The effect of hypoxia and work intensity on insulin resistance in type 2 diabetes

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

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CONTEXT: Hypoxia and muscle contraction stimulate glucose transport in vitro. We have previously demonstrated that exercise and hypoxia have an additive effect on insulin sensitivity in type 2 diabetics.

OBJECTIVES: Our objective was to examine the effects of three different hypoxic/exercise (Hy Ex) trials on glucose metabolism and insulin resistance in the 48 h after acute hypoxia in type 2 diabetics.

DESIGN, PARTICIPANTS, AND INTERVENTIONS: Eight male type 2 diabetics completed 60 min of hypoxic [mean (sem) O(2) = ∼14.7 (0.2)%] exercise at 90% of lactate threshold [Hy Ex(60); 49 (1) W]. Patients completed an additional two hypoxic trials of equal work, lasting 40 min [Hy Ex(40); 70 (1) W] and 20 min [Hy Ex(20); 140 (12) W].

MAIN OUTCOME MEASURES: Glucose rate of appearance and rate of disappearance were determined using the one-compartment minimal model. Homeostasis models of insulin resistance (HOMA(IR)), fasting insulin resistance index and β-cell function (HOMA(β-cell)) were calculated at 24 and 48 h after trials.

RESULTS: Peak glucose rate of appearance was highest during Hy Ex(20) [8.89 (0.56) mg/kg · min, P < 0.05]. HOMA(IR) and fasting insulin resistance index were improved in the 24 and 48 h after Hy Ex(60) and Hy Ex(40) (P < 0.05). HOMA(IR) decreased 24 h after Hy Ex(20) (P < 0.05) and returned to baseline values at 48 h.

CONCLUSIONS: Moderate-intensity exercise in hypoxia (Hy Ex(60) and Hy Ex(40)) stimulates acute- and moderate-term improvements in insulin sensitivity that were less apparent in Hy Ex(20). Results suggest that exercise duration and not total work completed has a greater influence on acute and moderate-term glucose control in type 2 diabetics.

Original languageEnglish
Pages (from-to)155-62
Number of pages8
JournalThe Journal of clinical endocrinology and metabolism
Issue number1
Publication statusPublished - Jan 2012


  • Adult
  • Blood Glucose
  • Diabetes Mellitus, Type 2
  • Exercise
  • Fasting
  • Glucose Tolerance Test
  • Humans
  • Hypoxia
  • Insulin Resistance
  • Male
  • Middle Aged
  • Physical Exertion
  • Workload

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