Search

Upon intramuscular entry, fatty acids are converted to amphiphatic fatty acyl‐CoAs by action of the acyl‐CoA synthetase (ACS) enzymes. While it has been reported that insulin resistant skeletal muscle shows an accumulation of fatty acyl‐CoAs, the role of the enzymes which catalyze their synthesis is still sparsely studied in human muscle, in particular the influence of obesity, and insulin resistance. We analyzed muscle biopsies obtained from normal weight controls (n = 7, average BMI 24), males/females with obesity (n = 7, average BMI 31), and males/females with obesity and type 2 diabetes (T2D) (n = 7, average BMI 34), for relevant ACS (long‐chain acyl‐CoA synthetase 1 (ACSL1), −3 (ACSL3) and − 4 (ACSL4), fatty acid transport protein 1 (FATP1) and − 4 (FATP4)). The mRNA expression was determined by real‐time PCR, and total oleoyl‐CoA synthetase activity was measured. In the males/females with obesity and T2D, the response to 16 weeks of exercise training with minor weight loss was evaluated. ACSL1 is the dominantly expressed ACS isoform in human skeletal muscle. The content of total ACS mRNA, as well as ACSL1 mRNA, were lower in muscle of males/females with obesity and T2D. Exercise training in the males/females with obesity and T2D increased the total ACS enzyme activity, along with a lowering of the HOMA‐IR index. The capacity for synthesis of fatty acyl‐CoAs is lower in skeletal muscle of obese males/females with T2D. This suggests a decreased ability to convert fatty acids to fatty acyl‐CoAs, which in turn may affect their entry into storage or metabolic pathways in muscle. Thus, the accumulation of fatty acyl‐CoAs in the obese or insulin resistant state that has been shown in previous reports is not likely to result from increased fatty acid acylation. The upregulation of ACS activity by exercise training appears beneficial and occurred concomitantly with increased insulin sensitivity. [ABSTRACT FROM AUTHOR]

In patients with type 2 diabetes, both supervised exercise and treatment with the glucagon-like peptide-1 ( GLP-1) receptor agonist ( GLP-1RA) liraglutide may improve cardiac function. We evaluated cardiac function before and after 16 weeks of treatment with the GLP-1RA liraglutide or placebo, combined with supervised exercise, in 33 dysregulated patients with type 2 diabetes on diet and/or metformin. Early diastolic myocardial tissue velocity was improved by exercise in the placebo group (mean ± standard deviation [s.d.] −7.1 ± 1.6 to −7.7 ± 1.8 cm/s, P = .01), but not in the liraglutide group (−7.1 ± 1.4 to −7.0 ± 1.4 cm/s, P = .60; between groups, P = .02). Similarly, the mean ± s.d. ratio of early and atrial mitral annular tissue velocities improved in the placebo group (1.0 ± 0.4 to 1.2 ± 0.4, P = .003), but not in the liraglutide group (1.0 ± 0.3 to 1.0 ± 0.3, P = .87; between groups, P = .03). We found no significant differences in heart rate, left ventricular ( LV) structure or function within or between the groups. In conclusion, the addition of liraglutide to exercise in sedentary patients with dysregulated type 2 diabetes may blunt the suggested beneficial effect of exercise on LV diastolic function. [ABSTRACT FROM AUTHOR]

Introduction. Physical training is considered an effective means of preventing and treating diseases of affluence such as T2DM. The key benefits of this therapy include improvements in physical performance and in metabolic processes. Aim of Study. The aim of this study was to investigate the impact of a 12-week long supervised combined strength and endurance training program on physical performance of T2DM patients with various complications. Material and Methods. The study was carried out on patients stratified into Groups (levels) 2 and 3 according to the criteria from the 2007 Danish program "Forløbsprogram for Type 2 Diabetes" (see Table 1). A total of 83 patients (29 women, 54 men) participated in the study, aged 65.5 ± 10.62 years. The subjects were offered 60 minutes of supervised group exercise, twice a week for 12 weeks. Each session consisted of a 5-min warm-up, 35-min strength exercise, and 10-min aerobic bicycling, with a load between 12 and 15 on the Borg Scale. Physical performance was measured using a 30-second sit-to-stand test (STS) and 6-minute-walk test (6MWT). Results. A significant improvement in STS was noted in Group 2 (mean = 1.6 ± 2.39; 95% CI 0.92-2.3) and in Group 3 (mean = 1.46 ± 2.14; 95% CI 0.74-2.17). Statistically significant (p <0.0001) 6MWT results were obtained in Group 2 (mean = 46.7 ± 54.08; (95% CI 30-63) and in Group 3 (mean = 46.2 ± 79.51; 95% CI 12-79). Participation in training sessions played a paramount role in improving the effectiveness of combined strength and endurance training. Conclusion. Participation in a 12-week exercise program increased physical performance in patients with type 2 diabetes, regardless of their complication status. [ABSTRACT FROM AUTHOR]