Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD 20742-2611, USA.
Med Sci Sports Exerc. 2011 Dec;43(12):2231-40. doi: 10.1249/MSS.0b013e318223b5f9.
It is generally accepted that if prediabetic individuals adopt healthy lifestyle habits, the progression to type 2 diabetes mellitus can be prevented or delayed. However, the role of exercise training independent of other lifestyle factors has not been determined. Furthermore, patients with type 2 diabetes mellitus have been shown to experience greater training-induced changes in glucose and insulin metabolism compared with healthy subjects, but the adaptations of prediabetic individuals have not been adequately examined. We hypothesized that (i) prediabetic subjects would have greater endurance training-induced changes in plasma glucose and insulin responses to an oral glucose challenge compared with age- and body mass index-matched normoglycemic subjects and (ii) training would completely reverse the abnormal glucose metabolism of prediabetic subjects.
Plasma glucose and insulin responses to oral glucose tolerance tests (OGTTs) were examined in normoglycemic (n = 119) and prediabetic (n = 47) older men and women before and after a 6-month standardized endurance exercise training program.
Prediabetic subjects had greater glucose and insulin OGTT responses than normoglycemic subjects both before and after training (P < 0.05). Prediabetic subjects had greater training-induced changes in glucose and insulin areas under the glucose tolerance curve, as well as greater changes in glucose and insulin concentrations at several points of the OGTT. However, these changes did not eliminate the baseline differences in glucose tolerance between normoglycemic and prediabetic subjects. The between-group differences in changes in glucose and insulin variables were largely independent of changes in body weight or composition.
Our data indicate that prediabetes is associated with greater training-induced changes in glucose tolerance. However, 6 months of endurance training alone was not sufficient to completely reverse prediabetes.
人们普遍认为，如果糖尿病前期患者采取健康的生活方式习惯，那么 2 型糖尿病的进展是可以预防或延缓的。然而，运动训练对其他生活方式因素的独立作用尚未确定。此外，与健康受试者相比，2 型糖尿病患者在接受运动训练后，其血糖和胰岛素代谢的变化更为明显，但对糖尿病前期患者的适应性变化还没有进行充分的研究。我们假设：（i）与年龄和体重指数匹配的血糖正常受试者相比，糖尿病前期患者在耐力训练后，其口服葡萄糖耐量试验（OGTT）的血糖和胰岛素反应会有更大的变化；（ii）训练将完全逆转糖尿病前期患者的异常血糖代谢。
在标准化的耐力运动训练计划之前和之后，我们检测了血糖正常（n = 119）和糖尿病前期（n = 47）的老年男女的 OGTT 时的血浆葡萄糖和胰岛素反应。
在训练前后，糖尿病前期患者的 OGTT 时的血糖和胰岛素反应均高于血糖正常患者（P < 0.05）。糖尿病前期患者的葡萄糖耐量曲线下面积和 OGTT 中几个点的葡萄糖和胰岛素浓度的变化与训练相关，这些变化更大。然而，这些变化并不能消除 OGTT 中血糖正常和糖尿病前期患者之间的基础差异。在葡萄糖和胰岛素变量的组间差异的变化中，体重或成分的变化在很大程度上是独立的。
我们的数据表明，糖尿病前期与更大的训练诱导的葡萄糖耐量变化有关。然而，单独进行 6 个月的耐力训练不足以完全逆转糖尿病前期。
