Exercise precision medicine for type 2 diabetes: Targeted benefit or risk?

Concurrent exercise and metformin administration may reduce the acute and chronic effects of exercise on glucose metabolism in the patients with type 2 diabetes (T2D). However, several studies suggest that combing metformin and exercise treatment may have neither additive effect nor even cause adver...

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Main Authors: Shenglong Le, Moritz Schumann, Siman Lei, Wu Yao, Sulin Cheng
Format: Article
Language:English
Published: KeAi Communications Co., Ltd. 2023-06-01
Series:Sports Medicine and Health Science
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666337623000082
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author Shenglong Le
Moritz Schumann
Siman Lei
Wu Yao
Sulin Cheng
author_facet Shenglong Le
Moritz Schumann
Siman Lei
Wu Yao
Sulin Cheng
author_sort Shenglong Le
collection DOAJ
description Concurrent exercise and metformin administration may reduce the acute and chronic effects of exercise on glucose metabolism in the patients with type 2 diabetes (T2D). However, several studies suggest that combing metformin and exercise treatment may have neither additive effect nor even cause adverse effects in T2D patients. This case report aimed to highlight the challenges associated with prescribing exercise to type 2 diabetes patients undergoing metformin treatment. A 67-years old woman was followed-up for five months, including assessment of the acute and chronic glucose and lactate metabolism induced by concomitant exercise and metformin. The findings were four-fold: 1) During a high-intensity interval training bout, blood glucose systematically decreased, while blood lactate concentrations fluctuated randomly; 2) Basal blood lactate levels were well above 2 mmol/L on days with medication only; 3) Combined exercise and metformin administration induced additive effects on the normalization of glucose and 4) high levels of physical activity had a positive impact on the continuous glucose fluctuations, while decreased levels of physical activity induced a large fluctuation of glucose due to home confinement of an infectious disease caused by the SARS-CoV-2 virus. Our findings showed that when combined with exercise and metformin treatment for T2D patients, exercise may contribute to improving glycemic control while metformin may elevate lactate levels in the long term. The observed results underline the need to prescribe exercise and monitor lactate levels for reducing possible risks associated with metformin treatment and reinforce the importance of tailoring exercise therapy.
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spelling doaj.art-42dc942fa626473c9f687e1718cb0fdf2023-06-23T04:44:34ZengKeAi Communications Co., Ltd.Sports Medicine and Health Science2666-33762023-06-0152146150Exercise precision medicine for type 2 diabetes: Targeted benefit or risk?Shenglong Le0Moritz Schumann1Siman Lei2Wu Yao3Sulin Cheng4Physical Education Department, Shanghai Jiao Tong University, Shanghai, China; Department of Physical Therapy, Taihe Hospital Affiliated to Hubei University of Medicine, Shiyan, China; Exercise Translational Medicine Center, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FinlandExercise Translational Medicine Center, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China; Department of Molecular and Cellular Sport Medicine, German Sport University, Cologne, GermanyExercise Translational Medicine Center, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China; Faculty of Education, University of Macao, Macao, ChinaPhysical Education Department, Shanghai Jiao Tong University, Shanghai, ChinaPhysical Education Department, Shanghai Jiao Tong University, Shanghai, China; Exercise Translational Medicine Center, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland; Corresponding author. Physical Education Department, Shanghai Jiao Tong University, Shanghai, 200240, China.Concurrent exercise and metformin administration may reduce the acute and chronic effects of exercise on glucose metabolism in the patients with type 2 diabetes (T2D). However, several studies suggest that combing metformin and exercise treatment may have neither additive effect nor even cause adverse effects in T2D patients. This case report aimed to highlight the challenges associated with prescribing exercise to type 2 diabetes patients undergoing metformin treatment. A 67-years old woman was followed-up for five months, including assessment of the acute and chronic glucose and lactate metabolism induced by concomitant exercise and metformin. The findings were four-fold: 1) During a high-intensity interval training bout, blood glucose systematically decreased, while blood lactate concentrations fluctuated randomly; 2) Basal blood lactate levels were well above 2 mmol/L on days with medication only; 3) Combined exercise and metformin administration induced additive effects on the normalization of glucose and 4) high levels of physical activity had a positive impact on the continuous glucose fluctuations, while decreased levels of physical activity induced a large fluctuation of glucose due to home confinement of an infectious disease caused by the SARS-CoV-2 virus. Our findings showed that when combined with exercise and metformin treatment for T2D patients, exercise may contribute to improving glycemic control while metformin may elevate lactate levels in the long term. The observed results underline the need to prescribe exercise and monitor lactate levels for reducing possible risks associated with metformin treatment and reinforce the importance of tailoring exercise therapy.http://www.sciencedirect.com/science/article/pii/S2666337623000082Exercise medicineHyperlactatemiaBlood glucoseExercise interventionCase report
spellingShingle Shenglong Le
Moritz Schumann
Siman Lei
Wu Yao
Sulin Cheng
Exercise precision medicine for type 2 diabetes: Targeted benefit or risk?
Sports Medicine and Health Science
Exercise medicine
Hyperlactatemia
Blood glucose
Exercise intervention
Case report
title Exercise precision medicine for type 2 diabetes: Targeted benefit or risk?
title_full Exercise precision medicine for type 2 diabetes: Targeted benefit or risk?
title_fullStr Exercise precision medicine for type 2 diabetes: Targeted benefit or risk?
title_full_unstemmed Exercise precision medicine for type 2 diabetes: Targeted benefit or risk?
title_short Exercise precision medicine for type 2 diabetes: Targeted benefit or risk?
title_sort exercise precision medicine for type 2 diabetes targeted benefit or risk
topic Exercise medicine
Hyperlactatemia
Blood glucose
Exercise intervention
Case report
url http://www.sciencedirect.com/science/article/pii/S2666337623000082
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AT wuyao exerciseprecisionmedicinefortype2diabetestargetedbenefitorrisk
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