Introduction: Diabetes mellitus type II forms major among non communicable diseases worldwide causing greater disability and impact on economy of individual and society physical activities, particularly hi intensity exercises are emerging area where more research are required.

Amis & Objectives of this monograph presentation was to critically analyse the impact of hi intensity resisted exercises among type II diabetic subjects.

Materials & Methodology: 6 type II diabetic subjects were treated with single session of high intensity resisted exercises. The subjects post parandial blood glucose was analyzed with statistical means

Results: highly significant statistically P<.001

Conclusion: with various limitations with high intensity exercises, needs further scientific validation and research for its effect on sustaining of glycemic control among researchers academician was mainly emphasized as key outcome of this monograph report.

Keywords: Hba₁c – Glycated Hemoglobin, GLUT4 - Glucose Transporter Type 4, Quality of life, HIE – High Intensity Exercises, Physical Exercises, RCT – Randomized Control Trial, FG- Fasting Glucose.

1. Shaw, R.A. Sicree, P.Z. Zimmet Baker IDI Heart and Diabetes Institute, Australia. Diabetes Atlas Global estimates of the prevalence of diabetes for 2010 and 2030. diabetes research and clinical practice 87 (2010) 4–14
2. Zhang P, Zhang X, Brown J, et al. Global healthcare expenditure on diabetes for 2010 and 2030. Diabetes Res Clin Pract2010;87:293–301 
3. Colberg, Facsm Ronald J. Sigal, Bo Fernhall, Judith G. Regensteiner Bryan J. Blissmer, Richard R. Rubin, Lisa Chasan-Taber, Ann L. Albright, Barry Braun. Exercise And Type 2 Diabetes. The American College Of Sports Medicine And The American Diabetes Association: Joint Position Statement. Diabetes Care, Volume 33, Number 12, December 2010, Pp: E 147- E 167
4. Cauza E, Hanusch-Enserer U, Strasser B, Kostner K, Dunky A, et al. (2005) Strength and endurance training lead to different post exercise glucose profiles in diabetic participants using a continuous subcutaneous glucose monitoring system. Eur J Clin Invest 35: 745-751.
5. Lee JS, Bruce CR, Tunstall RJ, CameronSmith D, Hugel H, Hawley JA: Interaction of exercise and diet on GLUT-4 protein and gene expression in type I and type II rat skeletal muscle. Acta Physiol Scand 175:37–44, 2002
6. Terada S, Yokozeki T, Kawanaka K, Ogawa K, Higuchi M, Ezaki O, Tabata I: Effects of high-intensity swimming training on GLUT-4 and glucose transport activity in rat skeletal muscle. J Appl Physiol 90:2019–2024, 2001
7. Stratton I, Cull C, Adler A, Matthews D, Neil H, Holman R. Additive effects of glycaemia and blood pressure exposure on risk of complications in type 2 diabetes: a prospective observational study (UKPDS 75) 2006;49:1761–1769. doi: 10.1007/s00125-006-0297-1.
8. Holten MK, Zacho M, Gaster M, Juel C, Wojtaszewski JFP, Dela F. Strength training increases insulin-mediated glucose uptake, GLUT4 content, and insulin signaling in skeletal muscle in patients with type 2 diabetes. Diabetes.  2004; 53(2):294–305.
9. Koranyi I , R. E. Bourey. Level of skeletal muscle glucose transporter protein correlates with insulin-stimulated whole body glucose disposal in man. Diabetologia (1991) 34:763-765
10. Boule NG, Haddad E, Kenny GP, Wells GA, Sigal RJ. Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: a meta-analysis of controlled clinical trials. 2001;286 (10):1218–27. doi: 10.1001/jama.286.10.1218. 
11. Boulé NG, Kenny GP, Haddad E, Wells GA, Sigal RJ. Meta-analysis of the effect of structured exercise training on cardiorespiratory fitness in Type 2 diabetes mellitus. 2003 Aug;46(8): 1071-81. Epub 2003 Jul 10.
12. Wei M, Gibbons LW, Kampert JB,  Nichaman MZ, Blair SN. Low cardiorespiratory fitness and physical inactivity as predictors of mortality in men with type 2 diabetes. Ann Intern Med.2000 Apr 18;132(8):605-11.
13. Wing RR: Exercise and weight control. In Handbook of Exercise in Diabetes. 2nd ed. Ruderman N, Devlin JT, Schneider SH, Kriska A, Eds. Alexandria, VA, American Diabetes Association, 2002, p. 355–364
14. Ross R, Dagnone D, Jones PJ, Smith H, Paddags A, Hudson R, Janssen I: Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men: a randomized, controlled trial. Ann Intern Med133:92–103, 2000
