Effective Exercise Modality to Reduce Insulin Resistance in Women With Type 2 Diabetes

• Published in: Diabetes care Vol. 26; no. 11; pp. 2977 - 2982
• Main Authors: CUFF, Darcye J, MENILLY, Graydon S, MARTIN, Alan, IGNASZEWSKI, Andrew, TILDESLEY, Hugh D, FROHLICH, Jiri J
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.11.2003
• Subjects: Adipose Tissue - diagnostic imaging; Aged; Biological and medical sciences; Blood Glucose; Body Composition; Care and treatment; Diabetes; Diabetes Mellitus, Type 2 - diagnostic imaging; Diabetes Mellitus, Type 2 - physiopathology; Diabetes Mellitus, Type 2 - therapy; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Exercise; Female; Glucose Clamp Technique; Hormones. Endocrine system; Humans; Insulin; Insulin Resistance; Isometric exercise; Medical sciences; Menopause; Middle Aged; Muscle, Skeletal - diagnostic imaging; Pharmacology. Drug treatments; Physical Fitness; Postmenopause; Tomography, X-Ray Computed; Women; Endocrinopathy; Type 2 diabetes; Physical exercise; Human; Obesity; Pancreatic hormone; Statistical analysis; Program; Treatment efficiency; Nutrition disorder; Striated muscle; Insulin; Protein hormone; Target tissue resistance; Postmenopause; Female; Nutritional status
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.26.11.2977

Effective Exercise Modality to Reduce Insulin Resistance in Women With Type 2 Diabetes Darcye J. Cuff , MSC 1 2 , Graydon S. Meneilly , MD 3 , Alan Martin , PHD 2 , Andrew Ignaszewski , MD, FRCPC 1 , Hugh D. Tildesley , MD 1 and Jiri J. Frohlich , MD, FRCPC 1 1 St. Paul’s Hospital, Vancouver, British Columbia, Canada 2 School of Human Kinetics, University of British Columbia, Vancouver, British Columbia, Canada 3 Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada Address correspondence and reprint requests to Darcye Cuff, Healthy Heart Program, Rm. B180, St. Paul’s Hospital, 1081 Burrard St., Vancouver BC, Canada V6Z 1Y6. E-mail: dcuff{at}providencehealth.bc.ca Abstract OBJECTIVE —The purpose of this study was to evaluate whether a combined resistance and aerobic training program would improve insulin sensitivity compared with aerobic training alone in postmenopausal women with type 2 diabetes. A second objective was to relate the improved insulin sensitivity to changes in abdominal adipose tissue (AT) and thigh muscle density. RESEARCH DESIGN AND METHODS —A total of 28 obese postmenopausal women with type 2 diabetes were randomly assigned to one of three 16-week treatments: control, aerobic only training (Ae only), or aerobic plus resistance training (Ae+RT). Pre- and posttreatment outcome measures included glucose disposal by hyperinsulinemic-euglycemic clamp and computed tomography scans of abdominal AT and mid-thigh skeletal muscle. RESULTS —Glucose infusion rates increased significantly ( P < 0.05) in the Ae+RT group. Both exercise groups had reduced abdominal subcutaneous and visceral AT and increased muscle density. The Ae+RT training group exhibited a significantly greater increase in muscle density than the Ae only group. Improved glucose disposal was independently associated with changes in subcutaneous AT, visceral AT, and muscle density. Muscle density retained a relationship with glucose disposal after controlling for abdominal AT. CONCLUSIONS —Adding resistance training to aerobic training enhanced glucose disposal in postmenopausal women with type 2 diabetes. The improved insulin sensitivity is related to loss of abdominal subcutaneous and visceral AT and to increased muscle density. Ae, aerobic only training Ae+RT, aerobic plus resistance training AT, adipose tissue CT, computed tomography HU, Hounsfield units Footnotes A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. Accepted June 30, 2003. Received April 11, 2003. DIABETES CARE