Sports Medicine

, Volume 47, Issue 3, pp 415–428 | Cite as

Impact of Endurance Exercise Training in the Fasted State on Muscle Biochemistry and Metabolism in Healthy Subjects: Can These Effects be of Particular Clinical Benefit to Type 2 Diabetes Mellitus and Insulin-Resistant Patients?

  • Dominique HansenEmail author
  • Dorien De Strijcker
  • Patrick Calders
Review Article


Exercise training intervention is a cornerstone in the care of type 2 diabetes mellitus (T2DM) and insulin resistance (IR), and it is pursued in order to optimize exercise interventions for these patients. In this regard, the nutritional state of patients during exercise (being in the fed or fasted state) can be of particular interest. The aim of the present review is to describe the impact of endurance exercise (training) in the fasted versus fed state on parameters of muscle biochemistry and metabolism linked to glycemic control or insulin sensitivity in healthy subjects. From these data it can then be deduced whether exercise training in the fasted state may be relevant to patients with T2DM or IR. In healthy subjects, acute endurance exercise in the fasted state is accompanied by lower blood insulin and elevated blood free fatty acid concentrations, stable blood glucose concentrations (in the first 60–90 min), superior intramyocellular triacylglycerol oxidation and whole-body lipolysis, and muscle glycogen preservation. Long-term exercise training in the fasted state in healthy subjects is associated with greater improvements in insulin sensitivity, basal muscle fat uptake capacity, and oxidation. Therefore, promising results of exercise (training) in the fasted state have been found in healthy subjects on parameters of muscle biochemistry and metabolism linked to insulin sensitivity and glycemic control. Whether exercise training intervention in which exercise sessions are organized in the fasted state may be more effective in improving insulin sensitivity or glycemic control in T2DM patients and insulin-resistant individuals warrants investigation.


Glycemic Control Exercise Training Fast State Endurance Exercise Muscle Glycogen 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Compliance with Ethical Standards


No sources of funding were used to assist in the preparation of this article.

Conflict of interest

Dominique Hansen, Dorien De Strijcker, and Patrick Calders declare that they have no conflicts of interest relevant to the content of this review.


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Dominique Hansen
    • 1
    • 2
    Email author
  • Dorien De Strijcker
    • 3
  • Patrick Calders
    • 3
  1. 1.Faculty of Medicine and Life Sciences, Rehabilitation Research CenterHasselt University, REVALDiepenbeekBelgium
  2. 2.Heart Centre HasseltJessa HospitalHasseltBelgium
  3. 3.Department of Rehabilitation Sciences and PhysiotherapyGhent UniversityGhentBelgium

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