Home Fitness EXERCISE IS MEDICINE SERIES: EXERCISE FOR IMMEDIATE AND LONG-TERM BLOOD GLUCOSE CONTROL

EXERCISE IS MEDICINE SERIES: EXERCISE FOR IMMEDIATE AND LONG-TERM BLOOD GLUCOSE CONTROL

by Eddie Jo April 11, 2020 0 comment

Exercise is Medicine Series
Insulin resistance, especially in adipose and skeletal muscle, is a core defect in type II diabetes and metabolic syndrome. In healthy individuals, when blood glucose rises like after consuming carbohydrates, insulin is secreted to signal cells like those in muscle to uptake glucose out of the blood to be used as a fuel molecule by those cells. Insulin resistance in these cells describes a defect in this process, ultimately leading to uncontrolled blood glucose levels, metabolic dysfunction, and increased risk for metabolic disease.
Thus, type II diabetics have two goals, 1) improve immediate blood glucose control and 2) long term improvement in insulin sensitivity.
The former requires an insulin-independent pathway to stimulate glucose uptake by cells (since these cells are resistant to insulin). Exercise (or more technically, muscle contraction) is a known stimulus for glucose uptake in muscle (both skeletal and cardiac) through an insulin-independent pathway involving the enzyme AMPK. AMPK has been largely implicated in the treatment of type II diabetes because of its role as a potent stimulus for glucose uptake. This is why AMPK-agonist drugs are prescribed to diabetics to improve blood glucose control. However, as indicated above, exercise does the same thing. Exercise is a KNOWN AMPK-agonist.
As for the goal to improve insulin sensitivity, longterm exercise and chronic AMPK activation can eventually lead to improved insulin sensitivity, restoring the insulin-dependent pathway of glucose uptake. This effect of exercise is underpinned by multiple AMPK-related mechanisms such as mitochondrial biogenesis and decreased tissue inflammation. These longterm effects do not appear to occur with chronic use of drugs that are AMPK-agonist. EXERCISE IS LITERALLY MEDICINE.

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