The Effect of Exercise on Hepatic Glucose Metabolism

Vanderbilt University

Status: Completed

Conditions: Obesity; Type 2 Diabetes

Treatments: Behavioral: Aerobic exercise

Study type: Interventional

Funder types: Other

Identifiers

NCT01783275

DK093799 (Other Identifier)

121031

Details and patient eligibility

About

It is known that obesity and/or physical inactivity greatly increase a person's risk of developing heart disease and other serious health problems. This is partly because diabetes is associated with inflammation, oxidative stress, and insulin resistance. Diabetes is also associated with high levels of triglycerides in the blood and tissues such as the liver (known as fatty liver or steatosis). This elevation of fat in the liver is known to cause liver insulin resistance and impair the function of the liver and this impairment contributes to the development of diabetes.

Studies have shown that both aerobic exercise and weight loss have beneficial results on insulin resistance. However, the cause of this benefit remains unclear. We know that both aerobic exercise and/or weight loss can improve how muscle responds to insulin. However, it is also known that aerobic exercise and/or weight loss lowers liver fat content, thereby making it possible that the liver's response to insulin is also improved by weight loss and/or exercise training. An improved responsiveness of the liver to insulin could lower blood sugar levels after a meal and it could also lower morning blood sugar levels. However, very little is known about how exercise and/or weight loss improves liver function in people with type 2 diabetes.

Hypothesis 1: Improved hepatic insulin sensitivity, as a result of exercise training will increase the amount of glucose from an oral load that is taken up by the liver in subjects with DM.

Hypothesis 2: Increases in hepatic insulin sensitivity as a result of exercise will cause reductions in EGP during the fasted state, and will improve the suppression of EGP seen in response to hyperinsulinemia.

Enrollment: 20 patients

Sex: All

Ages: 40 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 40-60 yrs of age
• sedentary lifestyle
• stable weight
• BMI 30 - 40kg/m2
• Hgb A1c <8.5
• Type 2 diabetes

Exclusion criteria

• Use of insulin
• Use of TZDs

Trial design

Primary purpose: Basic Science

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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20 participants in 2 patient groups

Aerobic Exercise

Experimental group

Description:

12 weeks of aerobic exercise

Treatment:

Behavioral: Aerobic exercise

Control

No Intervention group

Description:

12 weeks with no change in diet or exercise habits (weight maintenance).