15. Klem ML, Wing RR, McGuire MT, Seagle HM, Hill JO: A descriptive study of individuals successful at long-term maintenance of substantial weight loss. Am J Clin Nutr66:239–246, 1997
16. Weinsier RL, Hunter GR, Desmond RA, Byrne NM, Zuckerman PA, Darnell BE: Free-living activity energy expenditure in women successful and unsuccessful at maintaining a normal body weight. Am J Clin Nutr75:499–504, 2002
17. Albright A, Franz M, Hornsby G, et al. : American College of Sports Medicine. Position Stand: exercise and type 2 diabetes. Med Sci Sports Exerc2000;32 (7):1345–60
18. American College of Sports Medicine Position Stand. Exercise and physical activity for older adults. Med Sci Sports Exerc.1998 Jun;30(6):992-1008.
19. Dunstan DW, Daly RM, Owen N, et al. : High-intensity resistance training improves glycemic control in older patients with type 2 diabetes. Diabetes Care2002;25(10):1729–36
20. Colberg SR, Sigal RJ, Fernhall B,  Regensteiner JG, Blissmer BJ, Rubin RR, Chasan-Taber L, Albright AL, Braun B; American College of Sports Medicine; American Diabetes Association. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care.2010 Dec;33(12):e147-67. doi: 10.2337/dc10-9990.
21. Sigal RJ, Kenny GP, Wasserman DH, Castaneda-Sceppa C: Physical activity/ exercise and type 2 diabetes. Diabetes Care2004;27(10):2518–39
22. American Diabetes Association Standards of medical care in diabetes, 2012. Diabetes Care. 2012;35(Suppl 1):S11–S63. 
23. Wingate Test. [Video]2010 Available from: http://www.youtube.com/-watch?v=TCfgA3SurnMAccessed October 15, 2012
24. Gaesser GA, Angadi SS. High-intensity interval training for health and fitness: can less be more? J Appl Physiol. 2011;111 (6):1540–1541.
25. Little JP, Gillen JB, Percival ME, et al. Low-volume high-intensity interval training reduces hyperglycemia and increases muscle mitochondrial capacity in patients with type 2 diabetes. J Appl Physiol. 2011;111(6):1554–1560. 
26. Ritov VB, Menshikova EV, He J, Ferrell RE, Goodpaster BH, Kelley DE. 2005. Deficiency of subsarcolemmal mitochondria in obesity and type 2 diabetes. Diabetes54:8–14
27. Bruce CR, Anderson MJ, Carey AL,  Newman DG, Bonen A, Kriketos AD,  Cooney GJ, Hawley JA. Muscle oxidative capacity is a better predictor of insulin sensitivity than lipid status. J Clin Endocrinol Metab.2003 Nov;88(11):5444-51.
28. Holloszy JO. Skeletal muscle "mitochondrial deficiency" does not mediate insulin resistance. Am J Clin Nutr.2009 Jan;89(1):463S-6S. doi: 10.3945/ajcn.2008.26717C. Epub 2008 Dec 3.
29. Ren CL, Morio T, Fu SM, Geha RS. Signal transduction via CD40 involves activation of lyn kinase and phosphatid-ylinositol-3-kinase, and phosphorylation of phospholipase C gamma 2. J Exp Med.1994 Feb 1;179(2):673-80.
30. Wallace TM, Matthews DR. The assessment of insulin resistance in man. Diabet Med. 2002;19:527–534. 
31. Koyama Y, Coker RH, Denny JC, et al. Role of carotid bodies in the neuroendocrine response to exercise. Am J Physiol. 2001;281:E742–E748
32. Wasserman DH, Mohr T, Kelly P, Lacy DB, Bracy D. Impact of insulin deficiency on glucose fluxes and muscle glucose metabolism during exercise.  1992;41:1229–1238.
33. Kir S, Beddow SA, Samuel VT, Miller P, Previs SF, Suino-Powell K, Xu HE, Shulman GI, Kliewer SA, Mangelsdorf DJ. FGF19 as a postprandial, insulin-independent activator of hepatic protein and glycogen synthesis.   2011;331:1621–1624
34. Sigal GB, Bamdad C, Barberis A,  Strominger J, Whitesides GM. A self-assembled monolayer for the binding and study of histidine-tagged proteins by surface plasmon resonance. Anal Chem.1996 Feb 1;68(3):490-7.
35. Trost S.G., Pate R.R., Sallis J.F., Freedson P.S., Taylor W.C., Dowda M., Sırard J. (2002) Age and gender differences in objectively measured physical activity in youth. Medicine Science & Sports Exercise34, 350-5 
36. Maurer K, Volk S, Gerbaldo H. Auguste D and Alzheimer's disease. 1997 May 24;349(9064):1546-9.
37. Eriksson, A.E., Baase, W.A., Zhang, X.-J., Heinz, D.W., Blaber, M., Baldwin, E.P., & Matthews, B.W. (1992). Response of a protein structure to cavity-creating mutations and its relation to the hydrophobic effect. Science 255, 178-183.
