Resistance training in the treatment of diabetes mellitus II: a narrative review

Guilherme Saborosa; Raphael Dinalli Oliveira Freitas; Sandro Fernandes da Silva

doi:10.31893/multirev.2022016

Keywords:

glucose

insulin

muscular contraction

Abstract

Diabetes Mellitus is defined as a condition in which glucose levels in the bloodstream are present in high concentrations. Type II Diabetes Mellitus (DMT2) is the most common and develops in the long term, being mainly associated with the individual's lifestyle. It is characterized by the cellular situation of insulin resistance, and treatment is recommended through pharmacological, nutritional, and resources and regular exercise. Therefore, the objective of the study was to review the literature on the influences of the practice of Resistance Training (RT) in patients with Diabetes Mellitus Type II. The increase in the activation of the AMPK pathway induced by muscle contraction seems to be the most important mechanism of action since there is an increase in the translocation of GLUT4 to the cell membrane, which allows a greater uptake of glucose from the bloodstream in an insulin-independent manner, establishing a balance in glucose levels. RT, in addition to promoting serum glucose homeostasis, also reduces the risk factors for the disease, thus becoming an effective strategy for the prevention and treatment of T2DM.
References
1. ACSM (2010) Exercise and type 2 diabetes, Medicine and Science in Sports and Exercise 42:2282–2303. doi: 10.1249/MSS.0b013e3181eeb61c.
2. American Diabetes Association (2019) 2 Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2019. Diabetes Care 42:S13–S28. doi: 10.2337/dc19-S002.
3. American Diabetes Association (2005) Diagnosis and Classification of Diabetes. Diabetes care 32:S62–S267.
4. Arsa G, Lima L, Almeida SS, Moreira SR, Campbell CSG, Simões HG (2009) Diabetes Mellitus tipo 2: Aspectos fisiológicos, genéticos e formas de exercício físico para seu controle. Revista Brasileira de Cineantropometria & Desempenho Humano 11:103–111.
5. Aune D, Norat T, Leitzmann M, Tonstad S, Vatten LJ (2015) Physical activity and the risk of type 2 diabetes: A systematic review and dose-response meta-analysis. European Journal of Epidemiology. Springer Netherlands 30:529–542, doi: 10.1007/s10654-015-0056-z.
6. Barnes B, Zierath J (2005) Role of AMP-Activated Protein Kinase in the Control of Glucose Homeostasis. Current Molecular Medicine 5:341–348. doi: 10.2174/1566524053766103.
7. Calvinho HJV, Lira JSN (2008) Os beneficios da atividade física para o envelhecimento saudavel: Análise da revista brasileira de geriatria e gerontologia (2008 - 2012), 1–20.
8. Cambri LT, Santos DL (2006) Influência dos exercícios resistidos com pesos em diabéticos tipo 2. Motriz 12: 33–41.
9. Castaneda C, Layne JE, Munoz-Orians L, Gordon PL, Walsmith J, Foldvari M, Roubenoff R, Tucker KL, Nelson ME (2002) A Randomized Controlled Trial of Resistance Exercise Training to Improve Glycemic Control in Older Adults with Type 2 Diabetes. Diabetes Care 25:2335–2341. doi: 10.2337/diacare.25.12.2335.
10. Cho NH, Shaw JE, Karuranga S, Huang Y, da Rocha Fernandes JD, Ohlrogge AW, Malanda B (2018) IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Research and Clinical Practice. Elsevier B.V., 138:271–281. doi: 10.1016/j.diabres.2018.02.023.
11. Costa TAM, Porto M (2015) Efeitos Do Treinamento Resistido no Diabetes (Effects of Resistance Training in Diabetes). Revista Educação Física UNIFAFIBE, 6:107–117.
12. Dunstan DW, Puddey IB, Beilin LJ, Burke V, Morton AR, Stanton KG (1998) Effects of a short-term circuit weight training program on glycaemic control in NIDDM. Diabetes Research and Clinical Practice 40:53–61. doi: 10.1016/S0168-8227(98)00027-8.
13. Dunstan DW, Daly RM, Owen N, Jolley D, de Courten M, Shaw J, Zimmet P (2002) High-Intensity Resistance Training Improves Glycemic Control in Older Patients with Type 2 Diabetes. Diabetes Care 25:1729–1736. doi:10.2337/diacare.25.10.1729.
14. Entezari M, Hashemi D, Taheriazam A, Zabolian A, Mohammadi S, Fakhri F, Hashemi M, Hushmandi K, Ashrafizadeh M, Zarrabi A, Ertas YN, Mirzaei S, Samarghandian S (2022) AMPK signaling in diabetes mellitus, insulin resistance and diabetic complications: A pre-clinical and clinical investigation. Biomedicine & Pharmacotherapy. Elsevier Masson SAS 146:112563. doi: 10.1016/j.biopha.2021.112563.
15. Guedes JM, Pieri BLS, Luciano TF, Marques SO, Guglielmo LGA, Souza CT (2019) Muscular resistance, hypertrophy and strength training equally reduce adiposity, inflammation and insulin resistance in mice with diet-induced obesity. Einstein (São Paulo), 18. doi: 10.31744/einstein_journal/2020AO4784.
