#65 - Interactions between exercise and insulin with Professor Erik Richter

Dr Glenn McConell chats with his great collaborator Professor Erik Richter from the University of Copenhagen in Denmark. Erik is an absolute authority and the godfather of the field of glucose metabolism during exercise and how exercise increases insulin sensitivity in muscle. He was the first to show that contraction can increase muscle glucose uptake without insulin but at the same time exercise increases insulin sensitivity. Very relevant for all including people with diabetes. We talked about how exercise increases glucose uptake during exercise and how it increases insulin sensitivity after exercise. Limitations of determining insulin sensitivity using the “gold standard” euglycemic hyperinsulinemic clamp vs meals. We also talked a little about how exercise can reduce appetite (GLP1 and lactate) . A very interesting, fun chat. Twitter: @proferikrichter.

0:00. Introduction and how Erik got into exercise research after medicine
3:05. Henrik Galbo, Jen Holst GLP1, glycogen, exercise
5:32. Adrenaline, glycogen breakdown and glucose uptake
7:20. Niel Ruderman: exercise and insulin sensitivity
9:32. Contraction increases glucose uptake independent of insulin
11:30. Relevance to type 1 diabetes
14:20. High intensity exercise increases blood glucose levels
16:15. Normal increases in insulin sensitivity after exercise in T2D
17:15. Regulation of glucose uptake into muscle during exercise
20:15. Appears AMPK not needed for glucose uptake during exercise
23:10. Reactive oxygen species and glucose uptake during exercise
24:05. Complexity of the many changes in muscle during exercise
27:00. Is there still a place for integrative physiology?
28:30. The incredible methods that Erik uses in human exercise studies
31:40. Limitations of using clamps for insulin sensitivity after exercise
35:35. Meals result in higher glucose uptake after ex than clamps
41:50. Is glucose uptake into non exercise muscle inhibited?
42:58. What need to consider when doing a clamp
45:10. Are continuous glucose monitors worth using?
47:32. Incretins (including GLP1) and insulin sensitivity after exercise
49:57. Effects of one bout vs chronic exercise (training) on insulin sensitivity
52:56. Does muscle glycogen stimulate insulin sensitivity?
57:51. Endurance vs resistance exercise for insulin sensitivity?
59:14. Erik’s impressive recent running times
59:54. HIIT, hyperglycemia, lactate, GDF15 and appetite
1:04:10. RED-S, fasting and insulin sensitivity
1:10:38. Gut glucose transport into the blood
1:15:16. A lot of glucose passes through the liver after exercise
1:16:20. How does glucose leave the capillaries to enter the muscle?
1:22:12. Takeaway messages
1:23:52. Outro (9 seconds)

Inside Exercise brings to you the who's who of research in exercise metabolism, exercise physiology and exercise’s effects on health. With scientific rigor, these researchers discuss popular exercise topics while providing practical strategies for all.
The interviewer, Emeritus Professor Glenn McConell, has an international research profile following 30 years of Exercise Metabolism research experience while at The University of Melbourne, Ball State University, Monash University, the University of Copenhagen and Victoria University.
He has published over 120 peer reviewed journal articles and recently edited an Exercise Metabolism eBook written by world experts on 17 different topics (https://link.springer.com/book/10.1007/978-3-030-94305-9).
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Not medical advice