Download PDF
Horm Metab Res 2002; 34(1): 27-31
DOI: 10.1055/s-2002-19963
Original Clinical

© Georg Thieme Verlag Stuttgart · New York

Effect of Short-Term Low-Intensity Exercise on Insulin Sensitivity, Insulin Secretion, and Glucose and Lipid Metabolism in Non-Obese Japanese Type 2 Diabetic Patients

H.  Kishimoto 1 , A.  Taniguchi 1 , M.  Fukushima 2 , M.  Sakai 1 , K.  Tokuyama 3 , T.  Oguma 1 , K.  Nin 4 , I.  Nagata 1 , R.  Hayashi 1 , M.  Kawano 1 , K.  Hayashi 1 , Y.  Tsukamoto 1 , T.  Okumura 1 , S.  Nagasaka 5 , H.  Mizutani 1 , Y.  Nakai 6
  • 1Division of Diabetes, Kansai-Denryoku Hospital, Osaka, Japan
  • 2Department of Metabolism and Clinical Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
  • 3Laboratory of Biochemistry of Exercise and Nutrition, Institute of Health and Sports Science, Tsukuba University, Ibaraki, Japan
  • 4Nagoya University School of Health Sciences, Aichi, Japan
  • 5Division of Endocrinology and Metabolism, Jichi Medical School, Tochigi, Japan
  • 6College of Medical Technology, Kyoto University, Kyoto, Japan.
Further Information

Publication History

15 February 2001

20 August 2001

Publication Date:
14 August 2002 (online)

Also available at
    Permissions and Reprints

Abstract

The aim of the present study was to investigate the effects of short-term physical exercise that did not change body mass on insulin sensitivity, insulin secretion, and glucose and lipid metabolism in 39 non-obese Japanese type 2 diabetic patients. Insulin sensitivity and insulin secretion were estimated with homeostasis model assessment insulin resistance (HOMA-IR) and HOMA-B-cell function proposed by Matthews et al., respectively. All patients were hospitalized and were engaged in low-intensity exercise that consisted of walking and dumbbell exercise for successive 7 days. There were no changes in hospital diet and the dose of any medications used throughout the study. Fasting glucose, insulin, and lipids were measured before and after exercise.

After exercise, serum triglyceride levels significantly decreased, but no significant changes were observed in total and HDL cholesterol concentrations. Fasting glucose, insulin, and HOMA-IR levels significantly decreased after exercise, but HOMA-B-cell function did not change during the study. There was no significant difference between BMI levels before and after exercise.

From these results, it can be concluded that short-term (7 days) low-intensity physical exercise combined with hospital diet reduces serum triglycerides, insulin resistance, and fasting glucose levels without affecting BMI in non-obese Japanese type 2 diabetic patients.

