scholarly journals Physical activity versus metformin for increasing insulin sensitivity in children and adolescents at-risk for type 2 diabetes

2016 ◽  
Vol 85 (2) ◽  
pp. 26-28
Author(s):  
Andrew D Hanna ◽  
Natalie V Scime

Global rates of type 2 diabetes (T2D) among children and adolescents are steadily rising. As such, an increasing amount of attention and research has begun to focus on strategies to prevent this chronic and burdensome disease in pediatric populations. The purpose of this article is to briefly review current evidence pertaining to the effectiveness of physical activity versus metformin in improving insulin sensitivity of children at-risk (ie, obese and/or insulin resistant) for developing T2D. Potential barriers to each preventative intervention will also be discussed. Physical activity, both aerobic and resistance, has demonstrated effectiveness in a moderate number of demographically diverse pediatric studies. However, the pediatric population is already alarmingly sedentary with barriers such as lack of motivation, social stigma and discomfort presenting a challenge. A small number of studies have demonstrated the beneficial effects of metformin in children and adolescents for improved insulin sensitivity. However, longer and larger studies are required to confirm these findings and elucidate upon the long-term safety and efficacy of this pharmaceutical in pediatric populations. While no head-to-head studies examining physical activity and metformin exist in pediatric populations and more research is needed, current evidence seems to favour the use of physical activity given the larger quantity of studies and generalizability of its beneficial effects. Thus, physical activity should be emphasized in clinical and public health practice when targeting at-risk children and adolescents to prevent a T2D diagnosis.

PLoS ONE ◽  
2015 ◽  
Vol 10 (1) ◽  
pp. e0116851 ◽  
Author(s):  
Yoshinori Watanabe ◽  
Keiko Nakayama ◽  
Nobuhiko Taniuchi ◽  
Yasushi Horai ◽  
Chiaki Kuriyama ◽  
...  

SLEEP ◽  
2012 ◽  
Vol 35 (7) ◽  
pp. 977-984 ◽  
Author(s):  
Lindsay E. Bromley ◽  
John N. Booth ◽  
Jennifer M. Kilkus ◽  
Jacqueline G. Imperial ◽  
Plamen D. Penev

2014 ◽  
Author(s):  
◽  
Leryn J. Boyle

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT AUTHOR'S REQUEST.] Individuals with type 2 diabetes (T2D) have blunted femoral artery insulin mediated blood flow which is critical for the delivery and uptake of glucose into skeletal muscle. However, it is unclear in humans the precise mechanisms by which insulin resistance impairs insulin stimulated blood flow. Further, chronic physical inactivity is a powerful stimulus for reduced insulin sensitivity and vascular dysfunction; however, the effects of short term, modest reductions in physical activity are limited. Thus, we examined 1) if inactivity for 5 days would impair endothelial function in healthy individuals (study one) 2) if reducing whole body insulin sensitivity, via 5 days of inactivity, would impair the blood flow response to insulin stimulation in parallel with glycemic control (study two) and 3) phosphorylation of endothelial nitric oxide (eNOS) and endothelin-1 (ET-1) production to insulin stimulation would be decreased and increased, respectively, in insulin resistant individuals (study three). We demonstrated significant reductions in endothelial function with only 5 days of reduced daily steps while blood flow to glucose ingestion was unaltered. Further, in obese humans with type 2 diabetes it does not appear that that the reduction in blood flow to 1 hr of insulin stimulation is due to altered peNOS or ET-1. Collectively, these data suggest that reduced daily physical activity and chronic insulin resistance mediate negative impacts on vascular function and insulin stimulated blood flow and signaling.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Kevin Maki ◽  
Orsolya Palacios ◽  
Mary Buggia ◽  
Mary Dicklin ◽  
Marjorie Bell ◽  
...  

