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Diabetologia

, Volume 8, Issue 2, pp 141–144 | Cite as

Insulin secretion in obesity after exercise

  • M. Fahlén
  • J. Stenberg
  • P. Björntorp
Originals

Summary

Blood glucose and plasma insulin during glucose loads were measured in nine obese patients before and twice the days after a submaximal work of long duration. All subjects showed lower plasma insulin values the day after exercise. The insulin/glucose ratio was decreased indicating an increased insulin sensitivity. The effect could be demonstrated with the peroral as well as with the intravenous glucose test. The effect was remaining for four to six days after exercise in seven of the nine patients studied. The insulin concentration the day after exercise was well within the range of values of non-obese, non-exercising controls. No parallel lowering of plasma triglycerides was observed. It was concluded that an acute, submaximal, prolonged work produces a considerable decrease of plasma insulin levels during several days in hyperinsulinemic obese patients.

Key words

Obesity exercise insulin triglycerides glucose tolerance 

Sécrétion de l'insuline chez les obèses après exercice

Résumé

Le glucose sanguin et l'insuline du plasma ont été mesurés pendant des charges de glucose chez 9 malades obèses, d'une part, avant un exercice submaximal de longue durée, d'autre part, deux fois les jours après cet exercice. Tous les sujets ont montré une diminution des valeurs de l'insuline du plasma un jour après l'exercice. Le quotient insuline/glucose était réduit, montrant une augmentation de la sensibilité envers l'insuline. L'effet pouvait être démontré aussi bien par le test oral au glucose que par le test intra-veineux. L'effet durait 4 à 6 jours après l'exercice chez 7 des 9 malades étudiés. La concentration de l'insuline un joua après l'exercice restait bien dans la variation des valeurs des témoins non-obèses et sans exercice. On n'observe aucune diminution parallèle des triglycérides du plasma. En conclusion, un exercice intense, submaximal et prolongé provoque une réduction considérable du taux de l'insuline du plasma durant plusieurs jours chez les malades obèses hyperinsuliniques.

Insulinsekretion bei Übergewichtigen nach Arbeit

Zusammenfassung

Bei 9 übergewichtigen Patienten wurde vor und zweimal pro Tag nach einer untermaximalen, lang dauernden Arbeit der Blutzucker und das Plasmainsulin während einer Glucosebelastung gemessen. Alle Patienten hatten am Tage nach der Arbeitsbelastung einen geringeren Plasmainsulingehalt. Der verminderte Insulin/Glucose-Quotient deutet auf eine erhöhte Insulinempfindlichkeit hin. Dieser Effekt wurde sowohl mit dem oralen als auch mit dem intravenösen Glucosetoleranztest gefunden und hielt bei 7 von 9 Patienten 4–6 Tage nach der Arbeitsbelastung an. Die Insulinkonzentration am Tage nach der Arbeitsbelastung lag innerhalb der streuungsbreite von normgewichtigen, nicht arbeitenden Kontrollen. Die Plasmatriglizeride waren nicht vermindert. Daraus wurde geschlossen, daß eine akute, untermaximale, lang dauernde Arbeit eine über mehrere Tage beträchtliche Verminderung des Plasmainsulinspiegels bei hyperinsulinämischen, übergewichtigen Patienten bewirkt.

