Adipose tissue lipolytic inhibition enhances the glucoregulatory properties of exercise in type 2 diabetes patients

Aims: Exercise combined with adipose tissue lipolytic inhibition augments intramuscular lipid and glycogen use in type 2 diabetes patients. The present study investigates the impact of adipose tissue lipolytic inhibition during exercise on subsequent postprandial glycemic control in type 2 diabetes patients. Methods: Fourteen male type 2 diabetes patients (age 65 ± 2 years, HbA1c 6.7 ± 0.1% (50 ± 2 mmol/mol)) participated in a double-blind placebo-controlled randomized cross-over study in which subjects performed endurance-type exercise after being administered 250 mg of a nicotinic acid analogue (acipimox; ACP) or a placebo (PLA). A control experiment was included in which no exercise was performed (CON). Results: Sixty minutes of endurance-type exercise (at 45% Wpeak) did not significantly lower circulating plasma glucose and insulin excursions in PLA when compared with CON (P = .300). Acipimox administration strongly reduced circulating plasma FFA concentrations during exercise (P < .001). Circulating plasma glucose and insulin excursions were substantially lower during 7.5 h of recovery from exercise (i.e. postprandial) in ACP when compared with either CON (P = .041 and P = .002, respectively) or PLA (P = .009 and P = .001, respectively). Conclusions: Collectively, exercise with adipose tissue lipolytic inhibition reduces postprandial blood glucose and insulin excursions and, as such, further improves glycemic control in male type 2 diabetes patients