Intense exercise can improve insulin sensitivity. In the modern world this is of great importance, because the initial phase of diabetes usually means worsening the sensitivity of tissues to insulin. Under normal circumstances, sugar circulating in the blood can not be delivered to the muscles without mediating insulin. 

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The exception to the rule is the situation occurring after intense physical work (then the GLUT4 family receptor translocates to the cell surface). In type II diabetes, the number of glucose transporters of the GLUT4 family is normal, unfortunately insulin fails on the signal path associated with IRS-1 (insulin receptor substrate). In diabetes, GLUT4 translocation into the cell membrane is impaired. Translocation, i.e., transporting the transporter from cytoplasmic vesicles to the surface of the cell membrane. 

It should be added that 90% of the total number of transporters is inside the cell, in the membrane only 10%. 2 Without transferring, glucose can not penetrate inside the cells (protected by a lipid bilayer). This causes a lot of glucose in the blood, while β-pancreatic cells produce more and more insulin. Initially, nothing happens, but over time, the growing load causes β-pancreatic cell hypertrophy and their death! 3 Physical exercise can activate the insulin signaling pathway, restore expression of the glucose transporter (GLUT4). 

There are two main routes responsible for transporting glucose into the cells 

Which training improves insulin sensitivity? 

Intensive, continuous endurance exercise 6 lasting 45-60 minutes with intensity of 65-75% VO2 max (79-86% of maximal heart rate) increases tyrosine phosphorylation in insulin receptor, activates IRS proteins and increases PI3-K activity (PI3-K = phosphatidylinositol kinase) in untreated, healthy and insulin-resistant muscles. In addition, a similar session increases the activity of factors such as Rac1, AS160 and TBC1D1. 

In the study of SoJung Lee et al. 5 aerobic training (on an electronic treadmill or elliptical trainer), was conducted for 3 months, 3x a week and had a marked effect on many glycemic parameters. Initially, the sessions lasted 40 minutes, then each time 60 minutes (3 hours per week). There was an insignificant decrease in fasting glucose (2.3%) and a more significant decrease in fasting insulin (26.6%). Unfortunately, training without dietary intervention alone had no effect on hepatic insulin sensitivity (a slight decrease was noted), but improved peripheral insulin sensitivity (by 32.9%). 

HIIT training, e.g. 12 intervals, 60 seconds of work / 120 seconds of rest 8.9 (fasting glucose decreased by 6.6%), 

In the studies of Chien-Te Ho et al. 7 young men performed three days in a row of 100 m sprints (converged from the hill) and performed 20 sit-ups with a weight of ~ 13.6 kg. In the glucose tolerance test (OGTT), there was a greater drop in blood sugar levels after exercise. 75-100 g glucose is given at OGTT. When it comes to strength training, bodybuilding work or other low-intensity training does not have a big impact on insulin sensitivity. 5 The situation will look completely different when combining sessions such as TABLES, stations with intervals (eg 5 × 5 minutes). However, it should be added that in many studies strength training (even bad, including 4 exercises such as barbells, leg straightening, bench pressings and paddling on the machine) reduced fasting insulin and fasting blood glucose (5.8 decrease). % after 12 weeks of training, he also improved the HOMA-IR index.

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