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Item
#11
Aerobics
are Key to Improving Insulin Sensitivity
23%
increase in insulin sensitivity
The
extent to which lifestyle must be altered to improve
insulin sensitivity has not been established. This study
compares the effect on insulin sensitivity of current dietary
and exercise recommendations with a more intensive intervention
in normoglycemic insulin-resistant individuals.
Seventy-nine
normoglycemic insulin-resistant (determined by the
euglycemic insulin clamp) men and women were randomized
to either a control group or one of two combined
dietary and exercise programs. One group (modest level)
was based on current recommendations and the other on a
more intensive dietary and exercise program. Insulin sensitivity
was measured using a euglycemic insulin clamp, body
composition was measured using dual-energy X-ray
absorptiometry, and anthropometry and aerobic fitness
were assessed before and after a 4-month intervention
period. Four-day dietary intakes were recorded, and
fasting glucose, insulin, and lipids were measured.
Only
the intensive group showed a significant improvement in
insulin sensitivity (23% increase, P=0.006 vs. 9%
in the modest group, P=0.23). This was associated with a
significant improvement in aerobic fitness (11% increase in
the intensive group, P=0.02 vs. 1% in the modest
group, P=0.94) and a greater fiber intake, but
no difference in reported total or saturated dietary
fat.
CONCLUSIONS—
These data have important public health implications in countries
with high rates of type 2 diabetes, and they have a bearing
on intervention trials involving people with IGT. In those
who have already developed IGT and are prescribed
modest exercise as part of their program, it appears
that a substantial number will still go on to develop
type 2 diabetes. The greatest benefit of lifestyle
intervention may be seen when instituted in
insulin-resistant individuals who have not yet developed IGT
and who have achieved an improved level of aerobic fitness.
Current
clinical dietary and exercise recommendations, even
when vigorously implemented, did not significantly improve insulin
sensitivity; however, a more intensive program did. Improved
aerobic fitness appeared to be the major difference between
the two intervention groups, although weight loss and diet
composition may have also played an important role in determining
insulin sensitivity.
Diabetes
Care 25:445-452, 2002
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Did
You Know:
It
is estimated that there are at least 150 million people in the
world with diabetes now. This
figure is expected to double over the next 25 years.
Also:
Diabetes
Care November 1999
–“The
immediate feedback of HbA1c results at the time of patient
encounters resulted in a significant improvement of glycemic
control at 6-month follow-up and persisted for the 12-month study
–“Availability
of rapid HbA1c determinations appears to facilitate diabetes
management. The more favorable HbA1c profile in the rapid HbA1c
group occurs independently of the decision to intensify therapy,
suggesting the involvement of other factors such as enhanced
provider and/or patient motivation.”
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you can have an instant A1c test, Click here
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