Abstract Objectives To assess the effect of breakfast egg intake, vs. energy-matched carbohydrate (CHO)-based foods, on insulin sensitivity and markers of cardiometabolic health in adults at-risk for type 2 diabetes. Methods Overweight or obese adults with prediabetes and/or metabolic syndrome were included in this randomized crossover study consisting of two 4-wk dietary intervention periods, separated by a ≥4 wk washout. During each intervention, subjects consumed study products containing either 2 eggs/d for 6 d/wk (12 eggs/wk) or energy-matched CHO-based foods for breakfast. Percent changes from baseline were assessed for insulin sensitivity; CHO metabolism; lipid metabolism, including lipoprotein lipids, subfactions and particle sizes; high-sensitivity C-reactive protein (hs-CRP); and blood pressures (BP). Results Overall, 30 subjects (11 male; 19 female) with mean age of 53.5 ± 1.9 y and body mass index (BMI) of 31.9 ± 0.7 kg/m2 provided evaluable data. Median low-density lipoprotein cholesterol (LDL-C) decreased by 6.0% from a baseline of 119 mg/dL after 4-wk intake of the CHO breakfast foods, which was larger than the 2.9% reduction during the egg condition (P = 0.023 between diets). Mean systolic blood pressure was reduced significantly more during the egg condition vs. the CHO condition (2.7% vs. 0.0%, respectively, P = 0.018) from a baseline value of 127 mmHg. None of the other cardiometabolic risk factor parameters showed significant differences in response between diet conditions. Conclusions Intake of 12 eggs/wk for breakfast, vs. energy matched CHO-based foods, did not adversely affect the cardiometabolic risk factor profile in men and women at risk for diabetes. Funding Sources American Egg Board/Egg Nutrition Center, Park Ridge, IL Supporting Tables, Images and/or Graphs


2008 ◽  
Vol 88 (11) ◽  
pp. 1355-1364 ◽  
Author(s):  
Chiao-Nan Chen ◽  
Lee-Ming Chuang ◽  
Ying-Tai Wu

Background and Purpose Physical inactivity has been well documented as a risk factor for type 2 diabetes. Previous studies measured the level of physical activity either with questionnaires or with direct measurements of maximum oxygen uptake. However, questionnaires are patient-report measures, and methods for obtaining direct maximum oxygen uptake measurements often are not available clinically. The purpose of this study was to investigate whether clinical measurement of health-related physical fitness with a simple test battery can predict insulin resistance, a precursor of type 2 diabetes, in people at risk for diabetes. Subjects and Methods A total of 151 volunteers with at least one diabetes risk factor (overweight, hypertension, dyslipidemia, family history, impaired glucose tolerance, gestational diabetes, or delivering a baby weighing more than 4.0 kg) were recruited. Insulin resistance (as determined with the homeostasis model assessment of insulin resistance [HOMA-IR]), physical fitness (including body composition, as determined with the body mass index and waist circumference), muscle strength (handgrip strength [force-generating capacity]), muscle endurance (sit-up test), flexibility (sit-and-reach test), and cardiorespiratory endurance (step test) were measured, and a physical activity questionnaire was administered. Backward regression analysis was used to build the prediction models for insulin resistance from components of physical fitness and physical activity. Results Body mass index, muscle strength, and cardiorespiratory fitness predicted HOMA-IR in men (adjusted R2=.264). In women, age, waist circumference, and cardiorespiratory fitness were the predictors of HOMA-IR (adjusted R2=.438). Discussion and Conclusion Clinical measures of physical fitness can predict insulin resistance in people at risk for diabetes. The findings support the validity of clinical measures of physical fitness for predicting insulin resistance in people at risk for diabetes.


Folia Medica ◽  
2013 ◽  
Vol 55 (2) ◽  
pp. 33-42 ◽  
Author(s):  
Theodora Temelkova-Kurktschiev ◽  
Tsvetan Stefanov ◽  
Carsta Koehler ◽  
Elena Henkel ◽  
Frank Schaper ◽  
...  