Key words

Exercise - Insulin Sensitivity - Insulin Secretion - Diabetes - Triglyceride

References

  • 1 DeFronzo R A. Lilly Lecture 1987: The triumvirate: beta-cell, muscle, liver: a collusion responsible for NIDDM.  Diabetes. 1988;  37 667-687
    CrossrefPubMedGoogle Scholar
  • 2 Gerich J E. The genetic basis of type 2 diabetes mellitus: impaired insulin secretion versus impaired insulin sensitivity.  Endocrine Rev. 1998;  19 491-503
    CrossrefPubMedGoogle Scholar
  • 3 Taniguchi A, Nakai Y, Fukushima M, Kawamura H, Imura H, Nagata I, Tokuyama K. Pathogenic factors responsible for glucose tolerance in patients with NIDDM.  Diabetes. 1992;  41 1540-1546
    CrossrefPubMedGoogle Scholar
  • 4 Nagasaka S, Tokuyama K, Kusaka I, Hayashi H, Rokkaku K, Nakamura T, Kawakami A, Higashiyama M, Ishikawa S, Saito T. Endogenous glucose production and glucose effectiveness in type 2 diabetic subjects derived from stable-labeled minimal model approach.  Diabetes. 1999;  48 1054-1060
    PubMedGoogle Scholar
  • 5 Taniguchi A, Fukushima M, Sakai M, Nagata I, Doi K, Nagasaka S, Tokuyama K, Nakai Y. Insulin secretion, insulin sensitivity, and glucose effectiveness in non-obese individuals with varying degrees of glucose tolerance (letter).  Diabetes Care. 2000;  23 127-128
    PubMedGoogle Scholar
  • 6 Taniguchi A, Fukushima M, Sakai M, Kataoka K, Miwa K, Nagata I, Doi K, Tokuyama K, Nakai Y. Insulin-sensitive and insulin-resistant variants in non-obese Japanese type 2 diabetic patients.  Diabetes Care (letter). 1999;  22 2100-2101
    PubMedGoogle Scholar
  • 7 Taniguchi A, Fukushima M, Sakai M, Kataoka K, Nagata I, Doi K, Arakawa H, Nagasaka S, Tokuyama K, Nakai Y. The role of the body mass index and triglyceride levels in indentifying insulin-sensitive and insulin-resistant varaints in Japanese non-insulin-dependent diabetic patients.  Metabolism. 2000;  49 1001-1005
    CrossrefPubMedGoogle Scholar
  • 8 Taniguchi A, Fukushima M, Sakai M, Miwa K, Makita T, Nagata I, Nagasaka S, Doi K, Okumura T, Fukuda A, Kishimoto H, Fukuda T, Nakaishi S, Tokuyama K, Nakai Y. Remnant-like particle cholesterol, triglycerides, and insulin resistance in non-obese Japanese type 2 diabetic patients.  Diabetes Care. 2000;  23 1766-1769
    CrossrefPubMedGoogle Scholar
  • 9 Mingrone G, Henriksen F L, Greco A V, Krogh L N, Capristo E, Gastaldelli A, Castagneto M, Ferrannini E, Gasbarrini G, Beck-Nielsen H. Triglyceride-induced diabetes associated with familiar lipoprotein lipase deficiency.  Diabetes. 1999;  48 1258-1263
    PubMedGoogle Scholar
  • 10 Jones I R, Sawai A, Taylor R, Miller M, Laker M F, Alberti K GMM. Lowering of plasma glucose concentrations with bezafibrate in patients with moderately controlled NIDDM.  Diabetes Care. 1990;  13 855-863
    PubMedGoogle Scholar
  • 11 Fukushima M, Taniguchi A, Sakai M, Doi K, Nagata I, Nagasaka S, Tokuyama K, Nakai Y. Effect of bezafibrate on insulin sensitivity in non-obese Japanese type 2 diabetic patients.  Diabetes Care (letter). 2000;  23 259
    PubMedGoogle Scholar
  • 12 Ogawa S, Takeuchi K, Sugimura K, Fukuda M, Lee R, Ito S, Sato T. Bezafibrate reduces blood glucose in type 2 diabetes mellitus.  Metabolism. 2000;  49 331-334
    CrossrefPubMedGoogle Scholar
