Department of Physical Education, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Brazil.
Departament of Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil.
Photobiomodul Photomed Laser Surg. 2022 Sep;40(9):597-603. doi: 10.1089/photob.2022.0031. Epub 2022 Aug 30.
Insulin resistance (IR) is the main risk factor for the development of type 2 diabetes mellitus (DM2). Noninvasive and nonpharmacological therapies, such as exercise and diet are effective in treating IR and DM2; however, adherence to them generally is low and diminishes positive effects in the long term. Photobiomodulation therapy (PBMT) is another noninvasive and nonpharmacological therapy, which produces positive effects on mitochondrial metabolism, oxidative stress, and inflammation generally linked to IR and DM2 and may improve or attenuate the severity of these diseases. In this narrative review, we focus on the available literature related to the effects of PBMT on IR. In fact, recent and studies have demonstrated improvements in IR in skeletal muscle, adipose tissue, and hepatic cells mediated by PBMT. Further, there is evidence that PBMT can potentiate exercise-induced improvement in IR through ameliorating mitochondrial dysfunction, reducing inflammation, and modulating oxidative stress. Moreover, reduced adiposity and altered gut microbiota also appear to mediate PBMT effects on IR. Although these results are exciting, randomized clinical trials are urgently needed to confirm the clinical relevance of PBMT in the treatment of IR. Investigation about the effects of PBMT combined with different volumes of physical exercises may also contribute significantly for those patients having difficulty to adhere to the recommended minimal exercise volume. Finally, studies on PBMT parameters (e.g., dosimetry, wavelengths, single-point vs. full-body irradiation) are also necessary for the appropriate prescription of PBMT for the treatment of IR.
胰岛素抵抗（IR）是 2 型糖尿病（DM2）发展的主要危险因素。非侵入性和非药物治疗，如运动和饮食，对治疗 IR 和 DM2 有效；然而，人们对这些治疗方法的依从性通常较低，长期来看会降低其积极效果。光生物调节疗法（PBMT）是另一种非侵入性和非药物治疗方法，通常对与 IR 和 DM2 相关的线粒体代谢、氧化应激和炎症产生积极影响，并可能改善或减轻这些疾病的严重程度。在这篇叙述性综述中，我们重点介绍了与 PBMT 对 IR 影响相关的现有文献。事实上，最近的研究表明，PBMT 可改善骨骼肌、脂肪组织和肝细胞中的 IR。此外，有证据表明，PBMT 可以通过改善线粒体功能障碍、减轻炎症和调节氧化应激来增强运动引起的 IR 改善。此外，脂肪减少和肠道微生物群改变似乎也介导了 PBMT 对 IR 的影响。虽然这些结果令人兴奋，但迫切需要随机临床试验来确认 PBMT 在治疗 IR 中的临床相关性。研究 PBMT 与不同运动量的组合的效果也可能对那些难以遵守推荐最小运动量的患者有重要意义。最后，对 PBMT 参数（例如剂量学、波长、单点与全身照射）的研究对于为 IR 的治疗提供适当的 PBMT 处方也是必要的。
