Exercise intensity and insulin sensitivity: how low can you go?

Excerpt

Readers of Diabetologia will be aware that the prevalence of diabetes mellitus has reached global epidemic proportions and now exerts major health consequences at both individual and public health levels [1, 2]. The majority of diabetic patients (over 90%) suffer from type 2 diabetes, a progressive metabolic disorder with a slow and insidious onset. While the true incidence of type 2 diabetes is likely to be under-reported, it has been estimated that by the year 2025, approximately 300 million people worldwide will be afflicted with this condition [3]. The proliferation of the rate of diagnosis of type 2 diabetes (and associated conditions) stems from the readiness of industrialised and developing nations alike to adopt a sedentary lifestyle in the face of excess energy intake [4‐7]. While more than a half century of evidence from epidemiological, experimental and clinical trials pinpoints a positive correlation between dietary intake and disease risk, it has only recently been recognised that a physically inactive lifestyle rapidly initiates maladaptations that cause chronic disease [8‐10]. Indeed, low cardiorespiratory fitness is a powerful and independent predictor of mortality in people with diabetes [11, 12], even after controlling for traditional risk factors such as age, hyperlipidaemia, smoking and hypertension. …