexed: 01/04/2023] Open
Abstract
PURPOSE AND METHODS This review presents established knowledge on the effects of physical activity (PA) on whole-body insulin sensitivity (SI) and summarises the findings of recent (2013-2016) studies. DISCUSSION AND CONCLUSIONS Recent studies provide further evidence to support the notion that regular PA reduces the risk of insulin resistance, metabolic syndrome and type 2 diabetes, and SI improves when individuals comply with exercise and/or PA guidelines. Many studies indicate a dose response, with higher energy expenditures and higher exercise intensities, including high intensity interval training (HIIT), producing greater benefits on whole-body SI, although these findings are not unanimous. Aerobic exercise interventions can improve SI without an associated increase in cardiorespiratory fitness as measured by maximal or peak oxygen consumption. Both aerobic and resistance exercise can induce improvements in glycaemic regulation, with some suggestions that exercise regimens including both may be more efficacious than either exercise mode alone. Some studies report exercise-induced benefits to SI that are independent of habitual diet and weight loss, while others indicate an association with fat reduction, hence the debate over the relative importance of PA and weight loss continues. During exercise, muscle contraction stimulated improvements in SI are associated with increases in AMPK activity, which deactivates TCB1D1, promoting GLUT4 translocation to the cell membrane and thereby increasing glucose uptake. Postexercise, increases in Akt deactivate TCB1D4 and thereby increase GLUT4 translocation to the cell membrane. The reduction in intramuscular saturated fatty acids and concomitant reductions in ceramides, but not diacylglycerols, provide a potential link between intramuscular lipid content and SI. Increased skeletal muscle capillarisation provides another independent adaptation through which SI is improved, as does enhanced β cell activity. Recent studies are combining exercise interventions with dietary and feeding manipulations to investigate the potential for augmenting the exercise-induced improvements in SI and glycaemic control.
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Affiliation(s)
- Stephen R Bird
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - John A Hawley
- Mary MaKillop Institute for Health Research, Centre for Exercise and Nutrition, Australian Catholic University, Melbourne, Victoria, Australia.,Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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