Intermittent exercise with and without hypoxia improves insulin sensitivity in individuals with type 2 diabetes

R Mackenzie; N Maxwell; P Castle; B Elliott; G Brickley; P Watt

doi:10.1210/jc.2011-2829

Intermittent exercise with and without hypoxia improves insulin sensitivity in individuals with type 2 diabetes

R Mackenzie, N Maxwell, P Castle, B Elliott, G Brickley, P Watt

Research output: Contribution to journal › Article › peer-review

Abstract

CONTEXT: Hypoxia and muscle contraction stimulate glucose transport activity in vitro. Exercise and hypoxia have additive effects on insulin sensitivity in type 2 diabetics (T2D).

OBJECTIVE: The objective of the study was to examine the effectiveness of intermittent exercise with and without hypoxia on acute- and moderate-term glucose kinetics and insulin sensitivity in T2D.

SETTING: The study was conducted at a university research center.

DESIGN, PARTICIPANTS, AND INTERVENTIONS: Eight male T2D patients completed the following: 1) 60 min of continuous exercise at 90% lactate threshold in hypoxia (HyEx60); 2) intermittent exercise at 120% lactate threshold, separated by periods of passive recovery (5:5 min) in hypoxia [Hy5:5; O₂ ∼ 14.7 (0.2)%]; and 3) intermittent exercise (5:5 min) at 120% lactate threshold in normoxia (O₂ ∼ 20.93%).

MAIN OUTCOME MEASURES: Glucose appearance and glucose disappearance, using an adapted non-steady-state one-compartment model were measured. Homeostasis models of insulin resistance (HOMA(IR)), fasting insulin resistance index (FIRI), and β-cell function were calculated 24 and 48 h after exercise conditions.

RESULTS: Glucose disappearance increased from baseline (1.85 mg/kg · min⁻¹) compared with 24 h (2.01 min/kg · min⁻¹) after HyEx60 (P = 0.031). No difference was noted for both Hy5:5 (P = 0.064) and normoxia (P = 0.385). Hy5:5 demonstrated improvements in HOMA(IR) from baseline [d 1, 6.20 (0.40)] when comparisons were made with d 2 [4.83 (0.41)] (P = 0.0013). HOMA(IR) and FIRI improved in the 24 h (HOMA(IR), P = 0.002; FIRI, P = 0.003), remaining reduced 48 h after HyEx60 (HOMA(IR), P = 0.028; and FIRI, P = 0.034).

CONCLUSION: HyEx60 offered the greatest improvements in acute and moderate-term glucose control in T2D. Intermittent exercise stimulated glucose disposal and improved post-exercise insulin resistance, which was enhanced when exercise was combined with hypoxia (Hy5:5). The data suggest a use of hypoxic exercise in treatment of T2D.

Original language	English
Pages (from-to)	E546-55
Journal	The Journal of clinical endocrinology and metabolism
Volume	97
Issue number	4
DOIs	https://doi.org/10.1210/jc.2011-2829
Publication status	Published - Apr 2012

Keywords

Algorithms
Blood Glucose
Cross-Over Studies
Deuterium
Diabetes Mellitus, Type 2
Exercise
Glucose
Humans
Hyperglycemia
Hyperinsulinism
Hypoxia
Insulin Resistance
Insulin-Secreting Cells
Kinetics
Lactic Acid
Male
Middle Aged
Models, Biological
Oxygen
Sedentary Lifestyle

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10.1210/jc.2011-2829

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@article{891ad8074f8e497f928f0c790b6b4576,

title = "Intermittent exercise with and without hypoxia improves insulin sensitivity in individuals with type 2 diabetes",

