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Short-term eccentric exercise in newly diagnosed type II diabetics: an exploratory study

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Abstract

Purpose

Eccentric exercise has been proposed as an alternate modality for chronic disease patients who cannot tolerate strenuous or vigorous intensity exercise. However, there is limited information regarding the biological benefits of this type of training compared to ‘traditional’ exercise. In this exploratory randomised clinical trial, we evaluated the feasibility and efficacy of eccentric exercise in the amelioration of markers of insulin resistance and inflammation.

Methods

Ten participants (age 50.0 ± 15 years, BMI 31.3 ± 7.1 kg/m2) with newly diagnosed T2DM and a sedentary lifestyle were randomly assigned to eccentric or concentric training performed during ten 30-min sessions of aerobic exercise over a 2-week period. Fasting blood samples were obtained pre- and 24 h post-intervention to determine insulin resistance (HOMA-IR, OGTT) and circulating cytokine (IL-6, TNF-α) concentrations.

Results

Despite the reduced heart rate (p = 0.008), the eccentric training group performed more work over the ten training sessions (p = 0.016) with no differences in the participant’s perceived exertion (p = 0.69). No significant between- or within-group changes were observed for OGTT, HOMA-IR or markers of inflammation (p > 0.05). However, there was a modest but consistent amelioration of OGTT, IL-6 and TNF-α that was been observed in the eccentric training group but not in the concentric training group.

Conclusion

Preliminary findings from this exploratory study would tend to suggest that short-term eccentric exercise is well tolerated in previously sedentary T2DM patients and that the trend towards reductions in circulating insulin resistance and inflammatory markers requires validation in an adequately powered clinical trial conducted over a longer duration.

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References

  1. World Health Organisation (2009) Global health risks: mortality and burden of disease attributable to selected major risks. WHO, Geneva

    Google Scholar 

  2. International Diabetes Federation Diabetes Atlas, 5th edn. http://www.idf.org/diabetesatlas/5e/Update2012. Accessed 11 February 2012

  3. Wild S, Roglic G, Green A, Sicree R, King H (2004) Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 27(5):1047–1053

    Article  PubMed  Google Scholar 

  4. Boden G, Carnell L (2008) Obesity and free fatty acids (FFA). Endocrinol Metab Clin N Am 37(3):1–12

    Article  Google Scholar 

  5. Cameron A, Welborn T, Zimmet P, Dunstan D, Owen N, Salmon J, Dalton M, Jolley D, Shaw JE (2003) Overweight and obesity in Australia: the 1999–2000 Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Med J Aust 178:427–432

    PubMed  Google Scholar 

  6. Bruunsgaard H (2005) Physical activity and modulation of systemic low-level inflammation. J Leukoc Biol 78(4):819–835

    Article  CAS  PubMed  Google Scholar 

  7. Starkie R, Ostrowski SR, Jauffred S, Febbraio M, Pedersen BK (2003) Exercise and IL-6 infusion inhibit endotoxin-induced TNF-a production in humans. FASEB 17(8):884–886

    CAS  Google Scholar 

  8. Campbell PT, Campbell KL, Wener MH, Wood BL, Potter JD, McTiernan A, Ulrich CM (2009) A yearlong exercise intervention decreases CRP among obese postmenopausal women. Med Sci Sports Exerc 41(8):1533–1539

    Article  PubMed  Google Scholar 

  9. Handschin C, Spiegelman BM (2008) The role of exercise and PGC1[alpha] in inflammation and chronic disease. Nature 454(7203):463–469

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. Woods JA, Vieira VJ, Keylock KT (2006) Exercise, inflammation, and innate immunity. Neurol Clin 24(3):585–599

    Article  PubMed  Google Scholar 

  11. DE Thomas, Elliott EJ, Naughton GA (2006) Exercise for type 2 diabetes mellitus. Cochrane Database Syst Rev 19(3):CD002968

    Google Scholar 

  12. Wang Y, Simar D, Fiatarone Singh MA (2009) Adaptations to exercise training within skeletal muscle in adults with type 2 diabetes or impaired glucose tolerance: a systematic review. Diabetes Metab Rev 25(1):13–40

    Article  Google Scholar 

  13. Yates T, Khunti K, Bull F, Gorely T, Davies MJ (2007) The role of physical activity in the management of impaired glucose tolerance: a systematic review. Diabetologia 50(6):1116–1126

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  14. ACSM/ADA (2010) Exercise and type 2 diabetes. Med Sci Sports Exerc 42(12):2282–2303

    Article  Google Scholar 

  15. Plotnikoff RC, Taylor LM, Wilson PM, Courneya KS, Sigal RJ, Birkett N, Raine K, Svenson LW (2006) Factors associated with physical activity in Canadian adults with diabetes. Med Sci Sports Exerc 38(8):1526–1534

    Article  PubMed  Google Scholar 

  16. Nelson KM, Reiber G, Boyko EJ (2002) Diet and exercise among adults with type 2 diabetes: findings from the Third National Health and Nutrition Examination Survey (NHANES III). Diabetes Care 25:1722–1728

