The effect of metformin on glucose homeostasis during moderate exercise

TY - JOUR

T1 - The effect of metformin on glucose homeostasis during moderate exercise

AU - Hansen, Merethe

AU - Palsøe, Marie K.

AU - Helge, Jørn Wulff

AU - Dela, Flemming

N1 - © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

PY - 2015/2/1

Y1 - 2015/2/1

N2 - OBJECTIVE: We investigated the role of metformin on glucose kinetics during moderate exercise. RESEARCH DESIGN AND METHODS: Before, during, and after a 45-min bout of exercise at 60% VO2max, glucose kinetics were determined by isotope tracer technique in patients with type 2 diabetes mellitus with metformin treatment (DM2+Met) or without metformin treatment (DM2) and in healthy control subjects (CON) matched for BMI and age. Glucoregulatory hormones and metabolites were measured throughout the study. RESULTS: Plasma glucose concentration was unchanged during exercise in CON but decreased in DM2. No significant change was found in DM2+Met. Hormones and metabolites showed no differences among the groups except for elevated exerciseinduced concentrations of lactate in DM2 (area under the curve [AUC] 31±1% vs. CON) and glucagon in DM2 (AUC 5±1% vs. DM2+Met). Free fatty acid levels were lower in DM2+Met than in DM2 (AUC 214±1%). Absolute values of the baseline glucose rate of appearance (Ra) were elevated in DM2 and DM2+Met, but the increase in glucose Ra relative to baseline was blunted in DM2 (19±1%) and DM2+Met (18±4%) compared with CON (46±4%). Glucose rate of disappearance relative to baseline increased more in CON (31±3%) than in DM2 (6±1%) and DM2+Met (21±2%), showing a small increase caused by metformin. Glucose metabolic clearance rate relative to baseline was similar during exercise in DM2 (33±1%) and CON (35±3%) but was improved in DM2+Met (37±3%) compared with DM2. CONCLUSIONS: Metformin has a positive effect on glucose homeostasis during exercise.

AB - OBJECTIVE: We investigated the role of metformin on glucose kinetics during moderate exercise. RESEARCH DESIGN AND METHODS: Before, during, and after a 45-min bout of exercise at 60% VO2max, glucose kinetics were determined by isotope tracer technique in patients with type 2 diabetes mellitus with metformin treatment (DM2+Met) or without metformin treatment (DM2) and in healthy control subjects (CON) matched for BMI and age. Glucoregulatory hormones and metabolites were measured throughout the study. RESULTS: Plasma glucose concentration was unchanged during exercise in CON but decreased in DM2. No significant change was found in DM2+Met. Hormones and metabolites showed no differences among the groups except for elevated exerciseinduced concentrations of lactate in DM2 (area under the curve [AUC] 31±1% vs. CON) and glucagon in DM2 (AUC 5±1% vs. DM2+Met). Free fatty acid levels were lower in DM2+Met than in DM2 (AUC 214±1%). Absolute values of the baseline glucose rate of appearance (Ra) were elevated in DM2 and DM2+Met, but the increase in glucose Ra relative to baseline was blunted in DM2 (19±1%) and DM2+Met (18±4%) compared with CON (46±4%). Glucose rate of disappearance relative to baseline increased more in CON (31±3%) than in DM2 (6±1%) and DM2+Met (21±2%), showing a small increase caused by metformin. Glucose metabolic clearance rate relative to baseline was similar during exercise in DM2 (33±1%) and CON (35±3%) but was improved in DM2+Met (37±3%) compared with DM2. CONCLUSIONS: Metformin has a positive effect on glucose homeostasis during exercise.

U2 - 10.2337/dc14-1480

DO - 10.2337/dc14-1480

M3 - Journal article

C2 - 25468944

SN - 0149-5992

VL - 38

SP - 293

EP - 301

JO - Diabetes Care

JF - Diabetes Care

IS - 2

ER -