  • 13 Taniguchi A, Fukushima M, Sakai Y, Tokuyama K, Nagata I, Fukunaga A, Kishimoto H, Doi K, Yamashita Y, Matsuura T, Kitatani N, Okumura T, Nagasaka S, Nakaishi S, Nakai Y. Effects of bezafibrate on insulin sensitivity and insulin secretion in non-obese Japanese type 2 diabetic patients.  Metabolism. 2001;  50 477-480
    CrossrefPubMedGoogle Scholar
  • 14 Kobayashi M, Shigeta Y, Hirata Y, Omori Y, Sakamoto N, Nambu S, Baba S. Improvement of glucose tolerance in NIDDM by clofibrate: Randomized double-blind study.  Diabetes Care. 1988;  11 495-499
    PubMedGoogle Scholar
  • 15 Paolisso G, Barbagallo M, Petrella G. et al . Effects of simvastatin and atorvastatin administration on insulin resistance and respiratory quotient in aged dyslipidemic non-insulin dependent diabetic patients.  Atherosclerosis. 2000;  150 121-127
    CrossrefPubMedGoogle Scholar
  • 16 Gyntelberg F, Brennan R, Holloszy J O, Schonfeld G, Rennie M J, Weidman S W. Plasma triglyceride lowering by exercise despite increased food intake in patients with type IV hyperlipoproteinemia.  Am J Clin Nutr. 1977;  30 716-720
    PubMedGoogle Scholar
  • 17 Vanninen E, Uusitupa M, Siitonen O, Laitinen J, Lansimies E. Habitual physical activity, aerobic capacity and metabolic control in patients with newly-diagnosed type 2 (non-insulin-dependent) diabetes mellitus: effect of 1-year diet and exercise intervention.  Diabetologia. 1992;  35 340-346
    CrossrefPubMedGoogle Scholar
  • 18 Swinburn B A, Boyce V L, Bergman R N, Howard B V, Bogardus C. Deterioration in carbohydrate metabolism and lipoprotein changes induced by modern, high-fat diet in Pima Indians and Caucasians.  J Clin Endocrinol Metab. 1991;  73 156-165
    PubMedGoogle Scholar
  • 19 Lovejoy J, DiGirolamo M. Habitual dietary intake and insulin sensitivity in lean and obese adults.  Am J Clin Nutr. 1992;  55 1174-1179
    PubMedGoogle Scholar
  • 20 Feskens E JM, Bowles C H, Kromhout D. Inverse association between fish intake and risk of glucose intolerance in normoglycaemic elderly men and women.  Diabetes Care. 1991;  14 934-941
    PubMedGoogle Scholar
  • 21 Bogardus C, Ravussin E, Robbins D C, Wolfe R R, Horton E S, Sims E AH. Effect of physical training and diet therapy on carbohydrate metabolism in patients with glucose intolerance and non-insulin-dependent diabetes mellitus.  Diabetes. 1984;  33 311-318
    CrossrefPubMedGoogle Scholar
  • 22 Yamanouchi K, Shinozaki T, Chikada K, Nishikawa T, Ito K, Shimizu S, Ozawa N, Suzuki Y, Maeno H, Kato K, Oshida Y, Sato Y. Daily walking combined with diet therapy is a useful means for obese NIDDM patients not only to reduce body weight but also improve insulin sensitivity.  Diabetes Care. 1995;  18 775-778
    PubMedGoogle Scholar
  • 23 World Health Org .Diabetes Mellitus: Report of a WHO Study Group. Geneva; World Health Org (Tech. Rep. Ser., no.727) 1985
    Google Scholar
  • 24 Matsuo T, Suzuki M. Effects of dumbbell exercise with and without energy restriction on resting metabolic rate, diet-induced thermogenesis and body composition in mildly obese women.  Asia Pacific J Clin Nutr. 1999;  8 136-141
    PubMedGoogle Scholar
  • 25 Friedewald W T, Levy R I, Fredrickson D S. Estimation of the concentration of low- density lipoprotein cholesterol in plasma without use of the preparative ultracentrifuge.  Clin Chem. 1972;  18 499-508
    CrossrefPubMedGoogle Scholar