    Article  PubMed  Google Scholar 

  17. Brazeau AS, Rabasa-Lhoret R, Strychar I, Mircescu H (2008) Barriers to physical activity among patients with type 1 diabetes. Diabetes Care 31(11):2108–2109

    Article  PubMed Central  PubMed  Google Scholar 

  18. Huebschmann AG, Crane LA, Belansky ES, Scarbro S, Marshall JA, Regensteiner JG (2001) Fear of injury with physical activity is greater in adults with diabetes than in adults without diabetes. Diabetes Care 34(8):1717–1722

    Article  Google Scholar 

  19. Marcus R, LaStayo P, Dibble L, Hill L, McClain D (2009) Increased strength and physical performance with eccentric training in women with impaired glucose tolerance: a pilot study. J Womens Health 18:250–260

    Article  Google Scholar 

  20. Rattray B, Caillaud C, Ruell P, Thompson M (2011) Heat exposure does not alter eccentric exercise-induced increases in mitochondrial calcium and respiratory dysfunction. Eur J Appl Physiol 111(11):2813–2821

    Article  CAS  PubMed  Google Scholar 

  21. Vallejo AF, Schroeder ET, Zheng L, Jensky NE, Sattler FR (2006) Cardiopulmonary responses to eccentric and concentric resistance exercise in older adults. Age Ageing 35(3):291–297

    Article  PubMed  Google Scholar 

  22. Enoka RM (1996) Eccentric contractions require unique activation strategies by the nervous system. J Appl Physiol 81(6):2339–2346

    CAS  PubMed  Google Scholar 

  23. Asp S, Daugaard JR, Richter EA (1995) Eccentric exercise decreases glucose transporter GLUT4 protein in human skeletal muscle. J Physiol 482(3):705–712

    CAS  PubMed Central  PubMed  Google Scholar 

  24. del Aguila LF, Krishnan RK, Ulbrecht JS, Farrell PA, Correll PH, Lang CH, Zierath JR, Kirwan JP (2000) Muscle damage impairs insulin stimulation of IRS-1, PI 3-kinase, and Akt-kinase in human skeletal muscle. Am J Physiol Endocrinol Metab 279(1):206–212

    Google Scholar 

  25. del Aguila LF, Claffey KP, Kirwan JP (1999) TNF-alpha impairs insulin signaling and insulin stimulation of glucose uptake in C2C12 muscle cells. Am J Physiol Endocrinol Metab 276(5):E849–E855

    Google Scholar 

  26. Green MS (2008) Effect of a repeated bout of eccentrically-biased contractions on insulin resistance. Dissertation, Georgia State University

  27. Rattray B, Thompson M, Ruell P, Caillaud C (2013) Specific training improves skeletal muscle mitochondrial calcium homeostasis after eccentric exercise. Eur J Appl Physiol 113(2):427–436

    Article  CAS  PubMed  Google Scholar 

  28. Besson D, Joussain C, Gremeaux V, Morisset C, Laurent Y, Casillas JM, Laroche D (2013) Eccentric training in chronic heart failure: Feasibility and functional effects. Results of a comparative study. Ann Phys Rehabil Med 56(1):30–40

    Article  CAS  PubMed  Google Scholar 

  29. Hansen PA, Dechet CB, Porucznik CA, LaStayo PC (2009) Comparing eccentric resistance exercise in prostate cancer survivors on and off hormone therapy: a pilot study. Phys Med Rehabil 1(11):1019–1024

    Google Scholar 

  30. Dibble LE, Hale T, Marcus RL, Gerber JP, LaStayo PC (2006) The safety and feasibility of high-force eccentric resistance exercise in persons with Parkinson’s disease. Arch Phys Med Rehabil 87(9):1280–1282

    Article  PubMed  Google Scholar 

  31. Alfredson H, Pietila T, Jonsson P, Lorentzon R (1998) Heavy-load eccentric calf muscle training for treatment of chronic Achilles tendinosis. Am J Sports Med 26(3):360–366

    CAS  PubMed  Google Scholar 

  32. Mafi N, Lorentzon R, Alfredson H (2001) Superior short-term results with eccentric calf muscle training compared to concentric training in a randomized prospective multicentre study on patients with Achilles tendinosis. Knee Surg Sports Traumatol Arthrosc 9:42–47

    Article  CAS  PubMed  Google Scholar 

  33. Purdam CR, Jonsson P, Alfredson H, Lorentzon R, Cook R, Khan K (2004) A pilot study of the eccentric decline squat in the management of painful chronic patellar tendinopathy. Br J Sports Med 38(4):395–397

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  34. Borg G (1970) Perceived exertion as an indicator of somatic stress. Scand J Rehabil Med 2:92–98

    CAS  PubMed  Google Scholar 

  35. Nolan CJ, Damm P, Prentki M (2011) Type 2 diabetes across generations: from pathophysiology to prevention and management. Lancet 378:169–181

