In a clinical research center in an academic
medical center.Subjects:Twenty-seven obese [body mass index 37.2 ± 0.9
kg/m(2) (mean ± sem)] insulin-treated type 2 diabetes mellitus
patients.Intervention:Patients followed a 16-wk VLCD. Thirteen of them
simultaneously participated in an exercise
program (E) consisting of 1-h, in-hospital training and four 30-min
training sessions on a cycloergometer weekly.Outcome Measures:Insulin
resistance was measured by a hyperinsulinemic euglycemic clamp. Insulin
signaling, mitochondrial DNA (mtDNA) content, and intramyocellular lipid
content was measured in skeletal muscle biopsies.Results:Baseline
characteristics were identical in both groups, showed that Substantial weight loss occurred (-23.7 ± 1.7 kg VLCD-only vs. -27.2 ± 1.9 kg VLCD+E, P = NS within groups). The exercise
group lost more fat mass. Insulin-stimulated glucose disposal increased
similarly in both study groups [15.0 ± 0.9 to 39.2 ± 4.7 μmol/min(-1) ·
kg lean body mass (LBM(-1)) VLCD-only vs. 17.0 ± 1.0 to 37.5 ± 3.5
μmol/min(-1) · kg LBM(-1) in VLCD+E], as did phosphorylation of the
phosphatidylinositol 3-kinase-protein kinase B/AKT insulin signaling
pathway. In contrast, skeletal muscle mtDNA content increased only in
the VLCD+E group (1211 ± 185 to 2288 ± 358, arbitrary units, P = 0.016
vs. 1397 ± 240 to 1196 ± 179, P = NS, VLCD-only group). Maximum aerobic
capacity also only increased significantly in the VLCD+E group (+6.6 ±
1.7 ml/min(-1) · kg LBM(-1) vs. +0.7 ± 1.5 ml/min(-1) · kg LBM(-1)
VLCD-only, P = 0.017).Conclusion:Addition of exercise to a 16-wk VLCD induces more fat loss. Exercise augments maximum aerobic capacity and skeletal muscle mtDNA content(1).
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(1) "Effects of Adding Exercise to a 16-Week Very Low-Calorie Diet in Obese, Insulin-Dependent Type 2 Diabetes Mellitus Patients' by Snel M, Gastaldelli A, Ouwens DM, Hesselink MK, Schaart G, Buzzigoli E, Frölich M, Romijn JA, Pijl H, Meinders AE, Jazet IM.
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