ABSTRACT AIM: To examine the relationship between physical activity (PA) and various cardiometabolic risk factors during an oral glucose tolerance test (OGTT), including glycemic spikes (PGS) in individuals at risk for type 2 diabetes. SUBJECTS AND METHODS: A total of 949 middle-aged subjects from the Risk factors in Impaired Glucose Tolerance for Atherosclerosis and Diabetes (RIAD) trial aged 40-70 years were included in the present cross-sectional analysis. Standard 75 g OGTT was performed and blood was collected every 30 min for 2 hours for measurements of plasma glucose (PG) and other cardiometabolic risk factors. PA was assessed using interviewer-administered questionnaire. RESULTS: Post-challenge PGS and maximal PG (PGmax) during OGTT were significantly lower in individuals with high PA vs. individuals with low PA even after body mass index (BMI) adjustment (p = 0.026 and p = 0.035, respectively). In univariate analysis post-challenge PG 30, 60, 90, and 120 minutes, PGS and PGmax during OGTT were significantly inversely correlated to PA. This correlation was attenuated but remained significant after adjustment for BMI. Fasting PG and glycosylated hemoglobin were not correlated to PA. Significantly higher fasting and post-challenge insulin levels were found among subjects with low vs. subjects with medium (p < 0.05) and high PA (p < 0.05). Post-challenge C-peptide and proinsulin levels were significantly lower in participants with high vs. participants with low PA (p < 0.05 for all). The relationship between 2-h PG and PA was observed also in lean subjects and in subjects with normal fasting glucose. In multivariate analysis PA was a significant independent determinant of 2-h PG. CONCLUSION: We found a strong inverse relationship between PA and various post-challenge cardiometabolic parameters during OGTT, including glycemic spikes, in a population at risk for diabetes. This relationship was only partially dependent on BMI.


2019 ◽  
Vol 16 (12) ◽  
pp. 1105-1112 ◽  
Author(s):  
Nele Huys ◽  
Vicky Van Stappen ◽  
Samyah Shadid ◽  
Marieke De Craemer ◽  
Odysseas Androutsos ◽  
...  

Background: This study aimed to investigate whether the relationship between psychosocial and perceived environmental factors and physical activity (PA) in adults at risk for type 2 diabetes is influenced by educational level. Methods: Based on the Finnish Diabetes Risk Score questionnaire, this study selected 164 adults (Mage: 38 (5.34) y, 13.4% men) at type 2 diabetes risk from 11 low socioeconomic neighborhoods in Flanders (Belgium). Participants filled out questionnaires on psychosocial and perceived environmental factors and wore an ActiGraph accelerometer for 5 consecutive days. Statistical analyses were performed using analysis of covariance in SPSS. Results: Educational level significantly influenced the association between perception of body weight and light PA (P = .01) and total PA (P = .03) on weekend days. Educational level did not influence the associations between other psychosocial and perceived environmental factors (ie, perceived social influence; environmental, time and attitudinal barriers, perceived self-efficacy; knowledge and fatalism) and PA. Conclusions: Educational level did not influence the relationship between most psychosocial and perceived environmental factors and PA in this sample of adults at type 2 diabetes risk. This suggests that addressing different psychosocial and perceived environmental correlates in lower and higher educated participants might not be necessary. However, more research in this specific population is needed.


2005 ◽  
Vol 37 (Supplement) ◽  
pp. S310
Author(s):  
Dana Townsend ◽  
Mark D. Haub ◽  
Barbara J. Lutjemeier ◽  
Leonardo Ferreira ◽  
Allison J. Harper ◽  
...  

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2485
Author(s):  
Hsin-Jung Ho ◽  
Michio Komai ◽  
Hitoshi Shirakawa

Type 2 diabetes mellitus is a chronic disease that is characterized by hyperglycemia, insulin resistance, and dysfunctional insulin secretion. Glycemic control remains a crucial contributor to the progression of type 2 diabetes mellitus as well as the prevention or delay in the onset of diabetes-related complications. Vitamin K is a fat-soluble vitamin that plays an important role in the regulation of the glycemic status. Supplementation of vitamin K may reduce the risk of diabetes mellitus and improve insulin sensitivity. This mini-review summarizes the recent insights into the beneficial effects of vitamin K and its possible mechanism of action on insulin sensitivity and glycemic status, thereby suppressing the progression of diabetes mellitus.


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