abstract = "CONTEXT: Hypoxia and muscle contraction stimulate glucose transport activity in vitro. Exercise and hypoxia have additive effects on insulin sensitivity in type 2 diabetics (T2D).OBJECTIVE: The objective of the study was to examine the effectiveness of intermittent exercise with and without hypoxia on acute- and moderate-term glucose kinetics and insulin sensitivity in T2D.SETTING: The study was conducted at a university research center.DESIGN, PARTICIPANTS, AND INTERVENTIONS: Eight male T2D patients completed the following: 1) 60 min of continuous exercise at 90% lactate threshold in hypoxia (HyEx60); 2) intermittent exercise at 120% lactate threshold, separated by periods of passive recovery (5:5 min) in hypoxia [Hy5:5; O₂ ∼ 14.7 (0.2)%]; and 3) intermittent exercise (5:5 min) at 120% lactate threshold in normoxia (O₂ ∼ 20.93%).MAIN OUTCOME MEASURES: Glucose appearance and glucose disappearance, using an adapted non-steady-state one-compartment model were measured. Homeostasis models of insulin resistance (HOMA(IR)), fasting insulin resistance index (FIRI), and β-cell function were calculated 24 and 48 h after exercise conditions.RESULTS: Glucose disappearance increased from baseline (1.85 mg/kg · min⁻¹) compared with 24 h (2.01 min/kg · min⁻¹) after HyEx60 (P = 0.031). No difference was noted for both Hy5:5 (P = 0.064) and normoxia (P = 0.385). Hy5:5 demonstrated improvements in HOMA(IR) from baseline [d 1, 6.20 (0.40)] when comparisons were made with d 2 [4.83 (0.41)] (P = 0.0013). HOMA(IR) and FIRI improved in the 24 h (HOMA(IR), P = 0.002; FIRI, P = 0.003), remaining reduced 48 h after HyEx60 (HOMA(IR), P = 0.028; and FIRI, P = 0.034).CONCLUSION: HyEx60 offered the greatest improvements in acute and moderate-term glucose control in T2D. Intermittent exercise stimulated glucose disposal and improved post-exercise insulin resistance, which was enhanced when exercise was combined with hypoxia (Hy5:5). The data suggest a use of hypoxic exercise in treatment of T2D.",

keywords = "Algorithms, Blood Glucose, Cross-Over Studies, Deuterium, Diabetes Mellitus, Type 2, Exercise, Glucose, Humans, Hyperglycemia, Hyperinsulinism, Hypoxia, Insulin Resistance, Insulin-Secreting Cells, Kinetics, Lactic Acid, Male, Middle Aged, Models, Biological, Oxygen, Sedentary Lifestyle",

author = "R Mackenzie and N Maxwell and P Castle and B Elliott and G Brickley and P Watt",

year = "2012",

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doi = "10.1210/jc.2011-2829",

language = "English",

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journal = "The Journal of clinical endocrinology and metabolism",

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TY - JOUR

T1 - Intermittent exercise with and without hypoxia improves insulin sensitivity in individuals with type 2 diabetes

AU - Mackenzie, R

AU - Maxwell, N

AU - Castle, P

AU - Elliott, B

AU - Brickley, G

AU - Watt, P

PY - 2012/4

Y1 - 2012/4

N2 - CONTEXT: Hypoxia and muscle contraction stimulate glucose transport activity in vitro. Exercise and hypoxia have additive effects on insulin sensitivity in type 2 diabetics (T2D).OBJECTIVE: The objective of the study was to examine the effectiveness of intermittent exercise with and without hypoxia on acute- and moderate-term glucose kinetics and insulin sensitivity in T2D.SETTING: The study was conducted at a university research center.DESIGN, PARTICIPANTS, AND INTERVENTIONS: Eight male T2D patients completed the following: 1) 60 min of continuous exercise at 90% lactate threshold in hypoxia (HyEx60); 2) intermittent exercise at 120% lactate threshold, separated by periods of passive recovery (5:5 min) in hypoxia [Hy5:5; O₂ ∼ 14.7 (0.2)%]; and 3) intermittent exercise (5:5 min) at 120% lactate threshold in normoxia (O₂ ∼ 20.93%).MAIN OUTCOME MEASURES: Glucose appearance and glucose disappearance, using an adapted non-steady-state one-compartment model were measured. Homeostasis models of insulin resistance (HOMA(IR)), fasting insulin resistance index (FIRI), and β-cell function were calculated 24 and 48 h after exercise conditions.RESULTS: Glucose disappearance increased from baseline (1.85 mg/kg · min⁻¹) compared with 24 h (2.01 min/kg · min⁻¹) after HyEx60 (P = 0.031). No difference was noted for both Hy5:5 (P = 0.064) and normoxia (P = 0.385). Hy5:5 demonstrated improvements in HOMA(IR) from baseline [d 1, 6.20 (0.40)] when comparisons were made with d 2 [4.83 (0.41)] (P = 0.0013). HOMA(IR) and FIRI improved in the 24 h (HOMA(IR), P = 0.002; FIRI, P = 0.003), remaining reduced 48 h after HyEx60 (HOMA(IR), P = 0.028; and FIRI, P = 0.034).CONCLUSION: HyEx60 offered the greatest improvements in acute and moderate-term glucose control in T2D. Intermittent exercise stimulated glucose disposal and improved post-exercise insulin resistance, which was enhanced when exercise was combined with hypoxia (Hy5:5). The data suggest a use of hypoxic exercise in treatment of T2D.