16. Host HH, Hansen PA, Nolte LA, Chen MM, Holloszy JO (1998) Rapid reversal of adaptive increases in muscle GLUT-4 and glucose transport capacity after training cessation. Journal of Applied Physiology 84:798–802. doi: 10.1152/jappl.1998.84.3.798.
17. International Diabetes Federation (2019) IDF Diabetes Atlas. Ninth, The Lancet. Ninth. doi: 10.1016/S0140-6736(55)92135-8.
18. Ishii T, Yamakita T, Sato T, Tanaka S, Fujii, S (1998) Resistance training improves insulin sensitivity in NIDDM subjects without altering maximal oxygen uptake. Diabetes Care 21:1353–1355. doi: 10.2337/diacare.21.8.1353.
19. Jansson AK, Chan LX, Lubans DR, Duncan MJ, Plotnikoff RC (2022) Effect of resistance training on HbA1c in adults with type 2 diabetes mellitus and the moderating effect of changes in muscular strength: a systematic review and meta-analysis. BMJ Open Diabetes Research & Care 10:e002595. doi: 10.1136/bmjdrc-2021-002595.
20. Kelley D, Wing R, Buonocore C, Sturis J, Polonsky K, Fitzsimmons M (1993) Relative effects of calorie restriction and weight loss in noninsulin-dependent diabetes mellitus. Journal of Clinical Endocrinology and Metabolism 77:1287–1293. doi: 10.1210/jcem.77.5.8077323.
21. Kwon HR, Han KA, Ku YH, Ahn HJ, Koo Bo-K, Kim HC, Min KW (2010) The Effects of Resistance Training on Muscle and Body Fat Mass and Muscle Strength in Type 2 Diabetic Women. Korean Diabetes Journal 34:101. doi: 10.4093/kdj.2010.34.2.101.
22. Lavie C, Johannsen N, Swift D, Sénéchal M, Earnest C, Church T, Hutber A, Sallis R, Blair S, Ochsner J (2014) Exercise is Medicine-The Importance of Physical Activity, Exercise Training, Cardiorespiratory Fitness and Obesity in the Prevention and Treatment of Type 2 Diabetes. European Endocrinology 10:18–22. doi: 10.17925/EE.2014.10.01.18.
23. Marwick TH, Hordern MD, Miller T, Chyun DA, Bertoni AG, Blumenthal RS, Philippides G, Rocchini A (2009) Exercise training for type 2 diabetes mellitus: Impact on cardiovascular risk: A scientific statement from the american heart association. Circulation 119:3244–3262. doi: 10.1161/CIRCULATIONAHA.109.192521.
24. McArdle WD, Katch FI, Katch VL (2013) Fisiologia do Exercício: nutrição, energia e desempenho humano. 7th edn. Translated by G. Taranto. Rio de Janeiro: Guanabara Koogan.
25. McGee SL, van Denderen BJW, Howlett KF, Mollica J, Schertzer JD, Kemp BE, Hargreaves M (2008) AMP-Activated Protein Kinase Regulates GLUT4 Transcription by Phosphorylating Histone Deacetylase 5. Diabetes 57:860–867. doi: 10.2337/db07-0843.
26. OMS (2021) The Global Diabetes Compact what you need to know. Available in: https://cdn.who.int/media/docs/defaultsource/diabetes/gdc_need_to_know_web.pdf?sfvrsn=7a4af558_4&download=true. Access on: October 11, 2021.
27. Pacheco C, Santos LHP, Alves JO, Queiroz NA, Soares PM Ceccatto VM (2017) Regulação gênica da via ampk pelo exercício físico: revisão sistemática e análise in silico. Revista Brasileira de Medicina do Esporte 23:328–334. doi: 10.1590/1517-869220172304169935.
28. Pádua MF, Pádua TF, Pauli JR, Souza CT, Silva ASR, Ropelle ECC, Cintra DE, Carvalheira JBC, Ropelle ER (2009) Exercício físico reduz a hiperglicemia de jejum em camundongos diabéticos através da ativação da AMPK. Revista Brasileira de Medicina do Esporte 15:179–184. doi: 10.1590/S1517-86922009000300003.
29. Pan B, Ge L, Xun Y, Chen Y, Gao C, Han X, Zuo L, Shan H, Yang K, Ding G, Tian J (2018) Exercise training modalities in patients with type 2 diabetes mellitus: a systematic review and network meta-analysis. International Journal of Behavioral Nutrition and Physical Activity. International Journal of Behavioral Nutrition and Physical Activity 15:72. doi: 10.1186/s12966-018-0703-3.
30. Pauli JR, Cintra DE, Souza CT, Ropelle ER (2009) Novos mecanismos pelos quais o exercício físico melhora a resistência à insulina no músculo esquelético. Arquivos Brasileiros de Endocrinologia & Metabologia 53:399–408.
31. Pfeiffer AFH, Klein HH (2014) The Treatment of Type 2 Diabetes. Deutsches Aerzteblatt Online 111:69–82. doi: 10.3238/arztebl.2014.0069.
32. Sawada SS, Gando Y, Kawakami R, Blair SN, Lee IM, Tamura Y, Tsuda H, Saito H, Miyachi M (2019) Combined aerobic and resistance training, and incidence of diabetes: A retrospective cohort study in Japanese older women. Journal of Diabetes Investigation 10:997–1003. doi: 10.1111/jdi.12973.
33. SBD (2019) Diretrizes da Sociedade Brasileira de Diabetes 2019-2020.
34. Souza DR, Toigo AM (2018) O Efeito Do Treinamento De Alta Intensidade Nos Níveis Glicêmicos Em Pessoas Com Diabetes Mellitus Tipo 2. Revista Atenção à Saúde 16:64–73. doi: 10.13037/ras.vol16n57.4161.
35. Suchomel TJ, Nimphius S, Bellon CR, Stone MH (2018) The Importance of Muscular Strength: Training Considerations. Sports Medicine. Springer International Publishing 48:765–785. doi: 10.1007/s40279-018-0862-z.

