The influence of exercise training versus intensive insulin therapy on insulin resistance development in type 1 diabetes |
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| Institution: | 1. Exercise Biochemistry Laboratory, School of Kinesiology, Western University, London, ON, Canada;2. Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada;3. Department of Physiology and Pharmacology, Schulich School of Medicine, Western University, London, ON, Canada;1. Department of Ophthalmology, Research Unit of Clinical Medicine and Medical Research Centre, University of Oulu, Finland;2. Oulu University Hospital, Oulu, Finland;3. Research Service Unit, Oulu, Finland;4. The Research Unit of Surgery, Anaesthesia and Intensive Care, Oulu University Hospital and University of Oulu, Oulu, Finland;1. Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Tiyuchang Rd 453, Hangzhou 310007, People''s Republic of China;2. Hangzhou Third People''s Hospital, Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Westlake Ave 38, Hangzhou 310009, People''s Republic of China;1. Department of Medical Genetics, the Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong, China;2. Department of Prenatal Diagnosis Center, the Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong, China;3. Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong, China;4. Department of International Affairs, Qingdao Municipal Hospital, Qingdao 266071, Shandong, China;1. Karabuk University, Faculty of Health Sciences, Nutrition and Dietetic, Karabuk, Turkey;2. Ankara University, Faculty of Health Sciences, Nutrition and Dietetic, Ankara, Turkey;3. Derince Training and Research Hospital, Department of Endocrinology and Metabolic Diseases, Kocaeli, Turkey;1. Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, Cleveland, OH 44195, United States of America;2. Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH 44195, United States of America;3. Department of Endocrinology, University Hospitals, Cleveland, OH 44106, United States of America;1. Centre for Diabetes and Endocrinology, Royal Berkshire NHS Foundation Trust, Reading, England, UK;2. First Department of Propaedeutic Internal Medicine and Diabetes Center, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece |
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| Abstract: | The etiology of insulin resistance (IR) in Type 1 Diabetes (T1D) is unclear; however, intramyocellular lipids (IMCL) are likely contributors. While exercise lessens IR and IMCL content; T1D patients elevate glycemia to offset exercise-induced hypoglycemic risk. The preferred treatment for T1D patients is tight glucose management through intensive insulin therapy (IIT); however, IIT is accompanied with a sedentary lifestyle. The purpose of this study was to examine IR development and IMCL in combined exercise (DARE; aerobic/resistance) and IIT-treated T1D animals. 76 rats were divided into control sedentary (C), diabetic sedentary (CD), diabetes sedentary intensive insulin therapy (DIT) and DARE groups. Following streptozotocin (STZ), glycemia was maintained at either 9-15 mM (CD, DARE) or 5-9 mM (DIT) using insulin. DARE alternated between running and weighted climbing for 12 weeks. Results demonstrate that DARE exhibited reduced onset of IR compared with C, DIT and CD, indicated by increased glucose infusion rate (hyperinsulinemic-euglycemic-clamp). A shift in lipid metabolism was evident whereby diacylglycerol was elevated in DIT compared to DARE, while triacylglycerol was elevated in DARE. These findings indicate enhanced IMCL metabolism and the sequestration of fat as neutral triacylglycerol leads to reduced IR in DARE. In contrast, IIT and sedentary behavior leads to diacylglycerol accumulation and IR. |
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