AB - CONTEXT: Hypoxia and muscle contraction stimulate glucose transport activity in vitro. Exercise and hypoxia have additive effects on insulin sensitivity in type 2 diabetics (T2D).OBJECTIVE: The objective of the study was to examine the effectiveness of intermittent exercise with and without hypoxia on acute- and moderate-term glucose kinetics and insulin sensitivity in T2D.SETTING: The study was conducted at a university research center.DESIGN, PARTICIPANTS, AND INTERVENTIONS: Eight male T2D patients completed the following: 1) 60 min of continuous exercise at 90% lactate threshold in hypoxia (HyEx60); 2) intermittent exercise at 120% lactate threshold, separated by periods of passive recovery (5:5 min) in hypoxia [Hy5:5; O₂ ∼ 14.7 (0.2)%]; and 3) intermittent exercise (5:5 min) at 120% lactate threshold in normoxia (O₂ ∼ 20.93%).MAIN OUTCOME MEASURES: Glucose appearance and glucose disappearance, using an adapted non-steady-state one-compartment model were measured. Homeostasis models of insulin resistance (HOMA(IR)), fasting insulin resistance index (FIRI), and β-cell function were calculated 24 and 48 h after exercise conditions.RESULTS: Glucose disappearance increased from baseline (1.85 mg/kg · min⁻¹) compared with 24 h (2.01 min/kg · min⁻¹) after HyEx60 (P = 0.031). No difference was noted for both Hy5:5 (P = 0.064) and normoxia (P = 0.385). Hy5:5 demonstrated improvements in HOMA(IR) from baseline [d 1, 6.20 (0.40)] when comparisons were made with d 2 [4.83 (0.41)] (P = 0.0013). HOMA(IR) and FIRI improved in the 24 h (HOMA(IR), P = 0.002; FIRI, P = 0.003), remaining reduced 48 h after HyEx60 (HOMA(IR), P = 0.028; and FIRI, P = 0.034).CONCLUSION: HyEx60 offered the greatest improvements in acute and moderate-term glucose control in T2D. Intermittent exercise stimulated glucose disposal and improved post-exercise insulin resistance, which was enhanced when exercise was combined with hypoxia (Hy5:5). The data suggest a use of hypoxic exercise in treatment of T2D.

KW - Algorithms

KW - Blood Glucose

KW - Cross-Over Studies

KW - Deuterium

KW - Diabetes Mellitus, Type 2

KW - Exercise

KW - Glucose

KW - Humans

KW - Hyperglycemia

KW - Hyperinsulinism

KW - Hypoxia

KW - Insulin Resistance

KW - Insulin-Secreting Cells

KW - Kinetics

KW - Lactic Acid

KW - Male

KW - Middle Aged

KW - Models, Biological

KW - Oxygen

KW - Sedentary Lifestyle

U2 - 10.1210/jc.2011-2829

DO - 10.1210/jc.2011-2829

M3 - Article

C2 - 22278428

SN - 0021-972X

VL - 97

SP - E546-55

JO - The Journal of clinical endocrinology and metabolism

JF - The Journal of clinical endocrinology and metabolism

IS - 4

ER -