  • 26 Matthews D R, Hosker J P, Rudenski A S, Naylor B A, Treacher D F, Turner R C. Homeostasis model assessment: insulin resistance and B-cell function from fasting plasma glucose and insulin concentrations in man.  Diabetologia. 1985;  28 412-419
    Google Scholar
  • 27 Hermans M P, Levy J C, Morris R J. et al . Comparison of insulin sensitivity tests across a range of glucose tolerance from normal to diabetes.  Diabetologia. 1999;  42 678-687
    CrossrefPubMedGoogle Scholar
  • 28 Fukushima M, Taniguchi A, Sakai M, Doi K, Nagasaka S, Tanaka H, Tokuyama K, Nakai Y. Homeostasis model assessment as a clinical index of insulin resistance. Comparison with the minimal model analysis (letter).  Diabetes Care. 1999;  22 1911-1912
    PubMedGoogle Scholar
  • 29 Taniguchi A, Nagasaka S, Fukushima M, Sakai M, Nagata I, Doi K, Tanaka H, Yoneda M, Tokuyama K, Nakai Y. Assessment of insulin sensitivity and insulin secretion from the OGTT in non-obese Japanese type 2 diabetic patients: Comparison with minimal model approach (letter).  Diabetes Care. 2000;  23 1439-1440
    PubMedGoogle Scholar
  • 30 Groop L C. Drug treatment of non-insulin-dependent diabetes mellitus. In: Pickup J, Williams G (eds) Textbook of Diabetes. Oxford, U.K.; Blackwell Science 1997 38: 1-38
    Google Scholar
  • 31 Borona E, Kiechl S, Willeit J, Oberhollenzer F, Egger G, Targher G, Alberiche M, Bonadonna R C, Muggeo M. Prevalence of insulin resistance in metabolic disorders. The Bruneck Study.  Diabetes. 1998;  47 1643-1649
    CrossrefPubMedGoogle Scholar
  • 32 Emoto M, Nishizawa Y, Maekawa K, Hiura Y, Kanda H, Kawagishi T, Shoji T, Okuno Y, Morii H. Homeostasis model assessment as a clinical index of insulin resistance in type 2 diabetic patients treated with sulfoylureas.  Diabetes Care. 1999;  22 818-822
    PubMedGoogle Scholar
  • 33 Stumvoll M, Mitrakou A, Pimenta R J, Jenssen T, Yki-Jarvinen H, Haeften T V, Haring H, Fritsche A, Gerich J. Assessment of insulin secretion from the oral glucose tolerance test in white patients with type 2 diabetes (letter).  Diabetes Care. 2000;  23 1440-1441
    PubMedGoogle Scholar
  • 34 Taniguchi A, Nakai Y, Doi K, Fukuzawa H, Fukushima M, Kawamura H, Tokuyama K, Suzuki M, Fujitani J, Tanaka H, Nagata I. Insulin sensitivity, insulin secretion, and glucose effectiveness in nobese subjects: a minimal model analysis.  Metabolism. 1995;  44 1397-1400
    CrossrefPubMedGoogle Scholar
  • 35 Saltin B, Lindgarde F, Houston M, Horlin R, Nygaard E, Gad P. Physical training and glucose tolerance in middle-aged men with chemical diabetes.  Diabetes. 1979;  28 (Suppl. 1) 30-32
    PubMedGoogle Scholar
  • 36 Schneider S H, Amorosa L F, Kachadurian A K, Ruderman N B. Studies of the mechanisms of improved glucose control during regular exercise in type 2 (non-insulin-dependent) diabetes.  Diabetologia. 1984;  26 355-360
    PubMedGoogle Scholar
  • 37 Krotkiewski M, Lonnroth P, Mandroukas K, Wroblewski Z, Rebuffe-Scrive M, Holm G, Smith U, Bjorntorp P. The effect of physical training on insulin secretion and effectiveness and on glucose metabolism in obesity and type 2 (non-insulin-dependent) diabetes mellitus.  Diabetologia. 1985;  28 881-890
    CrossrefPubMedGoogle Scholar
  • 38 Reitman J S, Vasquez B, Klimes I, Nagulesparan M. Improvement of glucose homeostasis after exercise training in non-insulin-dependent diabetes.  Diabetes Care. 1984;  7 434-441
    PubMedGoogle Scholar
