비만을 동반한 제 2형 당뇨병환자의 혈당 조절을 위한 운동 중재 : 체계적 문헌고찰 = Exercise Intervention on Blood Glucose Control of Type 2 Diabetes with Obesity : A Systematic Review

다국어 초록 (Multilingual Abstract)

PURPOSE: The aim of this study was to review the effects of exercise intervention on blood glucose control in obese type 2 diabetic patients.
METHODS: The PubMed and KERISS search engines were used and 61 papers that met the key questions were selected.
RESULTS: Exercise is an effective intervention for the control of blood glucose in type 2 diabetic patients because it does not impair glucose transport in the skeletal muscle induced by muscle contractions. Insulin resistance, which is characteristic of type 2 diabetes, is caused by decreased insulin sensitivity or insulin responsiveness. Acute exercise improves the glucose metabolism by increasing the insulin-independent signaling pathways and insulin sensitivity in the skeletal muscle, and regular long-term exercise improves the skeletal muscle insulin responsiveness and systemic glucose metabolism by increasing the mitochondrial and GLUT4 protein expression in the skeletal muscle.
CONCLUSION: The improvement of the glucose metabolism through exercise shows a dose-response pattern, and if exercise consumes the same number of calories, high intensity exercise will be more effective for the glucose metabolism. On the other hand, it is practically difficult for a patient with obese type 2 diabetes to control their blood glucose with high intensity or long-term exercise. Therefore, it will be necessary to study safe adjuvants (cinnamic acid, lithium) that can produce similar effects to high-intensity and high-volume exercises in low-intensity and low-volume exercises.

참고문헌 (Reference)

1 임창훈, "복합운동프로그램이 여성노인의 체력과 항노화 호르몬에 미치는 영향" 대한물리의학회 10 (10): 53-61, 2015

2 주민, "대학생의 4주간 줄넘기 운동 후 신체조성 비교" 대한물리의학회 8 (8): 627-635, 2013

3 Ryder JW, "Use of a novel impermeable biotinylatedphotolabeling reagent to assess insulinand hypoxia-stimulated cell surface GLUT4 content in skeletal muscle from type 2 diabetic patients" 49 (49): 647-654, 2000

4 Becker-Zimmermann K, "Treadmill training improves intravenous glucose tolerance and insulin sensitivity in fatty Zucker rats" 22 (22): 468-474, 1982

5 Brozinick JT Jr, "The effects of muscle contraction and insulin on glucosetransporter translocation in rat skeletal muscle" 297 : 539-545, 1994

6 옥해안, "The Effects of Aquatic Group Exercise on Body Composition and Mental Health of Elderly Women" 대한물리의학회 12 (12): 103-112, 2017

7 김완수, "The Characteristics of Risk Factors in Korean CAD Patients Comparing to American Counterpart and Its Implications to Prevention of CAD" 대한물리의학회 12 (12): 9-20, 2017

8 Vendelbo MH, "Sustained AS160 and TBC1D1 phosphorylations in human skeletal muscle 30 min after a single bout of exercise" 117 (117): 289-296, 2014

9 Klip A, "Recruitment of GLUT-4 glucose transporters by insulin in diabetic rat skeletal muscle" 172 (172): 728-736, 1990

10 Sylow L, "Rac1-a novel regulator of contraction-stimulated glucose uptake in skeletal muscle" 99 (99): 1574-1580, 2014

11 Arias EB, "Prior exercise increases phosphorylation of Akt substrate of 160 kDa (AS160) in rat skeletal muscle" 292 : E1191-E200, 2007

12 Cartee GD, "Persistent effects of exercise on skeletal muscle glucose transport across the life-span of rats" 75 : 972-978, 1993

13 Ivy JL, "Muscle insulin resistance amended with exercise training: role of GLUT4 expression" 36 (36): 1207-1211, 2004

14 Bergstrom J, "Muscle glycogen synthesis after exercise: an enhancing factor localized to the muscle cellsin man" 10 : 309-310, 1966