    Article  PubMed  Google Scholar 

  36. Yan Z, Biggs R, Booth F (1993) Insulin-like growth factor immunoreactivity increases in muscle after acute eccentric contractions. J Appl Physiol 74:410–414

    CAS  PubMed  Google Scholar 

  37. Zebrowska A (2010) The relation between concentric and eccentric exercise and the carbohydrate metabolism in healthy individuals. Biophil Rehabil J 6:27–33

    Article  Google Scholar 

  38. Keskin M, Kurtoglu S, Kendirci M, Atabek M, Yazici C (2005) Homeostasis model assessment is more reliable than the fasting glucose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents. Pediatrics 115:501–504

    Article  Google Scholar 

  39. Winnick J, Sherman W, Habash D, Stout M, Failla M, Belury M, Schuster DP (2007) Short-term aerobic exercise training in obese humans with type 2 diabetes mellitus improves whole body insulin sensitivity through gains in peripheral, not hepatic insulin sensitivity. J Clin Endocrinol Metab 93:771–778

    Article  PubMed Central  PubMed  Google Scholar 

  40. Kirwan JP, Solomon TPJ, Wojta DM, Staten MA, Holloszy JO (2009) Effects of 7 days of exercise training on insulin sensitivity and responsiveness in type 2 diabetes mellitus. Am J Physiol Endocrinol Metab 297(1):E151–E156

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  41. Bloem CJ, Chang AM (2008) Short-term exercise improves β-Cell function and insulin resistance in older people with impaired glucose tolerance. J Clin Endocrinol Metab 93(2):387–392

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  42. Drexel H, Saely CH, Langer P, Lourenser G, Marte T, Risch L, Hoefle G, Aczel S (2008) Metabolic and anti-inflammatory benefits of eccentric endurance exercise—a pilot study. Eur J Clin Invest 38(4):218–226

    Article  CAS  PubMed  Google Scholar 

  43. Brandt C, Pedersen BK (2010) The role of exercise-induced myokines in muscle homeostasis and the defense against chronic diseases. J Biomed Biotechnol. doi:10.1155/2010/520258

    PubMed Central  PubMed  Google Scholar 

  44. Golbidi S, Badran M, Laher I (2012) Antioxidant and anti-inflammatory effects of exercise in diabetic patients. Exp Diabetes Res. doi:10.1155/2012/941868

    PubMed Central  PubMed  Google Scholar 

  45. Monzillo LU, Hamdy O, Horton ES, Ledbury S, Mullooly C, Jarema C, Porter S, Ovalle K, Moussa A, Mantzoros CS (2003) Effect of lifestyle modification on adipokine levels in obese subjects with insulin resistance. Obes Res 11:1048–1054

    Article  CAS  PubMed  Google Scholar 

  46. Lee J (2013) Adipose tissue macrophages in the development of obesity-induced inflammation, insulin resistance and type 2 Diabetes. Arch Pharmacal Res 36(2):208–222

    Article  CAS  Google Scholar 

  47. Muniyappa R, Montagnani M, Koh KK, Quon MJ (2006) Cardiovascular actions of insulin. Endocrinol Rev 28:463–491

    Article  Google Scholar 

  48. Laakso M, Edelman SV, Brechtel G, Baron AD (1992) Impaired insulin-mediated skeletal muscle blood flow in patients with NIDDM. Diabetes 41:1076–1083

    Article  CAS  PubMed  Google Scholar 

  49. Steinberg HO, Brechtel G, Johnson A, Fineberg N, Baron AD (1994) Insulin-mediated skeletal muscle vasodilation is nitric oxide dependent. J Clin Investig 94:1172–1179

    Article  CAS  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

The study was supported by an ACT Health and Medical Research Support program grant. The authors acknowledge the support of the ACT Health diabetes educators and Dr. Chris Nolan during the conduct of this study.

Conflict of interest

B Rattray, J Steele, S Semple, R Ramirez and W Abhayaratna declare that they have no conflict of interest.

Ethical standard

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5).

Informed consent

Informed consent was obtained from all patients for being included in the study.

Author information

Authors and Affiliations

  1. Discipline of Sport and Exercise Science, UC-Research Institute for Sport and Exercise, Faculty of Health, University of Canberra, Canberra, Australia

    B. Rattray, J. Steele & S. Semple

  2. Faculty of Education, Science, Technology and Mathematics, University of Canberra, Canberra, Australia

    R. Ramirez

  3. College of Medicine, Biology and Environment, Australian National University, Canberra, Australia

    W. P. Abhayaratna

Authors
  1. B. Rattray
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  2. J. Steele
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  3. S. Semple
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  4. R. Ramirez
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  5. W. P. Abhayaratna
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Corresponding author

Correspondence to B. Rattray.

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Rattray, B., Steele, J., Semple, S. et al. Short-term eccentric exercise in newly diagnosed type II diabetics: an exploratory study. Sport Sci Health 10, 199–204 (2014). https://doi.org/10.1007/s11332-014-0193-x

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  • DOI: https://doi.org/10.1007/s11332-014-0193-x

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