Changes in insulin sensitivity, glucose effectiveness, and B-cell function in regularly exercising subjects

  • Ronald L. Prigeon
    Address reprint requests to Ronald L. Prigeon, MD, VA Medical Center (151), 1660 S Columbian Way, Seattle, WA 98108.
    Division of Metabolism, Endocrinology and Nutrition, University of Washington and Veterans Affairs Medical Center, Seattle, WA, USA
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  • Steven E. Kahn
    Division of Metabolism, Endocrinology and Nutrition, University of Washington and Veterans Affairs Medical Center, Seattle, WA, USA
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  • Daniel Porte Jr
    Division of Metabolism, Endocrinology and Nutrition, University of Washington and Veterans Affairs Medical Center, Seattle, WA, USA
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      To determine the relative contributions of changes in glucose effectiveness, B-cell function, and insulin sensitivity to changes in glucose tolerance upon exercise cessation in regularly exercising individuals, we studied seven young subjects who were performing aerobic exercise on a regular schedule. Each subject was studied 12 and 84 hours after the last bout of exercise with an intravenous glucose tolerance test (IVGTT) to quantify insulin sensitivity and glucose effectiveness at zero insulin (GEZI) using the minimal model of glucose kinetics. Additionally, B-cell function was quantified as the acute insulin response to glucose (AIRglucose), and intravenous glucose tolerance as the glucose disappearance constant (Kg). Twelve hours after the last bout of exercise, Sl was 8.47 ± 1.12 × 10−5 min−1/pmol/L, as compared with 6.98 ± 1.17 × 10−5 min−1/pmol/L 84 hours after exercise (mean ± SE, P = .005). No change was observed in GEZI (0.020 ± 0.004 min−1 at 12 hours v 0.019 ± 0.002 min−1 at 84 hours, P = NS) or AIRglucose (588 ± 213 pmol/L at 12 hours v 687 ± 271 pmol/L at 84 hours, P = NS). Thus, the difference in intravenous glucose tolerance observed 12 hours after exercise as compared with 84 hours after the last bout of exercise (Kg, 2.91 ± 0.70 %/min at 12 hours v 2.23 ± 0.60 %/min at 84 hours, P < .05) would appear to be entirely related to a difference in Sl and not to differences in glucose effectiveness or B-cell function.
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        • Heath GW
        • Gavin III, JR
        • Hinderliter JM
        • et al.
        Effects of exercise and lack of exercise on glucose tolerance and insulin sensitivity.
        J Appl Physiol. 1983; 55: 512-517
        • Baron AD
        • Brechtel G
        • Wallace P
        • et al.
        Rates and tissue sites of non-insulin and insulin-mediated glucose uptake in humans.
        Am J Physiol. 1988; 255: E769-E774
        • Kahn SE
        • Prigeon RL
        • McCulloch DK
        • et al.
        The contribution of insulin-dependent and insulin-independent glucose uptake to intravenous glucose tolerance in healthy human subjects.
        Diabetes. 1994; 43: 587-592
        • LeBlanc J
        • Nadeau A
        • Richard D
        • et al.
        Studies on the sparing effect of exercise on insulin requirements in human subjects.
        Metabolism. 1981; 30: 1119-1124
        • Burstein R
        • Polychronakos C
        • Toews CJ
        • et al.
        Acute reversal of the enhanced insulin action in trained athletes: Association with insulin receptor changes.
        Diabetes. 1985; 34: 756-760
        • McGuire EAH
        • Helderman JH
        • Tobin JE
        • et al.
        Effects of arterial versus venous sampling on glucose kinetics in man.
        J Appl Physiol. 1976; 41: 563-573
        • Beard JC
        • Bergman RN
        • Ward WK
        • et al.
        The insulin sensitivity index in man: Correlation between clamp-derived and IVGTT-derived values.
        Diabetes. 1986; 35: 362-369
        • Morgan DR
        • Lazarow A
        Immunoassay of insulin: Two antibody system: Plasma insulin levels of normal, subdiabetic, and diabetic rats.
        Diabetes. 1963; 12: 115-126
        • Marangou AG
        • Alford FP
        • Ward G
        • et al.
        Hormonal effects of norepinephrine on acute glucose disposal in humans: A minimal model analysis.
        Metabolism. 1988; 37: 885-891
        • Evans MI
        • Halter JB
        • Porte Jr, D
        Comparison of double and single enzymatic derivative methods for measurement of catecholamines in human plasma.