15 Furnsinn C, "More marked stimulation by lithium than insulin of the glycogenic pathway in rat skeletal muscle" 273 (273): E514-E520, 1997

16 Edgett BA, "Mammalian target of rapamycin pathway is up-regulated by both acute endurance exercise and chronic muscle contraction in rat skeletal muscle" 38 (38): 862-869, 2013

17 Tabata I, "Lithium increases susceptibility of muscle glucose transport to stimulation by various agents" 43 (43): 903-907, 1994

18 Zhao R, "LBP-4a improves insulin resistance via translocation and activation of GLUT4 in OLETF rats" 5 (5): 811-820, 2014

19 Prabhakar PK, "Interaction of cinnamic acid derivatives with commercial hypoglycemic drugs on2-deoxyglucose uptake in 3T3-L1 adipocytes" 59 : 9835-9844, 2011

20 Wojtaszewski JF, "Insulin signaling and insulin sensitivity after exercise in human skeletal muscle" 49 (49): 325-331, 2000

21 Cortez MY, "Insulin resistance of obese Zucker rats exercise trained at two different intensities" 261 (261): E613-E619, 1991

22 Goodyear LJ, "Insulin receptor phosphorylation, insulin receptor substrate-1 phosphorylation, and phosphatidylinositol 3-kinase activity are decreased in intact skeletal muscle strips from obese subjects" 95 (95): 2195-2204, 1995

23 Consitt LA, "Impairments in site-specific AS160 phosphorylation and effects of exercise training" 62 (62): 3437-3447, 2013

24 Nitert MD, "Impact of an exercise intervention on DNA methylation in skeletal muscle from first-degree relatives of patients with type 2 diabetes" 61 (61): 3322-3332, 2012

25 Alam MA, "Hydroxycinnamic acid derivatives: A potential class of natural compounds for the management of lipidmetabolism and obesity" 13 : 27-, 2016

26 McGarry JD, "Glucose-fatty acid interactions in health and disease" 67 (67): 500S-504S, 1998

27 Wallberg-Henriksson H, "Glucose transport into rat skeletal muscle: interaction between exercise and insulin" 65 (65): 909-913, 1988

28 Etgen GJ Jr, "Glucose transport and cell surface GLUT-4 protein in skeletal muscle of the obese Zucker rat" 271 (271): E294-E301, 1996

29 Michelle Furtado L, "GLUT4 activation: thoughts on possible mechanisms" 178 : 287-296, 2003

30 Goodyear LJ, "Exercise-induced translocation of skeletal muscle glucose transporters" 261 (261): E795-E799, 1991

31 Combes A, "Exercise-induced metabolic fluctuations influence AMPK, p38-MAPK and CaMKII phosphorylation in human skeletal muscle" 3 (3): e12462-, 2015

32 King PA, "Exercise, unlike insulin, promotes glucose transporter translocation in obese Zucker rat muscle" 265 (265): R447-R452, 1993

33 Goodyear LJ, "Exercise, glucose transport, and insulin sensitivity" 49 : 235-261, 1998

34 Hayashi T, "Exercise regulation of glucose transport in skeletal muscle" 273 (273): E1039-E1051, 1997

35 Douen AG, "Exercise induces recruitment of the "insulin-responsive glucose transporter". Evidence for distinct intracellular insulin-and exercise-recruitabletransporter pools in skeletal muscle" 265 (265): 13427-13430, 1990

36 Roden M, "Exercise in type 2 diabetes: to resist or to endure" 55 (55): 1235-1239, 2012

37 Stanford KI, "Exercise and type 2 diabetes: molecular mechanisms regulating glucose uptake in skeletal muscle" 38 (38): 308-314, 2014

38 Colberg SR, "Exercise and type 2 diabetes: american college of sports medicine and the american diabetes association: joint position statement. Exercise and type 2 diabetes" 42 (42): 2282-2303, 2010

