25 Nov Some Diabetics Do Not Benefit From Exercise
MedicalResearch.com Interview with:
Lauren Marie Sparks, PhD
Faculty Scientist at the Translational Research Institute for Metabolism and Diabetes
Florida Hospital and the Sanford-Burnham Medical Research Institute Orlando, FL
Medical Research: What is the background for this study? What are the main findings?
Dr. Sparks: As a clinical scientist focused on exercise effects on muscle metabolism in diabetes, I have seen first-hand a significant minority of individuals with diabetes not improve their glucose control (HbA1c) after 9 months of supervised exercise. They poured their hearts out on those treadmills 3-4 days a week for 9 months and still ended up no better than when they started. I have also seen similar data from some of my colleagues’ studies. So I really want diabetes research to invest the intellect and dollars into discovering what these roadblocks are—I happen to believe it is in the DNA (genetics) and the way that DNA is “read” or expressed (epigenetics). So it’s a bit of a ‘call to action’ for researchers to start looking into some of their data to find these people and better understand this phenomenon and for hopefully the funding sources to recognize this as a viable area of research.
Medical Research: What should clinicians and patients take away from your report?
Dr. Sparks: On the clinical side, I want practitioners to understand that some people really don’t respond to exercise—and it’s not for lack of trying. So a lack of a positive metabolic result (for diabetics, usually measured by a decrease in their HbA1c) doesn’t always mean a lack of effort. And hopefully in time the science will catch up. Right now, we know these people exist—so called “non-responders”—but we don’t currently have strategies to appropriately help them in their journey toward a healthier self. Take home is message is for clinicians to still prescribe exercise to the patients with diabetes because exercise is a full body experience that will certainly have lots of beneficial effects—such as quality of life, etc. And for those that simply are not responding, don’t tell them to stop exercising, but just continue to work with them. The overall goal of the research in this area is to identify these ‘non-responders’ to exercise and begin to develop novel strategies to treat them—i.e. imagine one day that a person could take a pill that “releases the brake” on their DNA and allows them to respond to the exercise that they are doing.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Sparks: Clinically, the recommendation is for patients with T2Diabetes to STILL EXERCISE. We are not close to having all of the answers on this topic just yet. And exercise is a full body experience that still has many beneficial effects beyond what we have looked at here. Also, we don’t want people to start ‘self-diagnosing’ as “exercise resistant”.
This publication and research is a bit of a ‘call to action’ for researchers to start looking into some of their data to find these people and better understand this phenomenon and for hopefully the funding sources to recognize this as a viable area of research. I am also halfway through a study funded by the ADA to look at this exact phenomenon—so the hope is that in the next few years, we will have more concrete answers. Imagine that one day a person could take a pill prior to training in order to “release this brake” on their DNA and benefit from the exercise in which they are engaging.
Natalie A. Stephens, Lauren M. Sparks. Resistance to the Beneficial Effects of Exercise in Type 2 Diabetes: Are Some Individuals Programmed to Fail? The Journal of Clinical Endocrinology & Metabolism, 2014; jc.2014-2545 DOI: 10.1210/jc.2014-2545