Skeletal Muscle Hyperemia: A Potential Bridge Between Post-exercise Hypotension and Glucose Regulation.

Thomas K Pellinger,Chi-An W Emhoff

doi:10.3389/fphys.2021.821919

Abstract

For both healthy individuals and patients with type 2 diabetes (T2D), the hemodynamic response to regular physical activity is important for regulating blood glucose, protecting vascular function, and reducing the risk of cardiovascular disease. In addition to these benefits of regular physical activity, evidence suggests even a single bout of dynamic exercise promotes increased insulin-mediated glucose uptake and insulin sensitivity during the acute recovery period. Importantly, post-exercise hypotension (PEH), which is defined as a sustained reduction in arterial pressure following a single bout of exercise, appears to be blunted in those with T2D compared to their non-diabetic counterparts. In this short review, we describe research that suggests the sustained post-exercise vasodilation often observed in PEH may sub-serve glycemic regulation following exercise in both healthy individuals and those with T2D. Furthermore, we discuss the interplay of enhanced perfusion, both macrovascular and microvascular, and glucose flux following exercise. Finally, we propose future research directions to enhance our understanding of the relationship between post-exercise hemodynamics and glucose regulation in healthy individuals and in those with T2D.

Highlights

As with healthy individuals, in patients with type 2 diabetes (T2D), regular physical activity offers numerous benefits, including improved blood glucose regulation (Boulé et al, 2001; Umpierre et al, 2011) increased insulin sensitivity (Winnick et al, 2008), improved clinical symptoms (Wojtaszewski and Richter, 2006) and the delay or prevention of developing cardiovascular disease (Balducci et al, 2012)
We provide a brief overview of the phenomenon known as post-exercise hypotension (PEH) and how the sustained vasodilation that is frequently associated with PEH may affect glucose regulation in both healthy individuals and in people with T2D
While the aforementioned studies were conducted on healthy, non-diabetic subjects, their findings highlight the importance of understanding the complex interactions amongst post-exercise hemodynamic and glucose regulation mechanisms in patients with T2D, who may engage in regular exercise to help manage their blood glucose levels

Summary

Introduction

In patients with type 2 diabetes (T2D), regular physical activity offers numerous benefits, including improved blood glucose regulation (reduced HbA1c) (Boulé et al, 2001; Umpierre et al, 2011) increased insulin sensitivity (Winnick et al, 2008), improved clinical symptoms (Wojtaszewski and Richter, 2006) and the delay or prevention of developing cardiovascular disease (Balducci et al, 2012). In examining the influence of exercise on this relationship, Hamrin et al (2011) observed, via skeletal muscle microdialysis, that increased tissue perfusion was associated with enhanced glucose uptake 12 h after the completion of a 2-h bout of moderate-intensity one-legged cycling.

Results

Conclusion