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Abstract
The microcirculation in adipose tissue is markedly impaired in type 2 diabetes (T2D). Resistance training (RT) often increases muscle mass and promotes a favorable metabolic profile in people with T2D, even in the absence of fat loss. Whether the metabolic benefits of RT in T2D are linked to improvements in adipose tissue microvascular blood flow is unknown. Eighteen sedentary people with T2D (7 women/11 men, 52 ± 7 yr) completed 6 wk of RT. Before and after RT, overnight-fasted participants had blood sampled for clinical chemistries (glucose, insulin, lipids, HbA1c, and proinflammatory markers) and underwent an oral glucose challenge (OGC; 50 g glucose × 2 h) and a DEXA scan to assess body composition. Adipose tissue microvascular blood volume and flow were assessed at rest and 1 h post-OGC using contrast-enhanced ultrasound. RT significantly reduced fasting blood glucose ( P = 0.006), HbA1c ( P = 0.007), 2-h glucose area under the time curve post-OGC ( P = 0.014), and homeostatic model assessment of insulin resistance ( P = 0.005). This was accompanied by a small reduction in total body fat ( P = 0.002), trunk fat ( P = 0.023), and fasting triglyceride levels ( P = 0.029). Lean mass ( P = 0.003), circulating TNF-α ( P = 0.006), and soluble VCAM-1 ( P < 0.001) increased post-RT. There were no significant changes in adipose tissue microvascular blood volume or flow following RT; however those who did have a higher baseline microvascular blood flow post-RT also had lower fasting triglyceride levels ( r = -0.476, P = 0.045). The anthropometric, glycemic, and insulin-sensitizing benefits of 6 wk of RT in people with T2D are not associated with an improvement in adipose tissue microvascular responses; however, there may be an adipose tissue microvascular-linked benefit to fasting triglyceride levels.
Highlights
Resistance training (RT) is recommended for people with type 2 diabetes (T2D) to improve overall cardiometabolic health [1, 16]
We have recently demonstrated that 6 wk of RT markedly enhances skeletal muscle microvascular blood flow (MBF) in T2D subjects in response to an oral glucose challenge (OGC) [27]
The current study demonstrates that 6 wk of RT in people with T2D produced favorable effects of glycemic regulation, insulin sensitivity, and body composition; these effects occurred without a concomitant increase in adipose tissue microvascular blood volume (MBV) or MBF at rest or during an OGC
Summary
Resistance training (RT) is recommended for people with type 2 diabetes (T2D) to improve overall cardiometabolic health [1, 16]. We have recently demonstrated that 6 wk of RT markedly enhances skeletal muscle MBF in T2D subjects in response to an oral glucose challenge (OGC) [27]. This enhanced skeletal muscle microvascular response was tightly linked to improvements in overall glycemic control including reductions in fasting blood glucose and HbA1c levels, and improvements in glucose tolerance following an OGC. Body composition was affected by RT, vascular and metabolic changes were not related with changes in body composition [27] This novel finding positions the microvasculature in skeletal muscle as an important regulator of overall glucose homeostasis
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