Acute hypoxia improves insulin sensitivity (SI2*) and β cell function in individuals with Type 2 Diabetes

Type 2 diabetes is a multifactorial metabolic disease characterized by defects in β-cells function, insulin sensitivity, glucose effectiveness and endogenous glucose production (1). It is widely accepted that insulin and exercise are potent stimuli for glucose transport (2). Acute exercise is known to promote glucose uptake in skeletal muscle via an intact contraction stimulated mechanism (3), while post-exercise improvements in glucose control are due to insulin-dependant mechanisms (2). Hypoxia is also known to promote glucose uptake in skeletal muscle using the contraction stimulated pathway. This has been shown to occur in vitro via an increase in β-cell function, however data in vivo is lacking. The aim of this study was to examine the effects of acute hypoxia with and without exercise on insulin sensitivity (SI2*), glucose effectiveness (SG2*) and β-cell function in individuals with type 2 diabetes. Following an overnight fast, six type 2 diabetics, afer giving informed written consent, completed 60 min of the following: 1) normoxic rest (Nor Rest); 2) hypoxic rest [Hy Rest; O2 = 14.6 (0.4)%]; 3) normoxic exercise (Nor Ex); 4) hypoxic exercise [Hy Ex; O2 = 14.6 (0.4)%]. Exercise trails were set at 90% of lactate threshold. Each condition was followed by a labelled intravenous glucose tolerance test (IVGTT) to provide estimations of SI2*, SG2* and β-cell function. Values are presented as means (SEM). Two-compartmental minimal model analysis showed SI2* to be higher following Hy Rest when comparisons were made with Nor Rest (P = 0.047). SI2* was also higher following Hy Ex [4.37 (0.48) x10-4 . min-1 (μU/ml)] compared to Nor Ex [3.24 (0.51) x10-4 . min-1 (μU/ml)] (P = 0.048). Acute insulin response to glucose (AIRg) was reduced following Hy Rest vs. Nor Rest (P = 0.014 - Table 1). This study demonstrated that 1) hypoxia has the ability to increase glucose disposal; 2) hypoxic-induced improvements in glucose tolerance in the 4 hr following exposure can be attributed to improvements in peripheral SI2*; 3) resting hypoxic exposure improves β-cell function and 4) exercise and hypoxia have an additive effect on SG2* in type 2 diabetics. These findings suggest a possible use for hypoxia both with and without exercise in the clinical treatment of type 2 diabetes.

Introduction to the Special Section Value Development from Middle Childhood to Early Adulthood: New Insights from Longitudinal and Genetically Informed Research

Research into values at an early age has only started recently, although it has expanded quickly and dynamically in the past years. The purpose of this article is twofold: First, it provides an introduction to a special section that aims to help fill the gap in value development research. The special section brings together four new longitudinal and genetically informed studies of value development from the beginning of middle childhood through early adulthood. Second, this article reviews recent research from this special section and beyond, aiming to provide new directions to the field. With new methods for assessing children's values and an increased awareness of the role of values in children's and adolescents' development, the field now seems ripe for an in-depth investigation. Our review of empirical evidence shows that, as is the case with adults, children's values are organized based on compatibilities and conflicts in their underlying motivations. Values show some consistency across situations, as well as stability across time. This longitudinal stability tends to increase with age, although mean changes are also observed. These patterns of change seem to be compatible with Schwartz's (1992) theory of values (e.g., if the importance of openness to change values increases, the importance of conservation values decreases). The contributions of culture, family, peers, significant life events, and individual characteristics to values are discussed, as well as the development of values as guides for behavior.