RESUMEN
The present study was undertaken to analyze the acute and chronic effects of exercise on insulin sensitivity in elder diabetic patients using a horseback riding therapeutic equipment (Joba). The acute effects of exercise were examined by means of a single session of Joba riding that lasted for 30 min. The average glucose infusion rates (GIR) before and during exercise were regarded as an index of the insulin action in peripheral tissues by the euglycemic clamp. The chronic effects of exercise were studied by training the elder diabetic patients for 12 weeks using the Joba apparatus. The insulin sensitivity was determined pre- and post-training by a 90 min euglycemic clamp. In the acute study, average GIR during exercise was significantly higher than pre-exercise (7.8+/-0.4 versus 5.2+/-0.3 mg kg(-1)min(-1), P<0.01) and average GIR during recovery decreased to almost the same levels of pre-exercise (5.0+/-0.4 mg kg(-1)min(-1); P<0.01). The 12-week training resulted in a significant increase in the steady-state GIR (from 5.2+/-0.3 to 7.4+/-0.8 mg kg(-1)min(-1); P<0.05). The steady-state GIR after 12 weeks of detraining returned to pre-training levels (5.3+/-0.5 mg kg(-1)min(-1); P<0.05). In elder diabetic patients, mechanical horseback riding enhances the insulin-induced glucose uptake.
Asunto(s)
Glucemia/metabolismo , Diabetes Mellitus Tipo 2/fisiopatología , Ejercicio Físico , Anciano , Animales , Índice de Masa Corporal , Tamaño Corporal , Diabetes Mellitus Tipo 2/sangre , Femenino , Técnica de Clampeo de la Glucosa , Prueba de Tolerancia a la Glucosa , Hemoglobina Glucada/análisis , Caballos , Humanos , Persona de Mediana EdadRESUMEN
We investigated the effects of Goshajinkigan (GJG), a Chinese herbal medicine, on insulin sensitivity in patients with type 2 diabetes using the homeostasis model assessment of insulin resistance (HOMA-R) and the euglycemic insulin clamp procedure. Daily oral administration of GJG (7.5 g/day) was performed for 1 month in 71 type 2 diabetes patients: the GJG treatment group. HOMA-Rs were calculated before and after 1 month of GJG treatment and compared with those of 44 controls who were matched in terms of sex, age, body mass index (BMI) and HbA1c levels with the experimental group. In 64 patients out of the GJG treatment group, HOMA-R was calculated 1 month after discontinuation of treatment. In addition, euglycemic clamp was conducted in eight patients before and after the GJG treatment. HOMA-R was 4.78+/-0.37 (means+/-S.E.) before GJG treatment and significantly decreased to 4.02+/-0.25 after GJG treatment (P=0.019). No significant change was observed in the control group. HOMA-R returned to the pre-treatment level (P=0.018) 1 month after GJG treatment discontinuation. Glucose infusion rates and metabolic clearance rates determined by the high-dose euglycemic clamp increased after 1 month of GJG treatment (from 9.6+/-1.1 to 11.1+/-0.7 mg/kg/min, P=0.045 and from 7.9+/-0.8 to 9.1+/-0.8 ml/kg/min, P=0.046, respectively). These results indicate that GJG administration might be useful for improving insulin resistance in patients with type 2 diabetes.
Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Mellitus Tipo 2/fisiopatología , Medicamentos Herbarios Chinos/uso terapéutico , Resistencia a la Insulina , Glucemia/efectos de los fármacos , Glucemia/metabolismo , Índice de Masa Corporal , Femenino , Hemoglobina Glucada/metabolismo , Homeostasis , Humanos , Masculino , Persona de Mediana Edad , Modelos BiológicosRESUMEN
BACKGROUND: Anthropometric characteristics, lifestyle, and baseline biological markers of Japanese non-professional ultra-marathon runners have not been fully assessed. METHODS: We evaluated anthropometric characteristics, lifestyle, and baseline biological markers of 180 Japanese amateur ultra-marathon runners (144 males [mean age: 50.5 +/- 9.4 (standard deviation) years] and 36 females [48.9 +/- 6.9]), and compared them with those of participants in a community heath check-up program and with the figures in the literature. We furthermore evaluated baseline blood indices according to monthly running distance with analysis of variance adjusted for age, body mass index, smoking and alcohol drinking habits. RESULTS: The ultra-marathon runners demonstrated more favorable values for body mass index and bone density, and the proportion of smoking, and undertaking physical activity (for both sexes), eating breakfast (for males), and having daily bowel movements (for females), while greater proportion of alcohol drinking habit (for both sexes), than the comparison group. Average monthly running distances and standard deviations (km) were 257.2 +/- 128.9 for males and 209.0 +/- 86.2 for females. Male runners possessed beneficial markers, including lowered triglyceride and elevated high-density lipoprotein cholesterol, and their values showed hockey-stick (or inverse hockey-stick) patterns depending on their monthly running distance. Some subjects running more than 300 km/month exhibited signs of an over-reaching/training syndrome, including somewhat lowered hemoglobin, ferritin and white blood cell count, and elevated creatine kinase and lactate dehydrogenase. CONCLUSIONS: Together with a desirable lifestyle, Japanese non-professional ultra-marathon runners with vigorous exercise habit demonstrated a preferable health status according to biological indices.
Asunto(s)
Antropometría , Biomarcadores , Estilo de Vida , Evaluación de Procesos, Atención de Salud , Carrera/fisiología , Adulto , Biomarcadores/sangre , Biomarcadores/orina , Ingestión de Alimentos/fisiología , Ingestión de Energía/fisiología , Femenino , Humanos , Japón , Masculino , Persona de Mediana Edad , Educación y Entrenamiento Físico , Carrera/psicología , Carrera/estadística & datos numéricos , Medicina Deportiva , Encuestas y CuestionariosRESUMEN
To counteract insulin resistance, it is necessary to increase the utilization rate of fatty acids in blood and adipose tissue. The aim of the present study was to determine the relation between metabolic responses and exercise duration from changes in the respiratory exchange ratio (RER). The mean RER during 30 minutes of moderate exercise (mean pulse 115 beats/min) was 0.89 +/- 0.02, indicating no major change. Significant changes were observed in the levels of plasma glucose (PG), plasma free fatty acid (FFA), and plasma immunoreactive insulin (IRI) before and after exercise, demonstrating a decrease in PG and IRI, and an increase in FFA levels. However, the RER value indicated that carbohydrate was the dominant metabolic substrate; therefore, prolonged or repetitive brief and mild to moderate exercise is necessary to increase the utilization of fatty acids.