Managing Cardiometabolic Risk

Exercise and Insulin Resistance

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Numerous studies have also shown that chronic exercise can improve insulin sensitivity even without significant weight loss (25, 27, 57, 58). For example, three months of daily aerobic training in obese men who consumed compensatory kilocalories equivalent to the amount expended during exercise caused a 30% improvement in insulin sensitivity despite no change in weight (25).  

The results of the Diabetes Prevention Program have shown that, over a three-year period, a lifestyle modification program featuring a minimum of 150 minutes of exercise per week can reduce the incidence of type 2 diabetes by 58% in at-risk individuals (59). These results are consistent with other findings (60) and suggest that exercise can prevent diabetes in predisposed patients by improving insulin sensitivity and enhancing glucose disposal acutely and chronically, possibly to a greater degree than what can be achieved through pharmacological interventions (59).

Reference

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25. Ross R, Dagnone D, Jones PJ, et al. Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men. A randomized, controlled trial. Ann Intern Med 2000; 133: 92-103.

27. Giannopoulou I, Ploutz-Snyder LL, Carhart R, et al. Exercise is required for visceral fat loss in postmenopausal women with type 2 diabetes. J Clin Endocrinol Metab 2005; 90: 1511-8.

57. Boudou P, De Kerviler E, Vexiau P, et al. Effects of a single bout of exercise and exercise training on steroid levels in middle-aged type 2 diabetic men: relationship to abdominal adipose tissue distribution and metabolic status. Diabetes Metab 2000; 26: 450-7.

58. Dengel DR, Pratley RE, Hagberg JM, et al. Distinct effects of aerobic exercise training and weight loss on glucose homeostasis in obese sedentary men. J Appl Physiol 1996; 81: 318-25.

59. Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346: 393-403.

60. Tuomilehto J, Lindstrom J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001; 344: 1343-50.

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