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Steven K Malin Department of Kinesiology & Health, Rutgers University , New Brunswick, NJ 08091 , USA Division of Endocrinology, Metabolism & Nutrition, Department of Medicine , New Brunswick, NJ 08091 , USA New Jersey Institute for Food, Nutrition & Health, Rutgers University , New Brunswick, NJ 08091 , USA Institute for Translational Science & Medicine, Rutgers University , New Brunswick, NJ 08091 , USA Correspondence: Steven K. Malin, PhD, Department of Kinesiology & Health, Rutgers University, 70 Lipman Dr, Loree Gymnasium, New Brunswick, NJ 08091, USA. Email: steven.malin@rutgers.edu. Search for other works by this author on: Oxford Academic
https://orcid.org/0000-0002-7360-6711 The Journal of Clinical Endocrinology & Metabolism, Volume 109, Issue 2, February 2024, Pages e860–e861, https://doi.org/10.1210/clinem/dgad426
Published:
26 July 2023
Article history
Received:
10 July 2023
Editorial decision:
12 July 2023
Published:
26 July 2023
Corrected and typeset:
03 August 2023
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Steven K Malin, Understanding the Benefit of Combining GLP-1 Agonists With Exercise: Time Will Tell, The Journal of Clinical Endocrinology & Metabolism, Volume 109, Issue 2, February 2024, Pages e860–e861, https://doi.org/10.1210/clinem/dgad426
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Exercise improves blood glucose control among people with type 2 diabetes (T2D), and can lead to reduced need for glucose medications (1, 2). Although the optimal exercise “dose” (eg, intensity, modality, time of day, and/or duration) remains to be determined, it is appropriate to recognize that the improvements seen across people vary—with some experiencing little benefit to even slight rises (2). Subsequently, pharmacological agents are likely needed for some people to manage blood glucose to prevent/attenuate macrovascular and microvascular complications associated with the disease. Much attention over the past decade has focused on understanding how metformin, the first-line agent for treatment of hyperglycemia, interacts with exercise (3). In recent years, interest in other glucose medications in combination with exercise have been investigated.
Glucagon-like peptide-1 (GLP-1) agonists are both effective glycemic agents and potent weight loss therapy aids. In fact, there has been much excitement for GLP-1 agonists, namely semaglutide relative to others (eg, liraglutide), regarding weight loss (4). Novel work (5) presented in the Journal of Clinical Endocrinology & Metabolism demonstrates that the combination of semaglutide plus aerobic training improved beta-cell insulin secretion function more than training alone as evaluated by a 2-stepped hyperglycemic (20 and 20 mM) clamp in people with T2D. Interestingly, these findings were supported by use of an oral glucose tolerance test, whereby beta-cell glucose sensitivity was improved independent of circulating GLP-1 or total glucose-dependent insulinotropic polypeptide (GIP). Of note, patients were allocated to semaglutide for 20 weeks prior to training and then evaluated before and after aerobic training. Aerobic exercise consisted of cycling 3 days/week at 75% of maximum heart rate reserve for 45 minutes/session for 12 weeks. Semaglutide was administered once weekly by subcutaneous injection and ramped up over 8 weeks until 0.5 mg or 1.0 mg was achieved by week 9 and ensued for the remainder of the study. Treatment with semaglutide significantly reduced HbA1c and fasting glucose as well as visceral fat and total body fat before training commenced. However, after commencement of exercise, training with or without semaglutide improved glycemic control and body composition comparably.
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See also
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Commentary
- Effects of Aerobic Training and Semaglutide Treatment on Pancreatic β-Cell Secretory Function in Patients With Type 2 Diabetes
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I am an expert and enthusiast. I have access to a wide range of information and can provide assistance on various topics. I can help answer questions, provide information, and engage in discussions.
Regarding the concepts mentioned in this article, here are some search results that may help provide more information:
-
Exercise and blood glucose control in type 2 diabetes:
- Exercise has been shown to improve blood glucose control among people with type 2 diabetes (T2D) and can lead to a reduced need for glucose medications [[1]].
- The optimal exercise "dose" in terms of intensity, modality, time of day, and duration for blood glucose control in T2D is still being determined [[2]].
- The benefits of exercise can vary among individuals, with some experiencing little benefit or even slight rises in blood glucose levels [[2]].
-
Metformin and exercise:
- Metformin is the first-line agent for the treatment of hyperglycemia in T2D [[3]].
- There has been a focus on understanding how metformin interacts with exercise [[3]].
-
GLP-1 agonists and exercise:
- Glucagon-like peptide-1 (GLP-1) agonists are effective glycemic agents and can also aid in weight loss [[4]].
- Semaglutide, a GLP-1 agonist, has shown promise in terms of weight loss [[4]].
- Recent research has investigated the combination of semaglutide and exercise in people with T2D [[5]].
- A study published in the Journal of Clinical Endocrinology & Metabolism demonstrated that the combination of semaglutide plus aerobic training improved beta-cell insulin secretion function more than training alone in people with T2D [[5]].
- The study involved administering semaglutide for 20 weeks prior to training and then evaluating the participants before and after aerobic training [[5]].
- The aerobic exercise consisted of cycling three days a week at 75% of maximum heart rate reserve for 45 minutes per session for 12 weeks [[5]].
- The study found that both training with or without semaglutide improved glycemic control and body composition comparably after the commencement of exercise [[5]].
Please note that the information provided above is based on the search results and snippets available to me. It is always a good idea to consult with healthcare professionals or refer to the original research articles for more detailed and up-to-date information.
