Pancreatic β-cell function is a stronger predictor of changes in glycemic control after an aerobic exercise intervention than insulin sensitivity

Thomas P J Solomon; Steven K Malin; Kristian Karstoft; Sangeeta R Kashyap; Jacob M Haus; John P Kirwan

doi:10.1210/jc.2013-2232

Pancreatic β-cell function is a stronger predictor of changes in glycemic control after an aerobic exercise intervention than insulin sensitivity

Thomas P J Solomon, Steven K Malin, Kristian Karstoft, Sangeeta R Kashyap, Jacob M Haus, John P Kirwan

Sport, Exercise and Rehabilitation Sciences

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

47 Citations (Scopus)

Abstract

CONTEXT: Understanding intersubject variability in glycemic control following exercise training will help individualize treatment.

OBJECTIVE: Our aim was to determine whether this variability is related to training-induced changes in insulin sensitivity or pancreatic β-cell function.

DESIGN, SETTING, AND PARTICIPANTS: We conducted an observational clinical study of 105 subjects with impaired glucose tolerance or type 2 diabetes.

INTERVENTIONS AND MAIN OUTCOME MEASURES: Individual subject changes in fitness (VO2max), glycemia (glycosylated hemoglobin, fasting glucose, oral glucose tolerance test), insulin sensitivity (hyperinsulinemic-euglycemic clamp), oral glucose-stimulated insulin secretion (GSIS), and disposition index (DI) were measured following 12 to 16 weeks of aerobic exercise training. Regression analyses were used to identify relationships between variables.

RESULTS: After training, 86% of subjects increased VO2max and lost weight. Glycosylated hemoglobin, fasting glucose, and 2-hour oral glucose tolerance test were reduced in 69%, 62%, and 68% of subjects, respectively, while insulin sensitivity improved in 90% of the participants. Changes in glycemic control were congruent with changes in GSIS such that 66% of subjects had a reduction in first-phase GSIS, and 46% had reduced second-phase GSIS. Training increased first- and second-phase DI in 83% and 74% of subjects. Training-induced changes in glycemic control were related to changes in GSIS (P < .05), but not insulin sensitivity or DI, and training-induced improvements in glycemic control were largest in subjects with greater pretraining GSIS.

CONCLUSIONS: Intersubject variability in restoring glycemic control following exercise is explained primarily by changes in insulin secretion. Thus, baseline and training-induced changes in β-cell function may be a key determinant of training-induced improvements in glycemic control.

Original language	English
Pages (from-to)	4176-86
Number of pages	11
Journal	The Journal of clinical endocrinology and metabolism
Volume	98
Issue number	10
DOIs	https://doi.org/10.1210/jc.2013-2232
Publication status	Published - Oct 2013

Keywords

Adult
Blood Glucose
Body Mass Index
Diabetes Mellitus, Type 2
Exercise
Exercise Therapy
Female
Glucose Intolerance
Glucose Tolerance Test
Humans
Insulin Resistance
Insulin-Secreting Cells
Male
Obesity
Treatment Outcome
Weight Loss

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1210/jc.2013-2232

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@article{96709c69a63a4b7399a83ddf2d2603f6,

title = "Pancreatic β-cell function is a stronger predictor of changes in glycemic control after an aerobic exercise intervention than insulin sensitivity",

abstract = "CONTEXT: Understanding intersubject variability in glycemic control following exercise training will help individualize treatment.OBJECTIVE: Our aim was to determine whether this variability is related to training-induced changes in insulin sensitivity or pancreatic β-cell function.DESIGN, SETTING, AND PARTICIPANTS: We conducted an observational clinical study of 105 subjects with impaired glucose tolerance or type 2 diabetes.INTERVENTIONS AND MAIN OUTCOME MEASURES: Individual subject changes in fitness (VO2max), glycemia (glycosylated hemoglobin, fasting glucose, oral glucose tolerance test), insulin sensitivity (hyperinsulinemic-euglycemic clamp), oral glucose-stimulated insulin secretion (GSIS), and disposition index (DI) were measured following 12 to 16 weeks of aerobic exercise training. Regression analyses were used to identify relationships between variables.RESULTS: After training, 86% of subjects increased VO2max and lost weight. Glycosylated hemoglobin, fasting glucose, and 2-hour oral glucose tolerance test were reduced in 69%, 62%, and 68% of subjects, respectively, while insulin sensitivity improved in 90% of the participants. Changes in glycemic control were congruent with changes in GSIS such that 66% of subjects had a reduction in first-phase GSIS, and 46% had reduced second-phase GSIS. Training increased first- and second-phase DI in 83% and 74% of subjects. Training-induced changes in glycemic control were related to changes in GSIS (P < .05), but not insulin sensitivity or DI, and training-induced improvements in glycemic control were largest in subjects with greater pretraining GSIS.CONCLUSIONS: Intersubject variability in restoring glycemic control following exercise is explained primarily by changes in insulin secretion. Thus, baseline and training-induced changes in β-cell function may be a key determinant of training-induced improvements in glycemic control.",

keywords = "Adult, Blood Glucose, Body Mass Index, Diabetes Mellitus, Type 2, Exercise, Exercise Therapy, Female, Glucose Intolerance, Glucose Tolerance Test, Humans, Insulin Resistance, Insulin-Secreting Cells, Male, Obesity, Treatment Outcome, Weight Loss",

author = "Solomon, {Thomas P J} and Malin, {Steven K} and Kristian Karstoft and Kashyap, {Sangeeta R} and Haus, {Jacob M} and Kirwan, {John P}",

year = "2013",

month = oct,

doi = "10.1210/jc.2013-2232",

language = "English",

volume = "98",

pages = "4176--86",

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

issn = "0021-972X",

publisher = "Endocrine Society",

number = "10",

}

Pancreatic β-cell function is a stronger predictor of changes in glycemic control after an aerobic exercise intervention than insulin sensitivity. / Solomon, Thomas P J; Malin, Steven K; Karstoft, Kristian et al.
In: The Journal of clinical endocrinology and metabolism, Vol. 98, No. 10, 10.2013, p. 4176-86.