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

How to cite

Saborosa, G., Freitas, R. D. O., & da Silva, S. F. (2023). Resistance training in the treatment of diabetes mellitus II: a narrative review. Multidisciplinary Reviews, 5(4), 2022016. https://doi.org/10.31893/multirev.2022016

[1] ACSM (2010) Exercise and type 2 diabetes, Medicine and Science in Sports and Exercise 42:2282–2303. doi: 10.1249/MSS.0b013e3181eeb61c.

[2] American Diabetes Association (2019) 2 Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2019. Diabetes Care 42:S13–S28. doi: 10.2337/dc19-S002.

[3] American Diabetes Association (2005) Diagnosis and Classification of Diabetes. Diabetes care 32:S62–S267.

[4] Arsa G, Lima L, Almeida SS, Moreira SR, Campbell CSG, Simões HG (2009) Diabetes Mellitus tipo 2: Aspectos fisiológicos, genéticos e formas de exercício físico para seu controle. Revista Brasileira de Cineantropometria & Desempenho Humano 11:103–111.

[5] Aune D, Norat T, Leitzmann M, Tonstad S, Vatten LJ (2015) Physical activity and the risk of type 2 diabetes: A systematic review and dose-response meta-analysis. European Journal of Epidemiology. Springer Netherlands 30:529–542, doi: 10.1007/s10654-015-0056-z.

[6] Barnes B, Zierath J (2005) Role of AMP-Activated Protein Kinase in the Control of Glucose Homeostasis. Current Molecular Medicine 5:341–348. doi: 10.2174/1566524053766103.

[7] Calvinho HJV, Lira JSN (2008) Os beneficios da atividade física para o envelhecimento saudavel: Análise da revista brasileira de geriatria e gerontologia (2008 - 2012), 1–20.