        Clin Chem. 1978; 24: 567-570
        • Bergman RN
        • Ider YZ
        • Bowden CR
        • et al.
        Quantitative estimation of insulin sensitivity.
        Am J Physiol. 1979; 236: E667-E677
        • Marquardt D
        An algorithm for least squares estimation of nonlinear parameters.
        J Soc Ind Appl Math. 1963; 11: 431-441
        • Kahn SE
        • Klaff LJ
        • Schwartz MW
        • et al.
        Treatment with a somatostatin analog decreases pancreatic B-cell and whole body sensitivity to glucose.
        J Clin Endocrinol Metab. 1990; 71: 994-1002
        • Taylor HL
        • Haskell W
        • Fox SM
        • et al.
        Exercise tests: A summary of procedures and concepts of stress testing for cardiovascular diagnosis and function evaluation.
        in: Blackburn H Measurement in Exercise Electrocardiography. Thomas, Springfield, IL1969: 259-305
        • Abbate SL
        • Fujimoto WY
        • Brunzell JD
        • et al.
        Effect of heparin on insulin-glucose interactions measured by the minimal model technique: Implications for reproducibility using this method.
        Metabolism. 1993; 42: 353-357
        • Wasserman DH
        • Geer RJ
        • Rice DE
        • et al.
        Interaction of exercise and insulin action in humans.
        Am J Physiol. 1991; 260: E37-E45
        • Garetto LP
        • Richter EA
        • Goodman MN
        • et al.
        Enhanced muscle glucose metabolism after exercise in the rat: The two phases.
        Am J Physiol. 1984; 246: E471-E475
        • Ivy JL
        • Holloszy JO
        Persistent increase in glucose uptake by rat skeletal muscle following exercise.
        Am J Physiol. 1981; 241: C200-C203
        • Richter EA
        • Garetto LP
        • Goodman MN
        • et al.
        Enhanced muscle glucose metabolism after exercise: Modulation by local factors.
        Am J Physiol. 1984; 246: E476-E482
        • Bergstrom J
        • Hultman E
        Muscle glycogen synthesis after exercise: An enhancing factor localized to the muscle cells in man.
        Nature. 1966; 210: 309-310
        • Piehl K
        Time course for refilling of glycogen stores in human muscle fibres following exercise-induced glycogen depletion.
        Acta Physiol Scand. 1974; 90: 297-302
        • MacDougall JD
        • Ward GR
        • Sutton JR
        Muscle glycogen repletion after high-intensity intermittent exercise.
        J Appl Physiol. 1977; 42: 129-132
        • Ivy JL
        • Katz AL
        • Cutler CL
        • et al.
        Muscle glycogen synthesis after exercise: Effect of time of carbohydrate ingestion.
        J Appl Physiol. 1988; 64: 1480-1485
        • Tokuyama K
        • Higaki Y
        • Fujitam J
        • et al.
        Intravenous glucose tolerance test-derived glucose effectiveness in physically trained humans.
        Am J Physiol. 1993; 265: E298-E303
        • Chen M
        • Bergman RN
        • Porte Jr, D
        Insulin resistance and beta-cell dysfunction in aging: The importance of dietary carbohydrate.
        J Clin Endocrinol Metab. 1988; 67: 951-957
        • Lovejoy J
        • DiGirolamo M
        Habitual dietary intake and insulin sensitivity in lean and obese adults.
        Am J Clin Nutr. 1992; 55: 1174-1179
        • Swinburn BA
        • Boyce VL
        • Bergman RN
        • et al.
        Deterioration in carbohydrate metabolism and lipoprotein changes induced by modern, high fat diet in Pima Indians and caucasians.
        J Clin Endocrinol Metab. 1991; 73: 156-165
        • Houmard J
        • Hortobagyi T
        • Johns R
        • et al.
        Effect of short-term training cessation on performance measures in distance runners.
        Int J Sports Med. 1992; 13: 572-576
        • Coyle EF
        • Martin WH
        • Sinacore DR
        • et al.
        Time course of loss of adaptation after stopping prolonged intense endurance training.
        J Appl Physiol. 1984; 57: 1857-1864
        • Hickson R
        • Rosenkoetter M
        Reduced training frequencies and maintenance of increased aerobic power.
        Med Sci Sports Exerc. 1981; 13: 13-16
        • Londeree BR
        • Moeschberger ML
        Effect of age and other factors on maximal heart rate.
        Res Q Exerc Sport. 1982; 53: 297-304