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Effects of Exercise Training on Glucose Homeostasis

The HERITAGE Family Study

¹ Division of Kinesiology, Laval University, Ste-Foy, Québec, Canada
² Diabetes Research Unit, Centre de Recherche sur les Maladies Lipidiques, Laval University, Ste-Foy, Québec, Canada
³ Human Genomics Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
⁴ Kuopio Research Institute of Exercise Medicine and the Department of Physiology, University of Kuopio, Kuopio, Finland
⁵ Keck School of Medicine, University of Southern California, Los Angeles, California
⁶ Laboratory of Physiological Hygiene and Exercise Science, Division of Kinesiology, University of Minnesota, Minneapolis, Minnesota
⁷ Department of Kinesiology, Indiana University, Bloomington, Indiana
⁸ Department of Health and Kinesiology, Texas A&M University, College Station, Texas
⁹ Departments of Genetics and Psychiatry, Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri

Address correspondence and reprint requests to S. John Weisnagel, MD, FRCPC, Diabetes Research Unit, S-27, Centre Hospitalier Université Laval, Laval University, 2705 Boulevard Laurier Sainte-Foy, Québec, Canada, G1V 4G2. E-mail: john.weisnagel{at}kin.msp.ulaval.ca

OBJECTIVE—To determine the effect of a 20-week endurance training program in healthy, previously sedentary participants on measures derived from an intravenous glucose tolerance test (IVGTT).

RESEARCH DESIGN AND METHODS—An IVGTT was performed before and after a standardized training program in 316 women and 280 men (173 blacks and 423 whites). Participants exercised on cycle ergometers 3 days per week for 60 sessions. The exercise intensity was progressively increased from 55% VO_2max for 30 min per session to 75% VO_2max for 50 min per session.

RESULTS—Mean insulin sensitivity increased by 10% (P < 0.001) following the intervention, but the variability in the changes was high. Men had larger improvements than women (P = 0.02). Improvements in fasting insulin were transitory, disappearing 72 h after the last bout of exercise. There were also significant mean increases in the glucose disappearance index (3%, P = 0.02) and in glucose effectiveness (11%, P < 0.001), measures of glucose tolerance and of the capacity of glucose to mediate its own disposal, respectively. The acute insulin response to glucose, a measure of insulin secretion, increased by 7% in the quartile with the lowest baseline glucose tolerance and decreased by 14% in the quartile with the highest baseline glucose tolerance (P < 0.001). The glucose area below fasting levels during the IVGTT was reduced by 7% (P = 0.02).

CONCLUSIONS—Although the effects of structured regular exercise were highly variable, there were improvements in virtually all IVGTT-derived variables. In the absence of substantial weight loss, regular exercise is required for sustained improvements in glucose homeostasis.

Abbreviations: AIR_g, acute insulin response to glucose • IVGTT, intravenous glucose tolerance test

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