[8] Cambri LT, Santos DL (2006) Influência dos exercícios resistidos com pesos em diabéticos tipo 2. Motriz 12: 33–41.

[9] Castaneda C, Layne JE, Munoz-Orians L, Gordon PL, Walsmith J, Foldvari M, Roubenoff R, Tucker KL, Nelson ME (2002) A Randomized Controlled Trial of Resistance Exercise Training to Improve Glycemic Control in Older Adults with Type 2 Diabetes. Diabetes Care 25:2335–2341. doi: 10.2337/diacare.25.12.2335.

[10] Cho NH, Shaw JE, Karuranga S, Huang Y, da Rocha Fernandes JD, Ohlrogge AW, Malanda B (2018) IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Research and Clinical Practice. Elsevier B.V., 138:271–281. doi: 10.1016/j.diabres.2018.02.023.

[11] Costa TAM, Porto M (2015) Efeitos Do Treinamento Resistido no Diabetes (Effects of Resistance Training in Diabetes). Revista Educação Física UNIFAFIBE, 6:107–117.

[12] Dunstan DW, Puddey IB, Beilin LJ, Burke V, Morton AR, Stanton KG (1998) Effects of a short-term circuit weight training program on glycaemic control in NIDDM. Diabetes Research and Clinical Practice 40:53–61. doi: 10.1016/S0168-8227(98)00027-8.

[13] Dunstan DW, Daly RM, Owen N, Jolley D, de Courten M, Shaw J, Zimmet P (2002) High-Intensity Resistance Training Improves Glycemic Control in Older Patients with Type 2 Diabetes. Diabetes Care 25:1729–1736. doi:10.2337/diacare.25.10.1729.

[14] Entezari M, Hashemi D, Taheriazam A, Zabolian A, Mohammadi S, Fakhri F, Hashemi M, Hushmandi K, Ashrafizadeh M, Zarrabi A, Ertas YN, Mirzaei S, Samarghandian S (2022) AMPK signaling in diabetes mellitus, insulin resistance and diabetic complications: A pre-clinical and clinical investigation. Biomedicine & Pharmacotherapy. Elsevier Masson SAS 146:112563. doi: 10.1016/j.biopha.2021.112563.

[15] Guedes JM, Pieri BLS, Luciano TF, Marques SO, Guglielmo LGA, Souza CT (2019) Muscular resistance, hypertrophy and strength training equally reduce adiposity, inflammation and insulin resistance in mice with diet-induced obesity. Einstein (São Paulo), 18. doi: 10.31744/einstein_journal/2020AO4784.

[16] Host HH, Hansen PA, Nolte LA, Chen MM, Holloszy JO (1998) Rapid reversal of adaptive increases in muscle GLUT-4 and glucose transport capacity after training cessation. Journal of Applied Physiology 84:798–802. doi: 10.1152/jappl.1998.84.3.798.

[17] International Diabetes Federation (2019) IDF Diabetes Atlas. Ninth, The Lancet. Ninth. doi: 10.1016/S0140-6736(55)92135-8.

[18] Ishii T, Yamakita T, Sato T, Tanaka S, Fujii, S (1998) Resistance training improves insulin sensitivity in NIDDM subjects without altering maximal oxygen uptake. Diabetes Care 21:1353–1355. doi: 10.2337/diacare.21.8.1353.

[19] Jansson AK, Chan LX, Lubans DR, Duncan MJ, Plotnikoff RC (2022) Effect of resistance training on HbA1c in adults with type 2 diabetes mellitus and the moderating effect of changes in muscular strength: a systematic review and meta-analysis. BMJ Open Diabetes Research & Care 10:e002595. doi: 10.1136/bmjdrc-2021-002595.

[20] Kelley D, Wing R, Buonocore C, Sturis J, Polonsky K, Fitzsimmons M (1993) Relative effects of calorie restriction and weight loss in noninsulin-dependent diabetes mellitus. Journal of Clinical Endocrinology and Metabolism 77:1287–1293. doi: 10.1210/jcem.77.5.8077323.

[21] Kwon HR, Han KA, Ku YH, Ahn HJ, Koo Bo-K, Kim HC, Min KW (2010) The Effects of Resistance Training on Muscle and Body Fat Mass and Muscle Strength in Type 2 Diabetic Women. Korean Diabetes Journal 34:101. doi: 10.4093/kdj.2010.34.2.101.