  • 39 Rogers M A, Yamamoto C, King D S, Hagberg J M, Ehsani A A, Holloszy J O. Improvement in glucose tolerance after 1 wk of exercise in patients with mild NIDDM.  Diabetes Care. 1988;  11 623-628
    PubMedGoogle Scholar
  • 40 Heath G W, Gavin V JR, Hinderliter J M, Hagberg J M, Holloszy J O. Effects of exercise and lack of exercise on glucose tolerance and insulin sensitivity.  J Appl Physiol. 1983;  55 512-527
    PubMedGoogle Scholar
  • 41 King D S, Dalsky G P, Clutter W E. Effects of exercise and lack of exercise on insulin sensitivity and responsiveness.  J Appl Physiol. 1988;  64 1942-1946
    PubMedGoogle Scholar
  • 42 Trovati M, Carta Q, Cavalot F, Vitaly S, Banaudi C, Lucchina P G, Flocci F, Emanuelli G, Lenti G. Influence of physical training on blood glucose control, glucose tolerance, insulin secretion, and insulin action in non-insulin-dependent diabetic patients.  Diabetes Care. 1984;  7 416-420
    PubMedGoogle Scholar
  • 43 Choi C S, Kim C H, Lee W J, Park J Y, Hong S K, Lee K U. Elevated plasma proinsulin/insulin ratio is a marker of reduced insulin secretory capacity in healthy young men.  Horm Metab Res. 1999;  31 267-270
    PubMedGoogle Scholar
  • 44 Cononie C C, Goldberg A P, Rogus E, Hagberg J M. Seven consecutive days of exercise lowers plasma insulin responses to an oral glucose challenge in sedentary elderly.  J Am Geriatr Soc. 1994;  42 394-398
    PubMedGoogle Scholar
  • 45 Hickey M S, Gavigan A P, McCammon M R. Effects of 7 days of exercise training on insulin action in morbidly obese men.  J Clin Exerc Physiol. 1999;  1 24-28
    PubMedGoogle Scholar
  • 46 Kang J, Goss F L, Robertson R J, DaSilva S G, Hagberg J M, Suminski R R, Kelley D E, Utter A C. Effect of exercise intensity on glucose and insulin metabolism in obese individuals and obese NIDDM patients.  Diabetes Care. 1996;  19 341-349
    PubMedGoogle Scholar
  • 47 Vanninen E, Uusitupa M, Siitonen O, Laitinen J, Lansimiles E. Habitual physical activity, aerobic capacity and metabolic control in patients with newly-diagnosed type 2 (non-insulin-dependent) diabetes mellitus: effect of 1-year diet and exercise intervention.  Diabetologia. 1992;  35 340-346
    CrossrefPubMedGoogle Scholar
  • 48 Reaven G M, Lerner R L, Stern M P, Farquhar J W. Role of insulin in endogenous hypertriglyceridemia.  J Clin Invest. 1967;  46 1756-1767
    PubMedGoogle Scholar
  • 49 Sane T, Taskinen M R. Does familiar hypertriglyceridemia predispose to NIDDM?.  Diabetes Care. 1993;  16 1494-1501
    PubMedGoogle Scholar
  • 50 Steiner G. Insulin and hypertriglyceridemia. In: Waldhausl WK (ed) Diabetes. Amsterdam, The Netherlands; Excerpta Medica 1979: 590-593
    Google Scholar
  • 51 Bieger W P, Michel G, Barwich D, Biehl K, Wirth A. Diminished insulin receptors on monocytes and erythrocytes in hypertriglyceridemia.  Metabolism. 1984;  33 982-987
    CrossrefPubMedGoogle Scholar
  • 52 Jacob S, Stumvoll M, Becker R, Koch M, Nielsen M, Loblein K K, Maerker E, Volk A, Renn W, Balletshofer B, Machicao F, Rett K, Haring H U. The PPARγ-2 polymorphism Pro12Ala is associated with better insulin snesitivity in the offspring of type 2 diabetic patients.  Horm Metab Res. 2000;  32 413-416
    PubMedGoogle Scholar

A. Taniguchi, M.D.

First Department of Internal Medicine · Kansai-Denryoku Hospital

2-1-7 Fukushima · Fukushima-ku · Osaka-city · Osaka 553-0003 · Japan

Fax: + 81 (6) 64 58-69 94

Email: K-58403@kepco.co.jp