Hit Training as a Cure for Type 2 Diabetes – Prof. Dela

Hit Training as a Cure for Type 2 Diabetes – Prof. Dela
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Hit Training as a Cure for Type 2 Diabetes - Prof. Dela

Invited Session at ECSS Vienna 2016 “HIT training – Mechanisms and applicability”

Hit Training as a Cure for Type 2 Diabetes
Dela, F.
University of Copenhagen

Type 2 diabetes is characterized by a combination of insulin resistance, insufficient insulin secretory capacity and genetic disposition
combined with excess energy intake and physical. Physical training alleviates insulin resistance, may improve insulin secretory
capacity and improves glycemic control in patients with type 2 diabetes. Large clinical studies lifestyle interventions including weight
loss and increased physical activity have shown fewer hospitalizations, fewer medications, and lower health-care costs, but on
specific cardiovascular endpoints the results have been disappointing in large scale studies.
Thus, while there is no question about the effectiveness of physical training as medicine for insulin resistance, the major problem is
that the patients do not take the medicine. There are many barriers to overcome and motivation, safe environments, convenience and
lack of time are considered to be among the major reasons for not exercising on a regular basis. High intensity interval training (HIIT)
with short periods of intense exercise interspersed with brief periods of rest is a time efficient exercise modality which might surpass
some of the barriers.
As with almost any kind of exercise, an acute high intensity training bout will lower glucose concentrations in patients with type 2
diabetes. However, the longer term (training for 2 weeks or more) studies that have been conducted in patients with type 2 diabetes
have generally used insufficient methods for determining the effect of HIIT on insulin secretion and sensitivity, which are the key
parameters in the pathophysiology of type 2 diabetes. Hence, by using measurements of interstitial glucose concentrations, HOMA or
HbA1c, either marginal or no effect and significant effects of HIIT on glucose homeostasis have been reported.
None of the previous studies have used the gold standard for assessment of insulin sensitivity, the glucose clamp technique and
none have studied specifically skeletal muscle, which the tissue that takes up the vast majority of glucose during insulin stimulation.
Previous studies have addressed the molecular effects of high intensity interval training in skeletal muscle but only one study in
patients with type 2 diabetes. In general these studies shows that HIIT leads to increases in proteins (activity and/or content) related
to mitochondrial biogenesis, such as citrate synthase (CS), complexes in the mitochondrial respiratory chain, silent mating-type
information regulator 2 homolog 1 (SIRT1), peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α),
mitofusin (Mfn)-2. Also skeletal muscle GLUT4 protein and glycogen content seem to increase with HIIT, and furthermore, an
increased capacity to fat oxidation (less exercise induced decrease in glycogen and increased hydroxyl-acyl-dehydrogenase (HAD)
activity) takes place after HIIT.
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Insulin Resistance Part 1: Overview and Pathogenesis of Diabetes Mellitus

#InsulinResistance #DiabetesMellitus #Type2DiabetesMellitus #Obesity
In this visual medical lecture, Dr. Aizaz from MedicoVisual talks about Insulin Resistance:

00:00 Intro to this visual lecture
00:51 What is Insulin Resistance
05:13 Significance on Insulin Resistance – Role in Diabetes Mellitus Pathogenesis
11:23 How does Insulin Resistance occur?
19:54 Insulin Resistance analogy
20:44 Leprechaunism or Donohue Syndrome
23:23 Insulin Resistance and Obesity
24:08 Type 1 Diabetes vs Type 2 Diabetes Mellitus Mnemonic
24:58 Sneak peak of next lecture

What is Insulin resistance?
When a particular insulin concentration produces less than expected biological response, this is called insulin resistance. Insulin produces a plethora of biological responses but the clinically most relevant one is to lower the blood glucose levels.
For example, normally if 1 unit of insulin is needed to lower the blood glucose level from 200mg/dl to 150mg/dl, the body would need more units of insulin, let’s say 2 units rather than 1, to lower the same amount of glucose. Or in other words, 1 unit of insulin will lower the glucose by, let’s say, 25mg/dl rather than 50mg/dl. So, it means Insulin is present but due to some reasons there is a “resistance” to actions of insulin. This phenomenon is termed as “Insulin Resistance”.