[22] Lavie C, Johannsen N, Swift D, Sénéchal M, Earnest C, Church T, Hutber A, Sallis R, Blair S, Ochsner J (2014) Exercise is Medicine-The Importance of Physical Activity, Exercise Training, Cardiorespiratory Fitness and Obesity in the Prevention and Treatment of Type 2 Diabetes. European Endocrinology 10:18–22. doi: 10.17925/EE.2014.10.01.18.

[23] Marwick TH, Hordern MD, Miller T, Chyun DA, Bertoni AG, Blumenthal RS, Philippides G, Rocchini A (2009) Exercise training for type 2 diabetes mellitus: Impact on cardiovascular risk: A scientific statement from the american heart association. Circulation 119:3244–3262. doi: 10.1161/CIRCULATIONAHA.109.192521.

[24] McArdle WD, Katch FI, Katch VL (2013) Fisiologia do Exercício: nutrição, energia e desempenho humano. 7th edn. Translated by G. Taranto. Rio de Janeiro: Guanabara Koogan.

[25] McGee SL, van Denderen BJW, Howlett KF, Mollica J, Schertzer JD, Kemp BE, Hargreaves M (2008) AMP-Activated Protein Kinase Regulates GLUT4 Transcription by Phosphorylating Histone Deacetylase 5. Diabetes 57:860–867. doi: 10.2337/db07-0843.

[26] OMS (2021) The Global Diabetes Compact what you need to know. Available in: https://cdn.who.int/media/docs/defaultsource/diabetes/gdc_need_to_know_web.pdf?sfvrsn=7a4af558_4&download=true. Access on: October 11, 2021.

[27] Pacheco C, Santos LHP, Alves JO, Queiroz NA, Soares PM Ceccatto VM (2017) Regulação gênica da via ampk pelo exercício físico: revisão sistemática e análise in silico. Revista Brasileira de Medicina do Esporte 23:328–334. doi: 10.1590/1517-869220172304169935.

[28] Pádua MF, Pádua TF, Pauli JR, Souza CT, Silva ASR, Ropelle ECC, Cintra DE, Carvalheira JBC, Ropelle ER (2009) Exercício físico reduz a hiperglicemia de jejum em camundongos diabéticos através da ativação da AMPK. Revista Brasileira de Medicina do Esporte 15:179–184. doi: 10.1590/S1517-86922009000300003.

[29] Pan B, Ge L, Xun Y, Chen Y, Gao C, Han X, Zuo L, Shan H, Yang K, Ding G, Tian J (2018) Exercise training modalities in patients with type 2 diabetes mellitus: a systematic review and network meta-analysis. International Journal of Behavioral Nutrition and Physical Activity. International Journal of Behavioral Nutrition and Physical Activity 15:72. doi: 10.1186/s12966-018-0703-3.

[30] Pauli JR, Cintra DE, Souza CT, Ropelle ER (2009) Novos mecanismos pelos quais o exercício físico melhora a resistência à insulina no músculo esquelético. Arquivos Brasileiros de Endocrinologia & Metabologia 53:399–408.

[31] Pfeiffer AFH, Klein HH (2014) The Treatment of Type 2 Diabetes. Deutsches Aerzteblatt Online 111:69–82. doi: 10.3238/arztebl.2014.0069.

[32] Sawada SS, Gando Y, Kawakami R, Blair SN, Lee IM, Tamura Y, Tsuda H, Saito H, Miyachi M (2019) Combined aerobic and resistance training, and incidence of diabetes: A retrospective cohort study in Japanese older women. Journal of Diabetes Investigation 10:997–1003. doi: 10.1111/jdi.12973.

[33] SBD (2019) Diretrizes da Sociedade Brasileira de Diabetes 2019-2020.

[34] Souza DR, Toigo AM (2018) O Efeito Do Treinamento De Alta Intensidade Nos Níveis Glicêmicos Em Pessoas Com Diabetes Mellitus Tipo 2. Revista Atenção à Saúde 16:64–73. doi: 10.13037/ras.vol16n57.4161.

[35] Suchomel TJ, Nimphius S, Bellon CR, Stone MH (2018) The Importance of Muscular Strength: Training Considerations. Sports Medicine. Springer International Publishing 48:765–785. doi: 10.1007/s40279-018-0862-z.

Abstract

References

How to cite