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Strength Training Increases Insulin-Mediated Glucose Uptake, GLUT4 Content, and Insulin Signaling in Skeletal Muscle in Patients With Type 2 Diabetes
Open accessAbstract
Strength training represents an alternative to endurance training for patients with type 2 diabetes. Little is known about the effect on insulin action and key proteins in skeletal muscle, and the necessary volume of strength training is unknown. A total of 10 type 2 diabetic subjects and 7 healthy men (control subjects) strength-trained one leg three times per week for 6 weeks while the other leg remained untrained. Each session lasted no more than 30 min. After strength training, muscle biopsies were obtained, and an isoglycemic-hyperinsulinemic clamp combined with arterio-femoral venous catheterization of both legs was carried out. In general, qualitatively similar responses were obtained in both groups. During the clamp, leg blood flow was higher (P < 0.05) in trained versus untrained legs, but despite this, arterio-venous extraction glucose did not decrease in trained legs. Thus, leg glucose clearance was increased in trained legs (P < 0.05) and more than explained by increases in muscle mass. Strength training increased protein content of GLUT4, insulin receptor, protein kinase B-α/β, glycogen synthase (GS), and GS total activity. In conclusion, we found that strength training for 30 min three times per week increases insulin action in skeletal muscle in both groups. The adaptation is attributable to local contraction-mediated mechanisms involving key proteins in the insulin signaling cascade.
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“Training can enhance the responsiveness of skeletal muscles to insulin with increased expression and/or activity of proteins involved in glucose metabolism and insulin signaling ( 39 , 110 , 204 , 270 ).”
From Exercise and Type 2 Diabetes (2010) · cites this paper as [110]
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“5 s−1 Estimated b Basal level of blood insulin 4 pM s−1 [29] e Maximum rate of insulin production 36 pM s−1 [37] k3 Half-saturation constant of insulin production 30 pM Estimated s Maximum negative feedback of intracellular 30 mM Estimated glucose on insulin”
BackgroundRun for your life: can exercise be used to effectively target GLUT4 in diabetic cardiac disease?
Bowman, P. R. T., Smith, G. L., & Gould, G. W. (2021) · PeerJ · doi:10.7717/peerj.11485 · Cited by 8
“Separately, multiple studies have demonstrated the capacity of exercise interventions (of varying design and duration) to induce increases in skeletal muscle and adipose tissue GLUT4 protein expression in human diabetics, alongside improved glycaemic control (Dela et al., 1994; Holten et al., 2004; O’Gorman et al., 20…”
BackgroundMatsuda, T., Takahashi, H., Nakamura, M., Ogata, H., Kanno, M., Ishikawa, A., & Sakamaki‐Sunaga, M. (2022) · The Journal of Strength and Conditioning Research · doi:10.1519/jsc.0000000000004306 · Cited by 7
Bernat-Karpińska, M., Piątkiewicz, P., Czech, A., & Wierzbicki, P. (2012) · PubMed · Cited by 5
Impact of high-intensity interval training on HbA1c in patients with type 2 diabetes mellitus
Elsisi, H. F. E. M., Aneisb, Y. M., & Mounirc, K. M. (2015) · Bulletin of Faculty of Physical Therapy · doi:10.4103/1110-6611.174710 · Cited by 8
Yousefi, M.-R., & TaheriChadorneshin, H. (2017) · Interventional Medicine and Applied Science · doi:10.1556/1646.9.2017.34 · Cited by 7
Lee, S., Kim, K.-J., Lambrecht, N., Hong, J., Liao, Y., Yoon, A., & Bernard, J. R. (2016) · Acupuncture in Medicine · doi:10.1136/acupmed-2015-011028 · Cited by 7
Młynarska, E., Leszto, K., Katańska, K., Prusak, A., Wieczorek, A., Jakubowska, P., Rysz, J., & Franczyk, B. (2025) · Nutrients · doi:10.3390/nu17172860 · Cited by 10
The effects of 4 weeks normobaric hypoxia training on microvascular responses in the forearm flexor
Fryer, S. M., Stone, K. J., Dickson, T., Wilhelmsen, A., Cowen, D., Faulkner, J., Lambrick, D., & Stoner, L. R. (2018) · Journal of Sports Sciences · doi:10.1080/02640414.2018.1554177 · Cited by 6
“Whilst we did not measure the metabolic response, an increase in mBF has previously been attributed to an increase in glucose disposal in patients with type II diabetes (Baron, Laakso, Brechtel, & Edelman, 1991; Clark et al., 2003; Holten et al., 2004).”
