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Short-Term Aerobic Exercise Training in Obese Humans with Type 2 Diabetes Mellitus Improves Whole-Body Insulin Sensitivity through Gains in Peripheral, not Hepatic Insulin Sensitivity

School of Physical Activity and Educational Services (J.J.W., W.M.S., M.B.S.), and Departments of Internal Medicine (D.L.H., D.P.S.) and Human Nutrition (M.L.F., M.A.B.), The Ohio State University, Columbus, Ohio 43210

Address all correspondence and requests for reprints to: Jason J. Winnick, Ph.D., Vanderbilt University School of Medicine, Department of Molecular Physiology and Biophysics, 710 Robinson Research Building, 2200 Pierce Avenue, Nashville, Tennessee 37232. E-mail: jason.winnick{at}vanderbilt.edu.

Context: Short-term aerobic exercise training can improve whole-body insulin sensitivity in humans with type 2 diabetes mellitus; however, the contributions of peripheral and hepatic tissues to these improvements are not known.

Objective: Our objective was to determine the effect of 7-d aerobic exercise training on peripheral and hepatic insulin sensitivity during isoglycemic/hyperinsulinemic clamp conditions.

Design: Subjects were randomly assigned to one of two groups. The energy balance group consumed an isocaloric diet consisting of 50% carbohydrate, 30% fat, and 20% protein for 15 d. The energy balance plus exercise group consumed a similar diet over the 15 d and performed 50-min of treadmill walking at 70% of maximum oxygen consumption maximum during the second 7 d of the 15-d study period. Each subject underwent an initial isoglycemic/hyperinsulinemic clamp after 1-wk dietary control and a second clamp after completing the study.

Setting: The study was performed at Ohio State University’s General Clinical Research Center.

Participants: There were 18 obese, mildly diabetic humans included in the study.

Intervention: Aerobic exercise training was performed for 7 d.

Main Outcome Measures: Whole-body, peripheral, and hepatic insulin sensitivity were measured.

Results: Exercise training did not have an impact on peripheral glucose uptake or endogenous glucose production during the basal state or low-dose insulin. Likewise, it did not alter endogenous glucose production during high-dose insulin. However, 1-wk of exercise training increased both whole-body (P < 0.05) and peripheral insulin sensitivity (P < 0.0001) during high-dose insulin.

Conclusion: Improvements to whole body insulin sensitivity after short-term aerobic exercise training are due to gains in peripheral, not heptic insulin sensitivity.