By Wendy S. Meyer
More 30 million Americans have Type 2 Diabetes related to the obesity epidemic—this is approximately 9.4 percent of the entire U.S. population. Physicians and researchers know that lifestyle interventions can prevent diabetes, slow its progression and decrease the need for medications. Importantly, improved physical fitness increases life expectancy. The problem is that having diabetes interferes with one’s ability to exercise comfortably and effectively.
At the University of Colorado Anschutz Medical Campus, two researchers, Jane Reusch, MD and Judy Regensteiner, PhD are working in an interdisciplinary way to understand the mechanisms responsible for causing exercise to be more difficult and less effective in people with diabetes. In a collaboration that started in the mid-1990s, Professor of Medicine and Biochemistry Jane Reusch and Professor of Medicine and Director of the Center for Women’s Health Research Judy Regensteiner have been conducting multi-year investigations of molecular barriers to exercise in diabetes.
In this translational research program Dr. Reusch, the physician, brings special expertise in cell, molecular and rodent models of diabetes and, Dr. Regensteiner, a PhD clinical researcher, brings special expertise in vascular medicine, exercise physiology and evaluating these same interventions in human subjects. Together they have been working together for two decades using the adult Clinical and Translational Research Center at the CCTSI.
“We partner in our research,” says Regensteiner. “I don’t do animal research. Because Jane does, it has brought a lot of insights into the work we do in humans.”
Reusch says that people with Type 1 or 2 diabetes, even children, have a 20 percent decrease in maximal cardiorespiratory fitness. Together, Reusch and Regensteiner have characterized defects in maximal and submaximal exercise capacity.
Their work has provided proof that by targeting the functional defects in diabetes, individuals can improve their exercise dysfunction. In other words, they can exercise more comfortably and effectively. Especially important to this research team is their observation that women with diabetes have an even greater impairment in exercise function than do men with diabetes.
“We don’t want to replace exercise with a pill,” says Reusch. “We want a pill so that people can exercise.” The result will be that people with diabetes will not feel that exercise is so difficult, especially in the first few minutes. The hope is that if exercise feels easier, people will be more likely to engage in it and stick to their doctor’s recommendations.
“We want to help people with Type 2 Diabetes be more active and have healthier lives. If we can achieve that, we will be very happy,” Regensteiner says.
Reusch has a unique perspective, as she is an MD with an appointment at the VA Hospital in addition to being a basic and translational researcher. Her diabetes experience and expertise are widely renowned: this year she is the President of Medicine and Science for the American Diabetes Association.
Drs. Regensteiner and Reusch are leading three studies in the CCTSI’s adult Clinical and Translational Research Center. One study focuses on leg blood flow and muscle deoxygenation kinetics in Type 2 diabetes. Another looks at the impact of sitagliptin, an FDA approved drug for diabetes, on cardiovascular exercise performance in Type 2 diabetes. The third study, just starting, will examine sex differences in the way the heart and blood vessels respond to exercise training in men and women with and without diabetes, this is a VA funded research program.
Both Regensteiner and Reusch agree, “The payoff will be to improve the ability to enjoy day-to-day life and physical activity, and ultimately increase health span.”