BackgroundEffect of Exercise on Glucose Metabolism
Kim, S. H. (2011) · Journal of Korean Diabetes · doi:10.4093/jkd.2011.12.1.21 · Cited by 6
Kim, Y. Y., 최순미, Lee, M.-G., & 임수 (2012) · Korean Journal of Sport Science · doi:10.24985/kjss.2012.23.3.489 · Cited by 5
Lee, M., Jung, C.-S., Yoon, J.-H., & Lee, N. (2018) · Technology and Health Care · doi:10.3233/thc-181183 · Cited by 6
“Although this study did not measure body weight and muscle mass of the diabetic model through resistance exercise, previous studies [37,38] reported that resistance exercise promoted glucose metabolism and promoted insulin sensitivity and resistance through promotion of fat oxidation and muscle…”
Wu, C., Kao, T., Yang, H., Sun, Y., Chen, Y.-J., Wang, C., Lai, C., & Chen, W. (2018) · Obesity Research & Clinical Practice · doi:10.1016/j.orcp.2018.07.006 · Cited by 6
Physical Exercise in Chronic Diseases
Pedersen, B. K. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-810422-4.00014-2 · Cited by 7
Westcott, W. L. (2015) · ACSMʼs Health & Fitness Journal · doi:10.1249/fit.0000000000000134 · Cited by 6
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Blumenthal, R. S., Philippides, G. J., Rocchini, A. P., Hordern, M., Miller, T. D., & Chyun, D. A. (2010) · Cited by 6
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Rethinking insulin resistance in aging: A reserve-oriented clinical framework
Boccardi, V., & Sinclair, A. J. (2026) · Ageing Research Reviews · doi:10.1016/j.arr.2026.103180 · Cited by 7
Metadata
- Authors
- Holten, M. K., Zacho, M., Gaster, M., Juel, C., Wojtaszewski, J. F. P., & Dela, F.
- Affiliations
- University of Copenhagen (DK)
- Rigshospitalet (DK)
- Odense University Hospital (DK)
- Venue
- Diabetes
- Publisher
- American Diabetes Association
- Published
- 2004-02-01
- Volume
- 53
- Issue
- 2
- Pages
- 294-305
- ISSN
- 0012-1797 (ISSN-L)
- 1939-327X
- OpenAlex
- W2153401503
- Cited by
- 615
- References
- 48
- Citations by year
- 2026: 36 · 2025: 24 · 2024: 18 · 2023: 20 · 2022: 32 · 2021: 38 · 2020: 30 · 2019: 22 · 2018: 35 · 2017: 29 · 2016: 25 · 2015: 32 · 2014: 25 · 2013: 37 · 2012: 39
- FWCI
- 7.70
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
- Funders
- Sundhed og Sygdom, Det Frie Forskningsråd
- University of Cambridge
- National Research Foundation
- Danmarks Grundforskningsfond (504–14)
- Diabetesforeningen
- Medical Research Council
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Keywords
- resistance training, type 2 diabetes, insulin action, skeletal muscle, GLUT4, insulin signaling, glycogen synthase, Akt, insulin receptor, glucose uptake, glucose clearance, muscle blood flow, training volume
- MeSH terms
- Biological Transport, Capillaries, Denmark, Diabetes Mellitus, Type 2, Glucose, Glycogen, Humans, Insulin, Leg, Male, Monosaccharide Transport Proteins, Muscle Proteins, Physical Fitness, Reference Values, Tensile Strength, Exercise, Muscle, Skeletal, Muscle Fibers, Skeletal, White People, Glucose Transporter Type 4
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