Emerging Diabetes Research Being Conducted on the Eastern Shore
It is well-established that there are a myriad of benefits of regular physical activity for those with Type 2 Diabetes, including improved blood glucose regulation (reduced HbA1C)1, increased whole-body insulin sensitivity 2, and the delay or prevention of developing cardiovascular disease 3,4. Because of these benefits, in a Joint Position Statement, the American College of Sports Medicine and the American Diabetes Association recommended that Type 2 Diabetics engage in at least 150 minutes of moderate to vigorous dynamic exercise per week, spread out over 3 to 5 days 5. For individuals starting an exercise program, choosing types of physical activity that are personally enjoyable will help them stick with their program, allowing them to experience these benefits of exercise.
In addition to benefits of regular exercise, we have learned that during recovery from even a single session of aerobic exercise, humans can experience increased insulin sensitivity, although this response varies widely, depending on the exercise duration and intensity 6. During this postexercise period, humans also experience a sustained rise in blood flow to previously active skeletal muscles 7. We have recently learned that this increased blood flow is mediated by 2 receptors that can be blocked by common over-the-counter medications 8. The findings that both skeletal muscle blood flow and insulin action are increased following a bout of dynamic exercise got us thinking about how the 2 things might be related. Does the increased blood flow aide in delivery of glucose to the muscle cells? If so, is less insulin needed to escort the glucose into those cells?
We addressed those questions in a pair of research studies and found that in healthy individuals, elevated postexercise skeletal muscle blood flow was a key factor in both normal glucose delivery 9 and insulin sensitivity 10 following dynamic exercise. If postexercise blood flow plays a key role in glucose regulation in healthy individuals the potential clinical implications of the relationship between blood flow and glucose regulation following exercise in those with Type 2 Diabetes, who have impaired glucose delivery and insulin sensitivity, is substantial.
Currently, in our research laboratory at Salisbury University, we are conducting the first in a series of experiments examining postexercise blood flow and blood pressure in Type 2 Diabetics, as well as the role postexercise hemodynamics play in glucose regulation for this clinical population. We are seeking subjects to participate in this research study. Research subjects receive a free, medically supervised graded exercise test and explanation of the results, in addition to being compensated (in cash) for their time. If you or anyone you know meets the following inclusion criteria and is interested in participating in this study, please contact me at
Subject inclusion criteria:
- You must be 20 to 60 years of age
- You must have been diagnosed with Type 2 Diabetes Mellitus between 6 months and 15 years from the start of the study.
- You must have reasonably well-controlled blood glucose levels (HbA1c ≤ 9%)
- You must be non-insulin-dependent
- You must be free of co-morbidities, including but not limited to coronary artery disease, pulmonary disease, cancer, and hypertension (blood pressure ≥ 140/90) * requiring medication (*Please see exceptions in #10).
- You must have a body mass index (BMI) < 35 kg/m2 (Below the level of morbid obesity)
- You must be a non-smoker and may not be using any illegal/recreational drugs
- You must be free of diabetic complications, including retinopathy, nephropathy, and autonomic and peripheral neuropathy
- You must not be pregnant or breast feeding
- You must be taking no more than 3 diabetic medications. In addition, you must be taking no other medications, other than oral contraceptives, aspirin, dyslipidemia medications (e.g., statins), ACE Inhibitors/Angiotensin II Receptor Antagonists (for renal protection etc.), and bone health supplements (e.g., calcium).
If you have any questions about participating in this research study, please let me know.
Thank you and be well.
Tri-County Diabetes Alliance – Featured Article, October 2013
Tom Pellinger, PhD, ACSM RCEP – Assistant Professor of Physiology
Salisbury University - Department of Health Sciences
1 Umpierre, D. et al. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. Jama 305, 1790-1799, doi:10.1001/jama.2011.576 (2011).
2 Winnick, J. J. et al. Short-term aerobic exercise training in obese humans with type 2 diabetes mellitus improves whole-body insulin sensitivity through gains in peripheral, not hepatic insulin sensitivity. J Clin Endocrinol Metab 93, 771-778, doi:10.1210/jc.2007-1524 (2008).
3 Balducci, S. et al. Effect of an intensive exercise intervention strategy on modifiable cardiovascular risk factors in subjects with type 2 diabetes mellitus: a randomized controlled trial: the Italian Diabetes and Exercise Study (IDES). Arch Intern Med 170, 1794-1803, doi:10.1001/archinternmed.2010.380 (2010).
4 Balducci, S. et al. Changes in physical fitness predict improvements in modifiable cardiovascular risk factors independently of body weight loss in subjects with type 2 diabetes participating in the Italian Diabetes and Exercise Study (IDES). Diabetes Care 35, 1347-1354, doi:10.2337/dc11-1859 (2012).
5 Colberg, S. R. et al. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement executive summary. Diabetes Care 33, 2692-2696, doi:10.2337/dc10-1548 (2010).
6 Boule, N. G. et al. Effects of exercise training on glucose homeostasis: the HERITAGE Family Study. Diabetes care 28, 108-114 (2005).
7 Pricher, M. P., Holowatz, L. A., Williams, J. T., Lockwood, J. M. & Halliwill, J. R. Regional hemodynamics during postexercise hypotension. I. Splanchnic and renal circulations. J Appl Physiol 97, 2065-2070 (2004).
8 McCord, J. L. & Halliwill, J. R. H1 and H2 receptors mediate postexercise hyperemia in sedentary and endurance exercise-trained men and women. J Appl Physiol 101, 1693-1701 (2006).
9 Pellinger, T. K., Simmons, G. H., Maclean, D. A. & Halliwill, J. R. Local histamine H(1-) and H(2)-receptor blockade reduces postexercise skeletal muscle interstitial glucose concentrations in humans. Appl Physiol Nutr Metab 35, 617-626, doi:10.1139/H10-055 (2010).
10 Pellinger, T. K., Dumke, B. R. & Halliwill, J. R. Effect of H1- and H2-histamine receptor blockade on postexercise insulin sensitivity. Physiological Reports 1, n/a-n/a, doi:10.1002/phy2.33 (2013).