38. Ishii T, Yamakita T, Sato T, Tanaka S, Fujii S. Resistance training improves insulin sensitivity in NIDDM subjects without altering maximal oxygen uptake. Diabetes Care. 1998;21(8):1353–1355.
39. Dunstan DW, Puddey IB, Beilin LJ, Burke V, Morton AR, Stanton KG. Effects of a short-term circuit weight training program on glycaemic control in NIDDM. Diabetes Research and Clinical Practice. 1998; 40(1):53–61.
40. Castaneda C, Layne JE, Munoz-Orians L, et al. A randomized controlled trial of resistance exercise training to improve glycemic control in older adults with type 2 diabetes. Diabetes Care. 2002;25 (12):2335–2341.
41. Short etal 2010
42. Kjaer M, Hollenbeck CB, Frey-Hewitt B, Galbo H, Haskell W, Reaven GM. Glucoregulation and hormonal responses to maximal exercise in non-insulin-dependent diabetes. J Appl Physiol.  1990;68(5):2067–2074. 
43. Babraj JA, Vollaard NB, Keast C, Guppy FM, Cottrell G, Timmons JA. Extremely short duration high intensity interval training substantially improves insulin action in young healthy males. BMC Endocr Disord. 2009;9:3.
44. Richards, Tyler K. Johnson, Jessica N. Kuzma, Mark C. Lonac, Melani M. Schweder, Wyatt F. Voyles and Christopher Bell. Short-term sprint interval training increases insulin sensitivity in healthy adults but does not affect the thermogenic response to β-adrenergic stimulation. Jennifer. The Physiological Society. J Physiol 588.15 (2010) pp 2961–2972
45. Peter Adams. The impact of brief high-intensity exercise on blood glucose levels. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2013:6, 113–122
46. Burgomaster KA, Cermak NM, Phillips SM, Benton CR, Bonen A, Gibala MJ. Divergent response of metabolite transport proteins in human skeletal muscle after sprint interval training and detraining. Am J Physiol Regul Integr Comp Physiol. 2007;292:R1970–R1976.
47. Nybo L (2010) Cycling in the heat: performance perspectives and cerebral challenges. Scand J Med Sci Sports 20: 71–79.L. Nybo2010Cycling in the heat: performance perspectives and cerebral challenges.Scand J Med Sci Sports207179
48. Guelfi K. J., Jones T. W., and Fournier P. A.. 2005. The decline in blood glucose levels is less with intermittent high‐intensity compared with moderate exercise in individuals with type 1 diabetes. Diabetes Care28:1289–1294.
49. Cullen, Clint Cummins , Victor R. Fuchs. Geographic and Racial Variation in Premature Mortality in the U.S.: Analyzing the Disparities. April 2012 | Volume 7 | Issue 4. Plosone.org.
50. Sandvei M, Jeppesen PB, Støen L, Litleskare S, Johansen E, Stensrud T, Enoksen E, Hautala A, Martinmäki K, Kinnunen H, Tulppo M, Jensen J. Sprint interval running increases insulin sensitivity in young healthy subjects. Arch Physiol Biochem.2012 Jul;118(3):139-47. doi: 10.3109/13813455.2012.677454. Epub 2012 Apr 28.
51. Nagi D, Gallen I. ABCD position statem-ent on physical activity and exercise in diabetes. Practical Diabetes International.  2010;27(4):158–163a.
52. Gibala MJ, McGee SL. Metabolic adaptations to short-term high-intensity interval training: a little pain for a lot of gain? Exerc Sport Sci Rev. 2008;36:58–63.
53. Gibala MJ, Little JP, Macdonald MJ, Hawley JA. Physiological adaptations to low-volume, high-intensity interval training in health and disease. J Physiol. 2012;590:1077–84.
54. Talanian J, Galloway S, Heigenhauser G, Bonen A, Spriet L. Two weeks of high-intensity aerobic interval training increases the capacity for fat oxidation during exercise in women. J Appl Physiol. 2007;102(4):1439–1447. doi: 10.1152/japplphysiol.01098.2006.
55. Gunczler P, Lanes R, Paz-Martinez V, Martins R, Esaa S, Colmenares V, Weisinger JR: Decreased lumbar spine bone mass and low bone turnover in children and adolescents with insulin dependent diabetes mellitus followed longitudinally. J Pediatr Endocrinol Metab11:413–419, 1998.

Dr S.S. Subramanian

M.P.T (Orthopaedics), M.S (Education), M. Phil (Education), Ph.D (Physiotherapy)

The Principal, Sree Balaji College of Physiotherapy, Chennai – 100

Affiliated To (Bharath) University, BIHER Chennai – 73

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., This email address is being protected from spambots. You need JavaScript enabled to view it.

Phone: 99400 47137