Jaume Padilla1,2,3, T Dylan Olver4, John P Thyfault1,5,6, Paul J Fadel2,7. 1. Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, USA. 2. Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, USA. 3. Department of Child Health, University of Missouri, Columbia, MO, USA. 4. Department of Biomedical Sciences, University of Missouri, Columbia, MO, USA. 5. Department of Medicine, Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA. 6. Research Service, Harry S. Truman Memorial VA Hospital, Columbia, MO, USA. 7. Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO, USA.
Abstract
NEW FINDINGS: What is the topic of this review? This review highlights the importance of increased vascular insulin sensitivity for maintaining glycaemic control and cardiovascular health. What advances does it highlight? We discuss the role of habitual physical activity in modulating vascular actions of insulin. Type 2 diabetes and cardiovascular disease commonly coexist. Current evidence suggests that impaired insulin signalling in the vasculature may be a common link between metabolic and cardiovascular diseases, including glycaemic dysregulation and atherosclerosis. Herein, we highlight the importance of the actions of insulin on the vasculature for glycaemic control and arterial health. In addition, we summarize and discuss findings from our group and others demonstrating that increased physical activity may be an effective approach to enhancing vascular insulin sensitivity. Furthermore, in light of the existing literature, we formulate the hypothesis that increased shear stress may be a prime mechanism through which habitual physical activity improves insulin signalling in the vasculature. Ultimately, we propose that targeting vascular insulin resistance may represent a viable strategy for improving glycaemic control and reducing cardiovascular risk in patients with type 2 diabetes.
NEW FINDINGS: What is the topic of this review? This review highlights the importance of increased vascular insulin sensitivity for maintaining glycaemic control and cardiovascular health. What advances does it highlight? We discuss the role of habitual physical activity in modulating vascular actions of insulin. Type 2 diabetes and cardiovascular disease commonly coexist. Current evidence suggests that impaired insulin signalling in the vasculature may be a common link between metabolic and cardiovascular diseases, including glycaemic dysregulation and atherosclerosis. Herein, we highlight the importance of the actions of insulin on the vasculature for glycaemic control and arterial health. In addition, we summarize and discuss findings from our group and others demonstrating that increased physical activity may be an effective approach to enhancing vascular insulin sensitivity. Furthermore, in light of the existing literature, we formulate the hypothesis that increased shear stress may be a prime mechanism through which habitual physical activity improves insulin signalling in the vasculature. Ultimately, we propose that targeting vascular insulin resistance may represent a viable strategy for improving glycaemic control and reducing cardiovascular risk in patients with type 2 diabetes.
Authors: Jeffrey S Martin; Jaume Padilla; Nathan T Jenkins; Jacqueline M Crissey; Shawn B Bender; R Scott Rector; John P Thyfault; M Harold Laughlin Journal: J Appl Physiol (1985) Date: 2012-08-23
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