Insulin Resistance - Treatment Options
Both aerobic and resistance training exercises improve insulin sensitivity, but the beneficial effects of exercise tend to decrease after a few days of inactivity. Studies have shown that physical activity N Engl J Med. 1991 Jul 18;325(3):147-52 and fitness levels Ann Intern Med. 1999 Jan 19;130(2):89-96 are inversely associated with incidence of type 2 diabetes independent of BMI. So, how does exercise produce an improvement in insulin resistance? Regular exercise may increase translocation of GLUT-4 glucose transporters in skeletal muscle cells partly related to the increased skeletal muscle blood flow J Clin Endocrinol Metab.1995 Aug;80(8):2437-46. and AMPK (5'adenosine monophosphate activated protein kinase) activation Diabetes. 1999 Aug;48(8):1667-71. thus improving glucose uptake. The ability of insulin to increase skeletal muscle blood flow seems to be improved with exercise in normals and insulin resistant subjects. Diabetes. 1995 Sep;44(9):1010-20 , and the increased blood flow may improve local availability of insulin as well. Exercise has been associated with increased release of local bradykinin which may have stimulatory effects on glucose uptake. Diabetes. 1998 Apr;47(4):550-8 Exercise without weight loss significantly reduces visceral fat compared to controls. Exercise-induced weight loss reduces total fat to a greater extent than diet induced weight loss.