What is the clinical significance of Insulin Resistance?
Insulin resistance is the culprit behind pathogenesis of Type 2 Diabetes Mellitus. In Type 1 DM, we know that there is destruction of beta cells of pancreas that produces insulin, which ultimately leads to absolute deficiency of insulin. Of course, that is very easy to understand that when insulin won’t be there, insulin related biological actions will be lost.
But in Type 2 Diabetes, the story is a bit counter intuitive. Insulin is present, sometimes even higher than normal, but still there is hyperglycemia. In textbooks, you might have read it multitude of times that in Type 2 DM, there is insulin resistance but most of these books never even try to explain, what the heck is insulin resistance. So, in this lecture we will discuss what really is the insulin resistance.
Other than T2DM, even in T1DM, Insulin resistance may occur (especially in the obese patients) and the patients will need more than expected exogenous insulin injections. Even in many non-Type 1 and Type 2 DM i.e. Secondary DM Insulin Resistance is often the major player contributing to hyperglycemia and other implications of the disease.
But the questions remains that how this insulin resistance actually occurs?
Before I start the discussion, a bit of disclaimer that not much is known about precise mechanism of insulin resistance yet, so the information being present in this video might be an incomplete picture of molecular details.
Insulin is a peptide hormone, so it cannot enter into the cell directly to produces the response (as the cell membrane is hydrophobic in nature).
So, there are surface receptors for the insulin, where when insulin binds, a cascade of events start inside the cell, that ultimately, through multiple pathways, leads to numerous biological responses, especially relevant here is decrease in blood glucose levels.
Now imagine if there is some problem with the receptor or one or more components of the post-receptor signaling cascade and the problem is such that these components do not work efficiently, insulin will still bind to the receptor but because they are not working so efficiently, there will be some resistance to insulin actions.
So, a commonly thought reason for the insulin resistance is some problem with the insulin receptor or the elements of downstream signaling cascade, from the receptor up to the GLUT4 channels (the insulin dependent Glucose transporters) and even the enzymes of several different pathways that are effected by the insulin.
Insulin resistance is like an angry wife. You are there and trying to touch her, “Bind with” her and stimulate her but she fails to get stimulated.
A less efficient receptor or post-receptor elements alone don’t usually lead to Diabetes Mellitus. DM is a multifactorial disease. Usually, in some people due to genetic variability (also called Polymorphism) the insulin receptors or postreceptors are less efficient inherently. However, further insults to such less efficient receptors later in life makes them even more lazier thus causing chronic hyperglycemia i.e., DM. So, genetics play crucial role in development of T2DM. But genetics alone are not the culprit for this disease. Eating habits and physical activities are the major contributors to this process.
An extreme and rare form of inherited insulin resistance is called Donohue Syndrome or Leprechaunism, caused by severe loss-of-function mutation in the insulin receptor gene. So, insulin receptors produced are faulty and are only 15% as effective as normal receptors.
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27 Comments

  1. Dr MitoFit

    In my opinion the greatest benefit to fitness and health from HIIT is mitochondrial biogenesis in skeletal and cardiac muscle. ATP to ADP with low intensity exercise and ADP to AMP with intense training. AMP triggers the signaling pathway for mitochondrial biogenesis. I wrote a book with Greg LeMond "The Science of Fitness" which explains exercise, fitness, and health as a fundamental mitochondrial process. The book includes avoiding mitochondrial toxins (there are many), the best ways to train to trigger mitochondrial biogenesis, the best supportive diet, the mitochondrial theory of aging, and mitochondrial supplements. LeMond had one of the highest VO2 Maxes ever recorded (super mitochondrial physiology and from HIIT), but later developed a mitochondrial myopathy from lead poisoning (shotgun injury). So he is the best case study in mitochondrial fitness experiencing both extremes.

  2. Dr MitoFit

    As a busy person I have tried different physical training methods and have settled with doing HIIT, namely hill repeat bicycling every other day, for the best results in the least amount of time. I am losing body fat, gaining muscle mass and tone, improving speed and endurance, sleeping better and longer, no injuries and less joint pain, and have better mental focus and concentration. I have mild muscle soreness and a continuous pleasant feeling from endorphin release. If you don't you likely aren't training intensely enough. I figure that every other day is plenty and allows ample recovery at my age 59 with no degradation in fitness from too infrequent exercise while also preventing exercise obsession and over training. It is very time efficient and avoids free radical damage from too much mileage (quality of training is more important than the quantity). Maybe not enough training volume for a young competitive world class athlete but likely optimal for overall health (i.e. lean muscle mass, cardiovascular fitness, prevention of metabolic syndrome/type 2 diabetes, mitochondrial mass, joint health, and slowing the aging process).

  3. STEPHEN OKWORI

    My heart just keeps thanking you and thanking you Dr Igudia for all you have done for me, you gave me your words that you could heal any sickness or disease, thank you for permanently curing me of my type 2 Diabetes you are amazing.

