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

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

doi:10.1210/jc.2011-1843

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

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

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

Abstract

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 language	English
Pages (from-to)	155-62
Number of pages	8
Journal	The Journal of clinical endocrinology and metabolism
Volume	97
Issue number	1
DOIs	https://doi.org/10.1210/jc.2011-1843
Publication status	Published - Jan 2012

Keywords

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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10.1210/jc.2011-1843

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title = "The effect of hypoxia and work intensity on insulin resistance in type 2 diabetes",

abstract = "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.",

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

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

year = "2012",

month = jan,

doi = "10.1210/jc.2011-1843",

language = "English",

volume = "97",

pages = "155--62",

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

issn = "0021-972X",

publisher = "The Endocrine Society",

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TY - JOUR

T1 - The effect of hypoxia and work intensity on insulin resistance in type 2 diabetes

AU - Mackenzie, R

AU - Elliott, B

AU - Maxwell, N

AU - Brickley, G

AU - Watt, P

PY - 2012/1

Y1 - 2012/1

N2 - 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.

AB - 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.

KW - Adult

KW - Blood Glucose

KW - Diabetes Mellitus, Type 2

KW - Exercise

KW - Fasting

KW - Glucose Tolerance Test

KW - Humans

KW - Hypoxia

KW - Insulin Resistance

KW - Male

KW - Middle Aged

KW - Physical Exertion

KW - Workload

U2 - 10.1210/jc.2011-1843

DO - 10.1210/jc.2011-1843

M3 - Article

C2 - 21994967

SN - 0021-972X

VL - 97

SP - 155

EP - 162

JO - The Journal of clinical endocrinology and metabolism

JF - The Journal of clinical endocrinology and metabolism

IS - 1

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