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Summary HUB3006F - Diabetes and Exercise - Lecour

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This document discusses the relationship between diabetes and exercise, including the impact of physical activity on insulin sensitivity, endothelial function, and the autonomic nervous system. It also addresses the impairments caused by diabetes on exercise tolerance and cardiorespiratory fitness.   The notes further explore the benefits of exercise in managing diabetes, such as promoting weight loss, improving cardiovascular fitness, and reducing oxidative stress and inflammation.   Additionally, the document delves into the effects of exercise on glycated hemoglobin, GLUT4 expression, mitochondrial activity, and provides exercise guidelines for patients with diabetes. It also touches on the concept of an "exercise-in-a-pill" and its potential to enhance athletic endurance.

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Diabetes and Ex-cise


• Diabetic – mean fasting glucose levels is >125 mg/dl
• Pre-diabetic – between 100 mg/dl and 125 mg/dl
• Normal – less 100 mg/ml
• Decreased risk of developing diabetes if you exercise
o Increased physical activity of >3 hours per
week = 70% risk reduction for diabetes
compared to those who did not
• Reduction of weight loss must be associated with a
healthy nutritional pattern
• Can improve:
o Insulin sensitivity
o Endothelial function
o Autonomic NS function


Diabetes and exercise impairment
• Loss of cardiorespiratory fitness and exercise tolerance
• Accentuates the bp response to exercise
• Reduces oxygen uptake by 15%
Due to:
• Reduced heart rate variability
• Left ventricular dysfunction
• Lower lung capacity


• Factors are sex-dependent
o In females, diabetes had a worsened effect compared to females


Diabetes exaggerates exercise effort
• Mind shift – more difficult for TIID women to exercise compared
to non-TIIP diabetes who are obese
• Measured perception of exertion with exercise (how quickly they
get tired)
• Feeling of exhaustion was quicker in TIID




Benefits of exercise
• Promote weight loss and increases muscle strength ® improved mechanisms of glucose control
because you have an increase in glucose sensitivity
• Improves cardiovascular fitness
o Improved blood flow and blood pressure
• Improves cholesterol levels (beneficial to reduce risk of atherosclerotic plaque formation)
• Releases stress (oxidative stress reduction, diminishes risk of atherosclerotic plaque)
• Increases feeling of well-being
o Release of endorphins (happy chemicals)
o Helps with anxiety
o Reduces stress

, o Better sleep
o Improves self-confidence
o Improves workflow


• Circadian misalignment – increases both diastolic and systolic blood pressure
o Decreases epinephrine expression, lacking stimulation of PNS that could decrease the bp
o An increase in pro-inflammatory markers and a decrease in anti-inflammatory markers




• Influences the supply of leukocytes and lipids in the circulation
• Influences the behaviour of endothelial cells, smooth muscle cells, and macrophages in the vessel
o Mediate atherosclerosis
• Vasoconstriction due to an increase in bp


Effects of insulin sensitivity and resistance
• Reduces oxidative stress
• Reduces glycated haemoglobin
• Modulates GLUT4 translocation
• Reduces inflammation


Changes in cellular NO, Scavenger and ROS levels in relation to physical activity:


No exercise (sedentary lifestyle) Free radicals ® stress ® glycated proteins
Moderate exercise Minimal stress to your body = body’s defence
mechanism is active
• Body produces scavengers (catalase) ®
mops up free radicals (counters the
oxidative stress
• Increase in NO, scavengers and ROS
Strenuous exercise Too much exercise leads to the accumulation
of free radicals = massive increase in ROS (and
oxidative stress)
• Strenuous exercise for diabetics, monitor
and assess limits because exercise can be
harmful
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