Réponse de tolérance au glucose à l`exercice


Physical exercise improves glucose homeostasis but large differences have been found among individuals which strongly suggests that genetic factors play an important role. Research has been carried out to investigate whether variants that have been either confirmed or newly identified as type 2 diabetes susceptibility variants through GWAS modulate changes in phenotypes derived from an IVGTT in response to 20 weeks of regular exercise training.

 

In 1970, Berson and Yallow defined resistance to insulin as ‘a state (of a cell, tissue, system or body) in which greater than normal amounts of insulin are required to elicit a quantitatively normal response’ of glucose use. It can also be said that it is a decrease of circulating glucose in response to the insulin administered.

 

A syndrome is a set of symptoms and signs that generally group together to define a clinical picture or an illness. According to different authors, there are some variations in the integrating elements.

 

A metabolic syndrome is a clinical concept that is characterized by the association of Mellitus diabetes, glucose intolerance, elevated blood pressure, obesity, atherogenic dyslipidemia, microalbuminuria and atherosclerosis. This alteration is physiopathologically associated with hyperinsulinaemia by insulin resistance.

 

Does exercise help to lose weight? How does the human body respond to different types of exercise? The different fields of research are beginning to show genetic variations, what types of exercise are most beneficial for a person but also the specific benefits which each person can get from certain exercises, from reducing BMI to improving glucose tolerance. Glucose intolerance indicates a lessening in the body´s ability to decompose sugar and could be a precursor to diabetes.

 

A sedentary life, less physical activity and particularly, low cardiorespiratory conditioning are recognized as important causes of morbidity and mortality in those populations with greater industrial development. Physical inactivity contributes in great part to the emergence of degenerative chronic illnesses such as obesity, Mellitus type 2 diabetes, coronary and cerebrovascular disease. Consequently, it is an important cause of the development of said illnesses at any age, even in children proven in recent studies by the increase in its incidence in these populations.

 

The close association between inactivity and illness, and its elevated prevalence in society, leads to a substantial increase in health problems. The benefits of regular physical activity on health is widely recognized and has been documented in various studies about the direct relationship of physical activity and keeping healthy. On the other hand, various population studies show that by increasing the level of regular physical activity is inversely proportional to independent mortality, and when other risk factors are controlled there are greater benefits.

 

Specific studies that included endurance tests to determine aerobic ability by measuring maximum consumption of oxygen (VO2 max) have determined that the most important prognosis factors in all the mortality causes, including the rate of cardiovascular morbidity and mortality, are the levels of physical activity that is done on a daily routine basis. Having been physically activity at some time in the past is not sufficient; those who have kept a greater level of activity are 40% less apt to die early than those who have not been active. The data strongly supports the necessity of increasing daily physical activity and the level of physical conditioning (cardiovascular capacity, flexoelasticity and strength) in the population with the objective of improving health and reducing mortality rates by modifying the risk factors.

 

Glucose metabolism can be altered short term with changes in the level of physical activity; it has been demonstrated that subjects with a normal response to glucose tolerance after several days of bed rest increase insulin resistance.

 

Sedentism and obesity are the principal risk factors in Mellitus 2 diabetes, which is characterized by insulin resistance and alterations in it secretion. Treatment is centered on an adequate nutrition and an increase in physical activity that transcends the prevention of chronic complications. Experimental studies show that physical activity is one of the principal therapies to sharply reduce blood sugar in those who have Mellitus type 2 diabetes and it has been established that it has a synergic effect along with the insulin on those tissues sensitive to it. Abnormal secretion and peripheral resistance to insulin are the principal factors sharply modified by physical activity since it influences the metabolic response of Mellitus 2 diabetes patients.

 

Programmed physical activity is beneficial in Mellitus 2 diabetes patients for losing weight and for glycaemic control. It reduces insulin resistance and the plasma insulin levels in hyperinsulinemic subjects because of an increase in insulin sensitivity through the consumption of muscular glycogen during exercise; a molecular improvement in the insulin dependent diabetes glucose transport system and consequently increases glucose consumption, improving glucose tolerance, lowering the blood levels and those of glycolic hemoglobin.

 

Physical exercise as a measure to prevent, manage and control Mellitus 2 diabetes is gaining greater importance and should be recommended so that the patient gains from its benefits. The development of an exercise program should be adequately planned, individualized and monitored; thus the professional health care personnel must have the ability and theoretic knowledge to determine the objectives of the exercise, procedures and preferences, taking into account the active participation of the patient in this process in order to avoid the potential complications of a poorly prescribed or incorrectly oriented exercise and to promote compliance to the exercise program so that the diabetes patient can make it an inseparable part of his/her lifestyle.

 

Mellitus 2 diabetes can affect persons from childhood to adolescent age. In pediatric patients, it announces the appearance of cardiovascular illnesses, retinopathy, nephropathy and neuropathy, risking a loss of quality of life and premature death as a adult. Overweight children who have reached puberty (or older than 10 years of age)are considered at risk by the American Diabetes Association (ADA) if they meet 2 of the following criteria:

 

  • Family history of type 2 diabetes mellitus in first- or second-degree relative
  • Race or ethnicity is American Indian, Alaska Native, black, Hispanic, or Asian/Pacific Islander
  • Presence of a condition associated with insulin resistance (acanthosis nigricans, hypertension, dyslipidemia, PCOS)

 

Lifestyle modifications such as the acquisition and healthily integration of nutritional behavior, exercise and weight control are the basis of an initial treatment for Mellitus 2 diabetes with physical activity being the cornerstone. Exercise is associated with improvement in short- and long-term metabolic control and reduces insulin resistance. These measures have proven to be effective in preventing Mellitus 2 diabetes and its complications in adults. The evaluation of these measures in children with Mellitus 2 diabetes is an urgent necessity. Besides reducing the risk factors of diabetes, the recommendations for children and adolescents is important for feeling better and improving their quality of life.

 

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