References

  1. 1.
    Kreisberg, R.A., Boshell, B.R., di Placido, J., Roddam, R.F.: Insulin secretion in obesity. New Engl. J. Med.276, 314–319 (1967).Google Scholar
  2. 2.
    Perley, M.J., Kipnis, D.M.: Plasma insulin responses to oral and intravenous glucose. Studies in normal and diabetic subjects. J. clin. Invest.46, 1954–1962 (1967).Google Scholar
  3. 3.
    Luft, R., Cerasi, E., Andersson, B.: Obesity as an additional factor in the pathogenesis of diabetes. Acta Endocr.59, 344–352 (1968).Google Scholar
  4. 4.
    Butterfieid, W.J.H., Hanley, T., Whichelow, M.J.: Peripheral metabolism of glucose and free fatty acids during oral glucose tolerance tests. Metabolism14, 851–866 (1965).Google Scholar
  5. 5.
    Rabinowitz, P., Zierler, K.L.: Forearm metabolism in obesity and its response to intra-arterial insulin. Characterization of insulin resistance and evidence for adaptive hyperinsulinism. J. clin. Invest.41, 2173–2181 (1962).Google Scholar
  6. 6.
    Björntorp, P.: Disturbances in the regulation of food intake. Obesity: Anatomic and physiologic-biochemical observations. Adv. Psychosom. Med., in print (1971).Google Scholar
  7. 7.
    Kuo, P.T.: Metabolic basis of human atherosclerosis. Metabolism18, 631–634 (1971).Google Scholar
  8. 8.
    Davidson, P.C., Shane, S.R., Albrink, M.J.: Decreased glucose tolerance following a physical conditioning program. Circulation33, III-7 (1966).Google Scholar
  9. 9.
    Björntorp, P., Berchtold, P., Grimby, G., Lindholm, B., Sanne, H., Tibblin, G., Wilhelmsen, L.: Effects of physical training on glucose tolerance, plasma insulin and lipids and on body composition in men after myocardial infarction. Submitted for publication (1971).Google Scholar
  10. 10.
    — de Jounge, K., Sjöström, L., Sullivan, L.: The effect of physical training on insulin production in obesity. Metabolism19, 631–638 (1970).Google Scholar
  11. 11.
    Hultman, E.: Studies on muscle metabolism of glycogen and active phosphate in man with special reference to exercise and diet. Scand. J. clin. Lab. Invest.19, suppl. 94 (1967).Google Scholar
  12. 12.
    Levin, K., Linde, S.: Determination of glucose in blood, cerebrospinal fluid and urine with a new glucose oxidase reagent. J. Swedish Med. Ass.59, 3016–3026 (1962).Google Scholar
  13. 13.
    Hales, C.N., Randle, P.J.: Immunoassay of insulin with insulin antibody precipitate. Lancet 1963II, 200.Google Scholar
  14. 14.
    Goldberg, L., Luft, R.: Comparison of oral and intravenous dextrose tolerance tests in healthy subjects. Acta med. scand.132, 201–222 (1948).Google Scholar
  15. 15.
    Carlson, L.A.: Determination of serum triglycerides. J. Atheroscl. Res.3, 334–336 (1963).Google Scholar
  16. 16.
    Cramér, K., Isaksson, B.: An evaluation of the Theorell method for the determination of total serum cholesterol. Scand. J. clin. Lab. Invest.11, 213–216 (1959).Google Scholar
  17. 17.
    Lawrence, R.D.: The effect of exercise on insulin action in diabetes. Brit. med. J. 1926I, 648–650.Google Scholar
  18. 18.
    Björntorp, P., Bengtsson, C., Blohmé, G., Jonsson, A., Sjöström, L., Tibblin, E., Tibblin, G., Wilhelmsen, L.: Adipose tissue fat cell size and number in relation to metabolism in randomly selected middle-aged men and women. Metabolism20, 927–935 (1971).Google Scholar
  19. 19.
    Carlson, L.A., Mossfeldt, F.: Acute effects of prolonged, heavy exercise on the concentration of plasma lipids and lipoproteins in man. Acta physiol. scand.62, 51–59 (1967).Google Scholar
  20. 20.
    Holloszy, J.O., Skinner, J.S., Toro, G., Cureton, T.K.: Effects of a six month program of endurance exercise on the serum lipids of middle aged men. Amer. J. Cardiol.14, 753–760 (1964).Google Scholar
  21. 21.
    Goldstein, M.S.: Humoral nature of hypoglycemia in muscular exercise. Amer. J. Physiol.200, 67–70 (1966).Google Scholar
  22. 22.
    Dulin, W.E., Clark, J.J.: Studies concerning a possible humoral factor produced by working muscles. Its influence on glucose utilization. Diabetes10, 289–297 (1961).Google Scholar
  23. 23.
    Grey, N.J., Goldring, S., Kipnis, D.M.: The effect of fasting, diet, and actinomycin D on insulin secretion in the rat. J. clin. Invest.49, 881–889 (1970).Google Scholar
  24. 24.
    Salans, L.B., Knittle, J.L., Hirsch, J.: The role of adipose cell size and adipose tissue insulin sensitivity in the carbohydrate intolerance of human obesity. J. clin. Invest.47, 153–164 (1968).Google Scholar
  25. 25.
    Arky, R.A., Freinkel, N.: Alcohol hypoglycaemia. V. Alcohol infusion to test gluconeogenesis in starvation, with special reference to obesity. New Engl. J. Med.274, 426–433 (1966).Google Scholar
  26. 26.
    Björntorp, P., Berchtold, P., Holm, J., Larsson, B.: The glucose uptake of human adipose tissue in obesity. Europ. J. clin. Invest.1, 480–485 (1971).Google Scholar
  27. 27.
    Carlson, L.A., Fröberg, S.: Effect of training with exercise on plasma and tissue lipid levels of aging rats. Gerontologia15, 14–23 (1969).Google Scholar
  28. 28.
    Lamb, D.R., Peter, J.B., Jeffress, R.N., Wallace, H.A.: Glycogen, hexokinase, and glycogen synthetase adaptions to exercise. Amer. J. Physiol.217, 1628–1632 (1969).Google Scholar

Copyright information

© Springer-Verlag 1972

Authors and Affiliations

  • M. Fahlén
    • 1
  • J. Stenberg
    • 1
  • P. Björntorp
    • 1
  1. 1.First Medical Service, Sahlgren's HospitalUniversity of GothenburgGothenburgSweden

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