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

TY - JOUR

T1 - Pancreatic β-cell function is a stronger predictor of changes in glycemic control after an aerobic exercise intervention than insulin sensitivity

AU - Solomon, Thomas P J

AU - Malin, Steven K

AU - Karstoft, Kristian

AU - Kashyap, Sangeeta R

AU - Haus, Jacob M

AU - Kirwan, John P

PY - 2013/10

Y1 - 2013/10

N2 - CONTEXT: Understanding intersubject variability in glycemic control following exercise training will help individualize treatment.OBJECTIVE: Our aim was to determine whether this variability is related to training-induced changes in insulin sensitivity or pancreatic β-cell function.DESIGN, SETTING, AND PARTICIPANTS: We conducted an observational clinical study of 105 subjects with impaired glucose tolerance or type 2 diabetes.INTERVENTIONS AND MAIN OUTCOME MEASURES: Individual subject changes in fitness (VO2max), glycemia (glycosylated hemoglobin, fasting glucose, oral glucose tolerance test), insulin sensitivity (hyperinsulinemic-euglycemic clamp), oral glucose-stimulated insulin secretion (GSIS), and disposition index (DI) were measured following 12 to 16 weeks of aerobic exercise training. Regression analyses were used to identify relationships between variables.RESULTS: After training, 86% of subjects increased VO2max and lost weight. Glycosylated hemoglobin, fasting glucose, and 2-hour oral glucose tolerance test were reduced in 69%, 62%, and 68% of subjects, respectively, while insulin sensitivity improved in 90% of the participants. Changes in glycemic control were congruent with changes in GSIS such that 66% of subjects had a reduction in first-phase GSIS, and 46% had reduced second-phase GSIS. Training increased first- and second-phase DI in 83% and 74% of subjects. Training-induced changes in glycemic control were related to changes in GSIS (P < .05), but not insulin sensitivity or DI, and training-induced improvements in glycemic control were largest in subjects with greater pretraining GSIS.CONCLUSIONS: Intersubject variability in restoring glycemic control following exercise is explained primarily by changes in insulin secretion. Thus, baseline and training-induced changes in β-cell function may be a key determinant of training-induced improvements in glycemic control.

AB - CONTEXT: Understanding intersubject variability in glycemic control following exercise training will help individualize treatment.OBJECTIVE: Our aim was to determine whether this variability is related to training-induced changes in insulin sensitivity or pancreatic β-cell function.DESIGN, SETTING, AND PARTICIPANTS: We conducted an observational clinical study of 105 subjects with impaired glucose tolerance or type 2 diabetes.INTERVENTIONS AND MAIN OUTCOME MEASURES: Individual subject changes in fitness (VO2max), glycemia (glycosylated hemoglobin, fasting glucose, oral glucose tolerance test), insulin sensitivity (hyperinsulinemic-euglycemic clamp), oral glucose-stimulated insulin secretion (GSIS), and disposition index (DI) were measured following 12 to 16 weeks of aerobic exercise training. Regression analyses were used to identify relationships between variables.RESULTS: After training, 86% of subjects increased VO2max and lost weight. Glycosylated hemoglobin, fasting glucose, and 2-hour oral glucose tolerance test were reduced in 69%, 62%, and 68% of subjects, respectively, while insulin sensitivity improved in 90% of the participants. Changes in glycemic control were congruent with changes in GSIS such that 66% of subjects had a reduction in first-phase GSIS, and 46% had reduced second-phase GSIS. Training increased first- and second-phase DI in 83% and 74% of subjects. Training-induced changes in glycemic control were related to changes in GSIS (P < .05), but not insulin sensitivity or DI, and training-induced improvements in glycemic control were largest in subjects with greater pretraining GSIS.CONCLUSIONS: Intersubject variability in restoring glycemic control following exercise is explained primarily by changes in insulin secretion. Thus, baseline and training-induced changes in β-cell function may be a key determinant of training-induced improvements in glycemic control.

KW - Adult

KW - Blood Glucose

KW - Body Mass Index

KW - Diabetes Mellitus, Type 2

KW - Exercise

KW - Exercise Therapy

KW - Female

KW - Glucose Intolerance

KW - Glucose Tolerance Test

KW - Humans

KW - Insulin Resistance

KW - Insulin-Secreting Cells

KW - Male

KW - Obesity

KW - Treatment Outcome

KW - Weight Loss

U2 - 10.1210/jc.2013-2232

DO - 10.1210/jc.2013-2232

M3 - Article

C2 - 23966244

SN - 0021-972X

VL - 98

SP - 4176

EP - 4186

JO - The Journal of clinical endocrinology and metabolism

JF - The Journal of clinical endocrinology and metabolism

IS - 10

ER -

Pancreatic β-cell function is a stronger predictor of changes in glycemic control after an aerobic exercise intervention than insulin sensitivity

Abstract

Keywords

UN SDGs

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