Abstract
Aging is associated with insulin resistance and the development of type 2 diabetes. While this process is multifaceted, age-related changes to skeletal muscle are expected to contribute to impaired glucose metabolism. Some of these changes include sarcopenia, impaired insulin signaling, and imbalances in glucose utilization. Endurance and resistance exercise training have been endorsed as interventions to improve glucose tolerance and whole-body insulin sensitivity in the elderly. While both types of exercise generally increase insulin sensitivity in older adults, the metabolic pathways through which this occurs can differ and can be dependent on preexisting conditions including obesity and type 2 diabetes. In this review, we will first highlight age-related changes to skeletal muscle which can contribute to insulin resistance, followed by a comparison of endurance and resistance training adaptations to insulin-stimulated glucose metabolism in older adults.
Highlights
Aging is associated with insulin resistance and the development of type 2 diabetes
Since skeletal muscle is the primary target for insulin-mediated glucose uptake [12], age-related changes in the structure and metabolism of this tissue are thought to play a major role in the pathogenesis of insulin resistance in older adults
While sarcopenia likely plays a role in insulin resistance, the age-related metabolic and cellular changes that occur within skeletal muscle are thought to have a prominent role and have been the focus of researchers attempting to elucidate the intracellular mechanisms responsible for age-related insulin resistance
Summary
It is estimated that 30% of individuals over the age of 60 are affected by type 2 diabetes [1]. Aging has been associated with glucose intolerance and whole-body insulin resistance [2,3,4,5,6,7,8], with the factors contributing to these disorders being complex and likely multifaceted including chronological age [2], reduced physical activity [9], inflammation [10], and/or increased body fat [9,11]. Since skeletal muscle is the primary target for insulin-mediated glucose uptake [12], age-related changes in the structure and metabolism of this tissue are thought to play a major role in the pathogenesis of insulin resistance in older adults
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