Metabolic changes following a 1-year diet and exercise intervention in patients with type 2 diabetes

Jeanine B. Albu, Leonie K. Heilbronn, David E. Kelley, Steven R. Smith, Koichiro Azuma, Evan S. Berk, F. Xavier Pi-Sunyer, Eric Ravussin

Research output: Contribution to journalArticle

71 Citations (Scopus)

Abstract

OBJECTIVE - To characterize the relationships among long-term improvements in peripheral insulin sensitivity (glucose disposal rate [GDR]), fasting glucose, and free fatty acids (FFAs) and concomitant changes in weight and adipose tissue mass and distribution induced by lifestyle intervention in obese individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS - We measured GDR, fasting glucose, and FFAs during a euglycemic clamp and adipose tissue mass and distribution, organ fat, and adipocyte size by dual-energy X-ray absorptiometry, CT scan, and adipose tissue biopsy in 26 men and 32 women in the Look-AHEAD trial before and after 1 year of diet and exercise aimed at weight loss. RESULTS - Weight and fasting glucose decreased significantly (P = 0.0001) and significantly more in men than in women (-12 vs. -8% and -16 vs. -7%, respectively; P < 0.05), while FFAs during hyperinsulinemia decreased and GDR increased significantly (P < 0.00001) and similarly in both sexes (-53 vs. -41% and 63 vs. 43%; P = NS). Men achieved a more favorable fat distribution by losing more from upper compared with lower and from deeper compared with superficial adipose tissue depots (P < 0.01). Decreases in weight and adipose tissue mass predicted improvements in GDR but not in fasting glucose or fasting FFAs; however, decreases in FFAs during hyperinsulinemia significantly determined GDR improvements. Hepatic fat was the only regional fat measure whose change contributed independently to changes in metabolic variables. CONCLUSIONS - Patients with type 2 diabetes undergoing a 1-year lifestyle intervention had significant improvements in GDR, fasting glucose, FFAs and adipose tissue distribution. However, changes in overall weight (adipose tissue mass) and hepatic fat were the most important determinants of metabolic improvements.

Original languageEnglish
Pages (from-to)627-633
Number of pages7
JournalDiabetes
Volume59
Issue number3
DOIs
Publication statusPublished - 2010 Mar 1

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Fingerprint Dive into the research topics of 'Metabolic changes following a 1-year diet and exercise intervention in patients with type 2 diabetes'. Together they form a unique fingerprint.

  • Cite this

    Albu, J. B., Heilbronn, L. K., Kelley, D. E., Smith, S. R., Azuma, K., Berk, E. S., Xavier Pi-Sunyer, F., & Ravussin, E. (2010). Metabolic changes following a 1-year diet and exercise intervention in patients with type 2 diabetes. Diabetes, 59(3), 627-633. https://doi.org/10.2337/db09-1239