  4. Perry Scanlon

    Somebody please test the 5:5 interval. See 2nd part of Table VII in Christensen 1960 study.

  5. Abbas mukhtar

    This has been a challenging time, and I appreciate you so much Dr Igudia, you have created a life that I thought was lost, thank you so much for curing my Type 2 Diabetes

  6. Ibe Oge

    Being great full to Dr osaye from all time till all time I hope you find what your heart desires just as you have put a smile on many of our face with just your hands and herbal’s
    More grace to you work doctor thanks so much for the medication,it did fight the diabetes and nailed it..

  7. Favour Miller

    I have only made one promise to Dr osaye, and that’s when I promised to make my faith stronger, and have the guts that I will be healed, and I still don’t know how his herbs do it but I was recently tested negative for herpes and since then I’ve always had hope and never doubted
    Thanks doctor.

  8. abubakar asmau

    Being great full to Dr osaye from all time till all time I hope you find what your heart desires just as you have put a smile on many of our face with just your hands and herbal’s
    More grace to you work doctor thanks so much for the medication,it did fight the diabetes and nailed it..

  9. Dayo Solomon

    Living life to the fullest option was all I ever wanted thank you dr gboya for making that come through he gave me hope when I was lost all thanks to him 😊☺️..

  10. Auwal Muhammad

    Dr oiwoh on YouTube has really been a great impact to my health life and I'm forever grateful to God for directing me to him I recommend him,now the way to perfect healing is right in your hands🙂…

  11. Auwal Muhammad

    Dr oiwoh on YouTube has really been a great impact to my health life and I'm forever grateful to God for directing me to him I recommend him,now the way to perfect healing is right in your hands🙂…

  12. Marvin Favis

    I’ve learnt a lot from you Dr osaye ,I bless today for the the day I contacted you , I finally went for a Diabetes test and I was tested negative after 1 month of using his herbal medication I thank you Dr.

  13. Alex Becker's Channel

    From day one I always know that no problem doesn’t have a solution,but still I was thinking of how to get rid of my diabetes because I couldn’t stand it anymore,but I was suddenly recommended to Dr osaye due to the testimonies I saw, I also saw him on Instagram and then ordered the medicine, I finally came out negative for my test result thanks Dr I appreciate your kind gesture.

  14. Peter Joseph

    Humbly appreciate your kind gesture Dr osaye,you have always able to help with any health issues,the herpes virus was something the world thought has no cure but I’m happy to say today that I’ve been cured and I’m glad to have you as my doctorate .

  15. Saeed Nabilat Ahmed

    Since I’ve been seeing testimonies about Dr Osaye,I’ve always had hope that the world can be a better place,and there will be other people who also have different medical and herbal abilities,sometimes the fact that I always get depressed about my type two diabetes kills me the more,but he was able to help me with a herbal cure,now I can finally live a healthy life.

  16. mukhtar yusuf dundaye

    Thank you so much Dr osaye for fulfilling your trust,I and my lovely wife are very greatfull for your help with the herbal medicine for the type two diabetes,it hasn’t been easy suffering with that after so many years ,I’m so great-full.

  17. Bamidele Ishola

    Having Dr osaye as my personal herbal doctor has been something I should always keep thanking myself for now I never have to worry too much, he has all herbal potential, and I’ve always believed in your work so happy to be free from erectile dysfunction.

  18. saviour sampson

    I love DR Osaye for a reason, and it's that he is really steadfast to his work and has a great idea for what he is doing, I really want to appreciate him for helping me get rid of my type two diabetes.

  19. Abdulazeez Modinat

    I sincerely appreciate you Dr osaye, and you do have my full trust,you should be heard around the world , and you have a way of speach that entices me,thank you so much for curing my diabetes I had thought would never end.

  20. KEHINDE EDEMA

    Thank you so much Dr osaye for your ultimate help and I understanding in curing my p
    Diabetes type two now I know that anything is curable , you are good at what you do,keep up the good work .

  21. dr afzal critical care medicine

    Amazing knowledge and video

  22. Hassaan Tahir

    Brilliant video! 10/10 for the content 👏

  23. Anwar ul Haq

    V er y beautiful explaining of of topic. Very easily absorbable and understandsble to
    Pic

  24. Pipul Dewan

    Your explanation is amazing in a word . Very very thankful and blessed to have you as a teacher.Hope you will be continuing this.love from the core of my heart and I really mean it .

  25. Ritesh Wadhwani

    Great effort And great way of teaching ❤️ we are eagerly waiting of cvs embryo as well as physiology also

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