About this Research Topic
The first observations that muscle contraction increases muscle glucose uptake were made nearly 60-years ago. It is now very clear that regular exercise improves several aspects of glucose metabolism, including glucose uptake, insulin sensitivity, and pancreatic beta-cell function, as well as whole-body glycemic control. The huge volume of studies in this field has culminated in clear public health guidelines recommending that all adults should minimize their daily sedentary behavior and achieve at least 150-minutes per week of moderate- to vigorous-intensity physical activity combined with two to three strength sessions. While these guidelines apply to the general population, the standard of care guidelines for the prevention and treatment of type 2 diabetes contain the same physical activity recommendations for optimizing glycemic health.
Several randomized controlled trials show the benefits of regular exercise for both the prevention and the treatment of type 2 diabetes. However, many trials have also presented null findings while others have identified large variability in the inter-individual changes in glucose control in response to exercise. At the patient level, exercise can be a useful tool for improving glucose control, but some individuals find that exercise does not help or even worsens their glucose control. For the individual, it is indeed frustrating to invest huge effort in implementing and maintaining a lifestyle change only to see no obvious benefit to the target variable. Such a person may be labeled as a “non-responder” but this is only an accurate label if all known approaches have been exhausted.
Identifying and understanding the causes of response heterogeneity and adverse outcomes is critical for maximizing therapeutic outcomes for patients with, or at risk of, diabetes. Optimizing the therapeutic effect of exercise also has the potential to reduce diabetes incidence, complications, and health care burdens. Some sources of this response heterogeneity have been identified. These include variables like exercise dose, meal-exercise timing, positive and negative interactions with diabetes drugs or other pharmacological agents, and more complex phenomena like genetics and glucotoxicity. However, much of the prior work is observational and correlative and few prospective studies testing the causality of such factors exist.
The aim of this research topic is to publish articles that:
1. advance our understanding of the inter-individual heterogeneity of exercise-induced changes in blood glucose control (and related variables) in humans,
2. identify the factors that influence such heterogeneity and,
3. intervene to test the causality of such factors.
Addressing these aims will provide valuable information that will facilitate the advancement of science in this field. High-quality studies and hypothesis-prompting discussions are urgently needed. For this reason, this research topic is open for the following types of articles: Original Research in human subjects (including clinical trials), Reviews (including systematic reviews of human studies), Perspectives, General Commentaries, and Opinions. Ultimately, this collection of articles will have an impact at the patient level by providing insights to help remedy the lack of therapeutic outcome seen in some individuals in response to exercise.
Topic editor Dr. Thomas Solomon is the owner of Blazon Scientific company. All other topic editors declare no competing interests with regards to the Research Topic subject.
Keywords: Diabetes prevention, Diabetes treatment, Exercise, Inter-individual variability, Type 2 diabetes
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