Exercise Program
In human beings, prescriptive exercise is widely used in the management of obesity, IR, and type-2 diabetes mellitus.
An exercise prescription of 150 to 200 min/wk of moderate-intensity activity (eg, brisk walking or cycling) results in a sustained increase in insulin sensitivity, as well as improvements in other risk factors for diabetes mellitus and metabolic syndrome. Additionally, studies that investigated the relationship between physical activity-related energy expenditure, aerobic fitness, obesity, and the progression toward metabolic syndrome or diabetes have provided evidence for a protective role of exercise.
Finally, it has been shown that the combination of caloric restriction and regular physical activity can result in more substantial weight loss when compared with either strategy alone. Regular exercise upregulates expression of the insulin-sensitive glucose transporter isoform GLUT4 in skeletal muscle, thereby enhancing total capacity for glucose transport. Additionally, a single bout of dynamic exercise enhances insulin sensitivity for glucose uptake for 24 to 48 hours.
Exercise also counters IR in skeletal muscle through improvements in lipid metabolism and increased mitochondrial biogenesis.