Impact of Metformin on Exercise-Induced Metabolic Adaptations to Lower Type 2 Diabetes Risk

Malin, Steven K.; Braun, Barry

doi:10.1249/jes.0000000000000070

Cited by 56Metabolism, Diabetes, and CancerPhysical Activity and HealthExercise and Physiological Responses

Impact of Metformin on Exercise-Induced Metabolic Adaptations to Lower Type 2 Diabetes Risk

Malin, Steven K., Braun, Barry·2016·Exercise and Sport Sciences Reviews

DOI 10.1249/jes.0000000000000070

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Abstract

In Brief Combining metformin with exercise has been proposed to improve glucose homeostasis. However, we primarily discuss evidence suggesting that metformin and other pharmacological agents/dietary supplements (e.g., statins, resveratol, or antioxidants) may in fact oppose exercise-induced benefits on insulin sensitivity and cardiometabolic health. We explore the novel hypothesis that attenuation of oxidative stress from exercise by these exogenous compounds blunts metabolic adaptation. Combining metformin (as well as statins and antioxidants) with exercise may not add and even attenuate exercise-induced adaptations for glucose homeostasis.

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The data suggest that exercise, and not metformin, is the "ideal drug".
“The data suggest that exercise, and not metformin, is the “ideal drug” (201).”
From A Critical Review of the Evidence That Metformin Is a Putative Anti-Aging Drug That Enhances Healthspan and Extends Lifespan (2021) · cites this paper as [201]
Metformin blunted the exercise-induced increase in VO2peak.
“In addition, metformin blunted the exercise-induced increase in VO2peak (201).”
From A Critical Review of the Evidence That Metformin Is a Putative Anti-Aging Drug That Enhances Healthspan and Extends Lifespan (2021) · cites this paper as [201]
In that study, metformin improved skeletal muscle insulin sensitivity by 55% and exercise by 90%.
“The results indicated that although both metformin and exercise improved skeletal muscle insulin sensitivity by 55 and 90% respectively the combination resulted in only a 30% enhancement.”
From A Critical Review of the Evidence That Metformin Is a Putative Anti-Aging Drug That Enhances Healthspan and Extends Lifespan (2021) · cites this paper as [201]
In that study, systolic BP and CRP were reduced by 7 to 8% versus 20-25% respectively.
“The results were similar for effects on systolic BP and C-Reactive Protein (CRP) that were reduced by 7 to 8% versus 20-25% respectively (201).”
From A Critical Review of the Evidence That Metformin Is a Putative Anti-Aging Drug That Enhances Healthspan and Extends Lifespan (2021) · cites this paper as [201]
In that study, the combination of metformin and exercise resulted in only a 30% enhancement of skeletal muscle insulin sensitivity.
“The results indicated that although both metformin and exercise improved skeletal muscle insulin sensitivity by 55 and 90% respectively the combination resulted in only a 30% enhancement.”
From A Critical Review of the Evidence That Metformin Is a Putative Anti-Aging Drug That Enhances Healthspan and Extends Lifespan (2021) · cites this paper as [201]

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“Despite randomized clinical trials showing the efficacy of exercise and diet therapy to prevent the progression from prediabetes to type 2 diabetes (13,30), long-term adherence to exercise remains low and individuals often require pharmacological therapy to maintain normoglycemia.”
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Authors: Malin, S. K., & Braun, B.
Affiliations: University of Virginia (US)
Colorado State University (US)
Corresponding author: Malin, Steven K.
ORCID: Malin, Steven K.
Braun, Barry
Venue: Exercise and Sport Sciences Reviews
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2016-01
Volume: 44
Issue: 1
Pages: 4-11
ISSN: 0091-6331 (ISSN-L)
DOI: 10.1249/jes.0000000000000070
OpenAlex: W2404424654
Cited by: 56
References: 32
Citations by year: 2026: 4 · 2025: 3 · 2024: 3 · 2023: 3 · 2022: 7 · 2021: 5 · 2020: 12 · 2019: 3 · 2018: 4 · 2017: 5 · 2016: 6 · 2015: 1
FWCI: 0.52
Type: journal article
Language: en
Open access: closed
Locations: Exercise and Sport Sciences Reviews (publishedVersion)
PubMed (publishedVersion)
Topics: Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
Health Sciences › Medicine › Physiology › Physical Activity and Health
Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
Keywords: metformin, physical activity, type 2 diabetes risk, insulin sensitivity, glucose homeostasis, oxidative stress, statins, antioxidants, cardiometabolic health, metabolic adaptation
MeSH terms: Blood Glucose, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Exercise Therapy, Humans, Hypoglycemic Agents, Insulin Resistance, Metformin, Physical Fitness, Risk Factors, Oxidative Stress

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Impact of Metformin on Exercise-Induced Metabolic Adaptations to Lower Type 2 Diabetes Risk

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