Exercise precision medicine for type 2 diabetes:Targeted benefit or risk?

Concurrent exercise and metformin administration may reduce the acute and chronic effects of exercise on glucose metabolism in the patients with type 2 diabetes(T2D).However,several studies suggest that combing metformin and exercise treatment may have neither additive effect nor even cause adverse effects in T2D patients.This case report aimed to highlight the challenges associated with prescribing exercise to type 2 diabetes patients undergoing metformin treatment.A 67-years old woman was followed-up for five months,including assessment of the acute and chronic glucose and lactate metabolism induced by concomitant exercise and metformin.The findings were four-fold:1)During a high-intensity interval training bout,blood glucose systematically decreased,while blood lactate concentrations fluctuated randomly;2)Basal blood lactate levels were well above 2 mmol/L on days with medication only;3)Combined exercise and metformin administration induced additive effects on the normalization of glucose and 4)high levels of physical activity had a positive impact on the continuous glucose fluctuations,while decreased levels of physical activity induced a large fluctuation of glucose due to home confinement of an infectious disease caused by the SARS-CoV-2 virus.Our findings showed that when combined with exercise and metformin treatment for T2D patients,exercise may contribute to improving glycemic control while metformin may elevate lactate levels in the long term.The observed results underline the need to prescribe exercise and monitor lactate levels for reducing possible risks associated with metformin treatment and reinforce the importance of tailoring exercise therapy.

Effects of exercise and dietary interventions on serum metabolites in men with insomnia symptoms:A 6-month randomized controlled trial

Accumulating evidence show that exercise and diet interventions are associated with improved sleep quality.Studies investigating the effects of exercise and dieting on circulating metabolomics in people with sleep disorders,particularly insomnia,are scarce.This 6-month randomized study aimed to assess the effects of exercise and dietary interventions on serum metabolites in men with insomnia symptoms.Seventy-two Finnish men(age:51.6±10.1 years)with chronic insomnia symptoms who were assigned to different intervention groups completed this study(exercise,n=24;diet,n=27;and control,n=21).The Shapiro-Wilk W-test,Levene test,Spearman correlation analysis,and analysis of variance were used for data analysis.We found that exercise and diet intervention were associated with improved sleep quality and with a number of metabolites across different biochemical pathways.Although we could not show causality,our findings provide new insight into the biological mechanisms underlying the health effects of physical activity,diet,and sleep quality.Further investigation is needed to better understand the link among lifestyle,sleep quality,and metabolic health.