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Journal of Diabetes Research
Volume 2017 (2017), Article ID 8314852, 8 pages
Review Article

Enhancing Exercise Responsiveness across Prediabetes Phenotypes by Targeting Insulin Sensitivity with Nutrition

1Department of Kinesiology, University of Virginia, Charlottesville, VA, USA
2Division of Endocrinology and Metabolism, University of Virginia, Charlottesville, VA, USA
3Robert M. Berne Cardiovascular Research Center, University of Virginia, Charlottesville, VA, USA

Correspondence should be addressed to Steven K. Malin; ude.ainigriv@n6mks

Received 4 July 2017; Accepted 12 November 2017; Published 13 December 2017

Academic Editor: Maria Pia Francescato

Copyright © 2017 Julian M. Gaitan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Exercise is a cornerstone therapy for chronic diseases related to multiorgan insulin resistance. However, not all individuals show the anticipated improvement in insulin sensitivity following exercise and these individuals are considered exercise resistant. Caloric restriction is an approach to enhance the effect of exercise on increasing peripheral and hepatic insulin sensitivity, as replenishing expended calories blunts these benefits. Alternatively, restricting carbohydrate intake, independent of energy balance, following exercise provides an additive effect on peripheral insulin sensitivity when compared to refeeding carbohydrate. Although carbohydrate composition modulates insulin sensitivity, few have studied effects of low glycemic index or whole-grain diets following exercise across prediabetes phenotypes on insulin sensitivity. Herein, we propose the novel hypothesis that the combination of individualized nutrition therapy and exercise should be based on the clinical pathology of prediabetes to overcome exercise resistance and improve responsiveness in people at risk for type 2 diabetes and cardiovascular disease.