Exercise and insulin sensitivity

[phoenix]

As someone with T1/LADA I've always found exercise to be crucial in keeping insulin sensitive. I notice if I don't do it, insulin needs rise quickly. This was really noticeable when I lost a lot of my motivation last year ( lots of reasons family illness and being very hypothyroid) There's no doubt that although I kept the same HbA1c, I was getting less insulin sensitive .
I've been getting back to doing things more regularly and have really quickly found insulin needs decreasing

As I've mentioned in other posts, I'm doing an online e diabetes course at the moment and this week is about exercise .

I found the results of this study really emphasised what exercise can do for improving insulin sensitivity . It wasn't in people with diabetes, it was in moderately overweight men.
Each column shows a measure of insulin sensitivity
The green column (T) Training :is men who were exercising for about an hour or expending 600 calories per day
the red column (D) diet: is men who were dieting and eating 600 calories per day less than they needed
the blue column (T-iD) is men who used up 600 calories a day exercising but who also were eating 600 calories a day extra (ie the amount of calories used in exercise was made up by extra food).
the yellow column (C) was a control , no exercise , no dieting and no extra calories.

As you can see those that exercised showed a big increase in insulin sensitivity, those that exercised and ate to compensate also had a rise in sensitivity . Those who were just dieting basically had no change in insulin sensitivity ..

Interestingly though other studies seem to show that though some exercise is great, doubling it doesn't go anywhere near doubling the effectiveness. So marathon training not essential

 

[noblehead]

That is interesting Phoenix, goes to show that we should never underestimate the benefits of exercise for all round health, certainly my insulin requirements increase when I'm not active so I make a point of exercising everyday.

 

[mo1905]

I always knew this to be the case but nice to see supporting evidence. Doesn't have to be anything too strenuous either, walking is beneficial.


Sent from the Diabetes Forum App

 

[ElyDave]

Doesn't surprise me at all.

A couple of weeks ago, pressure of work stopped me exercising for about 3-4 days, that coupled with the stress at the time had me hyper most of the time.

Solution - get back to the running, get a break from the stress, hey presto, control comes back.

 

[Karbstruck]

Most interesting. A good incentive to keep exercising.

Phew! So relieved I don't have to run marathons.

 

[Bebo321]

As someone with T1/LADA I've always found exercise to be crucial in keeping insulin sensitive. I notice if I don't do it, insulin needs rise quickly. This was really noticeable when I lost a lot of my motivation last year ( lots of reasons family illness and being very hypothyroid) There's no doubt that although I kept the same HbA1c, I was getting less insulin sensitive .
I've been getting back to doing things more regularly and have really quickly found insulin needs decreasing

As I've mentioned in other posts, I'm doing an online e diabetes course at the moment and this week is about exercise .

I found the results of this study really emphasised what exercise can do for improving insulin sensitivity . It wasn't in people with diabetes, it was in moderately overweight men.
Each column shows a measure of insulin sensitivity
The green column (T) Training :is men who were exercising for about an hour or expending 600 calories per day
the red column (D) diet: is men who were dieting and eating 600 calories per day less than they needed
the blue column (T-iD) is men who used up 600 calories a day exercising but who also were eating 600 calories a day extra (ie the amount of calories used in exercise was made up by extra food).
the yellow column (C) was a control , no exercise , no dieting and no extra calories.

As you can see those that exercised showed a big increase in insulin sensitivity, those that exercised and ate to compensate also had a rise in sensitivity . Those who were just dieting basically had no change in insulin sensitivity ..
View attachment 4078


Interestingly though other studies seem to show that though some exercise is great, doubling it doesn't go anywhere near doubling the effectiveness. So marathon training not essential

Thanks for that Phoenix - there is no doubt that exercise helps with insulin sensitivity, so it's great that you shared such a clear diagram to demonstrate the effectiveness!
Out of interest, do you know if the diets of the test group was the same for the study - that is, we're the component parts of calories the same (carb to protein to fat ratio)? Could be that because the study was done on individuals without insulin resistance they didn't monitor that?
Interesting stuff!

 

[phoenix]

Hi, I've found the full paper.
The subjects were free living and they used a diet diary and subjects were required to weigh food for part of the time.
This is recorded as a limitation
"Limitations of the present study include inherent difficulties in controlling and measuring energy expenditure and intake in free-living subjects. Especially, the T-iD group needed careful instructions on how to increase energy intake to avoid losing weight. Nonoptimal or biased reporting of diets are common (32). However, changes in VO2max and body mass demonstrated that the subjects did behave as required (Table 2). The D group showed according to the diet registration a drop in alcohol intake from 1.75 to 0.4 glasses of wine/day. This small variation in chronic alcohol consumption is unlikely to have had any major effects on the primary end points of the study"
http://onlinelibrary.wiley.com/doi/10.1038/oby.2012.70/full

 

[Bebo321]

Thanks so much phoenix, I've just been reading through.

Looks as though diet was pretty much as current government guidelines suggest, so fairly standard and quite carb heavy.
What amazes me is how significant the abdominal fat reduction is between T, and T-id. : T reduced from 41.1% to 33.2% vs T-id 39.9% down to 37.7%.
That must make quite a considerable difference to insulin sensitivity. Interesting that diet (and reduced calorie intake) is so significant. I am assuming that with a calorie restricted diet, energy has to come from fat burning hence T group see a really significant difference.

I would love to see the same research done on a carb restricted diet (I wonder if you wouldn't get these sort of results much more quickly), and also have the same sort of data for T2D!

Great resource. Many thanks for sharing.

 

[phoenix]

But as I read it, the T-id weren't reducing calories, it was devised so that the calories stayed the same They were eating 600 cal more to compensate for the 600 cal worth of exercise. At the end their weight had changed only a little. (-1kg)

 

[borofergie]

Interestingly though other studies seem to show that though some exercise is great, doubling it doesn't go anywhere near doubling the effectiveness. So marathon training not essential

Doh!

That's really interesting and motivational!

I always find that intense exercise (such as a 5k race) causes a big liver dump that spikes my BG, but after that my BG is much more stable (even in response to more carbohydrate).

 

[ElyDave]

Doh!

That's really interesting and motivational!

I always find that intense exercise (such as a 5k race) causes a big liver dump that spikes my BG, but after that my BG is much more stable (even in response to more carbohydrate).

Of course there is the adrenaline factor of a race to start with and then the high intensity of a 5k. I found the same with my recent 10k race, that the BG stayed much higher throughout the race than expected, based on training without the insulin.

What I've found out to my cost though is that you need to be careful not to over adjust with insulin as the body is wanting to naturally replenish the muscles and the liver, which is an easy way to a hypo.

 

[Bebo321]

But as I read it, the T-id weren't reducing calories, it was devised so that the calories stayed the same They were eating 600 cal more to compensate for the 600 cal worth of exercise. At the end their weight had changed only a little. (-1kg)

Apologies Phoenix - you're absolutely right. It was purely exercise with no dietary change for T, and T-iD took on board additional calories to compensate for the deficiency caused by the exercise.
I've just spotted the GLUT4 results too - approximately 50% increase for the T and T-iD groups. I'm going to have to look up the significance of HK II, as I have no idea what that is!