Exercise Boosts Fat and Protein Metabolism in Diabetic Patients

Exercise Boosts Fat and Protein Metabolism in Diabetic Patients

In the body, glucose, fat, and protein serve as major energy sources, and they can be converted or interchanged as needed. However, in diabetes, where insulin function is impaired and mitochondrial function in skeletal muscle cells is compromised, disorders in lipid and protein metabolism accompany glucose metabolism issues.

Lipid metabolism disorders in insulin resistance often stem from various metabolic dysfunctions. When triglyceride metabolism defects occur in adipose tissue, it leads to an accumulation of free fatty acids in the liver, triggering the overproduction of large, very low-density lipoprotein particles and causing high blood pressure and hypertriglyceridemia.

Insulin plays a crucial role in stimulating cell protein synthesis and inhibiting protein breakdown. In diabetes, insufficient insulin or reduced effectiveness results in weakened protein synthesis, increased protein breakdown, and a negative nitrogen balance. This imbalance primarily affects skeletal muscle and liver, leading to muscle atrophy and decreased plasma protein synthesis.

Exercise not only improves glucose metabolism in diabetes but also addresses lipid and protein metabolism issues. During exercise, skeletal muscles utilize oxidized free fatty acids for energy at rest and rely on a combination of glucose, muscle glycogen, and free fatty acids during activity. As exercise progresses, muscles tap into glucose from liver glycogen breakdown and gluconeogenesis. Enhanced fat mobilization from adipose tissue during exercise increases blood free fatty acid levels, which are then taken up and oxidatively metabolized by muscles and the liver. Triglycerides stored in skeletal muscles also serve as important energy sources during exercise.

Studies indicate that moderate-intensity exercise can significantly increase fat oxidation, reducing lipid accumulation in adipose and muscle cells and ultimately enhancing skeletal muscle insulin sensitivity. Exercise can reverse the negative nitrogen balance in diabetes, increase skeletal muscle mass, and improve insulin resistance associated with aging. The underlying mechanisms likely involve improved endothelial function, insulin-mediated vasodilation, and nutrient delivery to muscles.

In summary, exercise plays a vital role in improving not only glucose metabolism but also lipid and protein metabolism in diabetes, offering holistic benefits for overall health and insulin sensitivity.

References

1.Chinese Guidelines of Exercise Therapy in Diabetes Mellitus

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