Diabetes and its associated complications affect more than 20 million Americans, and the prevalence of type 2 diabetes and impaired glucose tolerance rises dramatically with age such that 40% of Americans over age 60 are affected. In older adults, glucose metabolism may be affected by reduced skeletal muscle capillary supply, which limits insulin, glucose, and oxygen delivery to skeletal muscle. Reduced capillary supply to skeletal muscle is found in older individuals with impaired glucose tolerance and we hypothesize that this is due to reduced vascular growth factor expression, and chronic inflammation. Further, we hypothesize that reversal of a sedentary lifestyle through aerobic exercise training will increase insulin signaling and vascular growth factor expression, as well as decrease inflammation, to increase capillary supply to skeletal muscle, which contributes to improved glucose metabolism in older adults. This study will: 1) Determine the mechanisms underlying reduced skeletal muscle capillarization in older adults with impaired glucose tolerance; and 2) Determine the effect of aerobic exercise training-induced increases in skeletal muscle capillarization on glucose metabolism in older adults.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
90
24 weeks of aerobic exercise training: 3 times per week, 60 minutes per session, at 70% of maximal aerobic capacity
Cessation of exercise for 2 weeks
VA Maryland Health Care System, Baltimore
Baltimore, Maryland, United States
Baseline Glucose Utilization
Insulin-stimulated glucose uptake
Time frame: baseline
Glucose Utilization (Pre/Post Intervention)
Insulin-stimulated glucose uptake
Time frame: baseline, 24 weeks, 26 weeks
Baseline Skeletal Muscle Capillarization
Time frame: baseline
Skeletal Muscle Capillarization (Pre/Post Intervention)
Time frame: baseline, 24 weeks, 26 weeks
Baseline 2-hour Postprandial Glucose
Time frame: baseline
2-hr Post-prandial Plasma Glucose Level
Time frame: baseline, 24 weeks, 26 weeks
Baseline Cardiorespiratory Fitness
maximal oxygen consumption
Time frame: baseline
Cardiorespiratory Fitness
Maximal oxygen consumption
Time frame: baseline, 24 weeks, 26 weeks
Body Composition (%Fat)
Time frame: baseline, 24 weeks
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