39 Harrell NB, "Essential role of p38 MAPK for activation of skeletal muscle glucose transport by lithium" 113 (113): 221-227, 2007

40 Mascher H, "Enhanced rates of muscle protein synthesis and elevated mTOR signalling following endurance exercise in human subjects" 202 (202): 175-184, 2011

41 Calegari VC, "Endurance training activates AMP-activated protein kinase, increases expression of uncoupling protein 2 and reduces insulin secretion from rat pancreatic islets" 208 (208): 257-264, 2011

42 Rohling M, "Effects of long-term exercise interventions on glycaemic control in type 1 and type 2 diabetes: a systematic review" 124 (124): 487-494, 2016

43 Sriwijitkamol A, "Effect of acute exercise on AMPK signaling in skeletal muscle of subjects with type 2 diabetes: a time-course and dose-response study" 56 (56): 836-848, 2007

44 Jung SR, "Effect of Lithium on Mechanism of Glucose Transport in Skeletal Muscles" 63 : 365-371, 2017

45 Camera DM, "Early time course of Akt phosphorylation after endurance and resistance exercise" 42 (42): 1843-1852, 2010

46 Vissing K, "Differentiated mTOR but not AMPK signaling after strength vs endurance exercise in training-accustomed individuals" 23 (23): 355-366, 2013

47 Kemp BE, "Dealing with energy demand: the AMP-activated protein kinase" 24 (24): 22-25, 1999

48 Stuart CA, "Cycle training increased GLUT4 and activation of mammalian target of rapamycin in fast twitch muscle fibers" 42 (42): 96-106, 2010

49 Maarbjerg SJ, "Current understanding of increased insulin sensitivity after exerciseemerging candidates" 202 (202): 323-335, 2011

50 Sharoff CG, "Combining short-term metformin treatment and one bout of exercise does not increase insulin action in insulinresistant individuals" 298 : E815-E823, 2010

51 Luo L, "Chronic resistance training activates autophagy and reduces apoptosis of muscle cells by modulating IGF-1 and its receptors, Akt/mTOR and Akt/FOXO3a signaling in aged rats" 48 (48): 427-436, 2013

52 Katta A, "Altered regulation of contraction-induced Akt/mTOR/p70S6k pathway signaling in skeletal muscle of the obese Zucker rat" 384683-, 2009

53 Pugh JK, "Acute molecular responses to concurrent resistance and high-intensity interval exercise in untrained skeletal muscle" 3 (3): e12364-, 2015

54 Kleinert M, "Acute mTOR inhibition induces insulin resistance and alters substrate utilization in vivo" 3 (3): 630-641, 2014

55 Kennedy JW, "Acute exercise induces GLUT4 translocation in skeletal muscle of normal human subjects and subjects with type 2 diabetes" 48 (48): 1192-1197, 1999

56 Haugaard ES, "Actions of lithium ions and insulin on glucose utilization, glycogen synthesis and glycogen synthase in the isolated rat diaphragm" 23 (23): 1675-1685, 1974

57 Thomson DM, "AMPK activation attenuates S6K1, 4E-BP1, and eEF2 signaling responses to high-frequency electrically stimulated skeletal muscle contractions" 104 (104): 625-632, 2008

58 Witczak CA, "AMP-activated protein kinase in skeletal muscle: from structure and localization to its role as a master regulator of cellular metabolism" 65 (65): 3737-3755, 2008

59 Merrill GF, "AICA riboside increases AMP-activated protein kinase, fatty acid oxidation, and glucose uptake in rat muscle" 273 (273): E1107-E1112, 1997

60 Stein SA, "A review of the efficacy and safety of oral antidiabetic drugs" 12 : 153-175, 2013

61 김완수, "40대 남성에서 비만, 혈압, 생활양식이 지질지표 및 혈압에 미치는 영향" 대한물리의학회 8 (8): 239-243, 2013

62 김현애, "20대 남성 비만인의 자세에 따른 가슴우리 확장과 폐기능 특성분석" 대한물리의학회 6 (6): 247-256, 2011