Introduction
Aging is often accompanied by a decline in skeletal muscle insulin sensitivity, abnormal fat distribution, and a gradual reduction in pancreatic β-cell function. These changes can lead to impaired glucose homeostasis and an increased risk of type 2 diabetes mellitus and related complications. Exercise is widely recognized as a key non-pharmacological strategy to improve glucose metabolism in older adults. This narrative review, based on a comprehensive search of PubMed and Web of Science databases up to September 2025, summarizes current evidence on the effectiveness of different exercise modalities in ameliorating age-related glucose metabolism disorders.
Types of Exercise and Their Effects
The review examines various exercise modalities, including aerobic, resistance, high-intensity interval, and combined training. Evidence suggests that, in the long term, combined training yields more comprehensive improvements in insulin secretion and multiple metabolic markers compared with single-modality interventions. Each type of exercise offers unique benefits, and understanding these can help tailor interventions to individual needs.
Aerobic Training
Aerobic exercise is known for its cardiovascular benefits and its ability to enhance glucose metabolism. It improves insulin sensitivity and helps in reducing visceral fat, which is crucial for older adults at risk of metabolic disorders.
Resistance Training
Resistance training focuses on building muscle strength and mass. It plays a significant role in improving glucose uptake by increasing muscle mass, which is a primary site for glucose disposal.
High-Intensity Interval Training (HIIT)
HIIT involves short bursts of intense exercise followed by rest or low-intensity periods. This type of training has been shown to improve insulin sensitivity and glucose metabolism efficiently, even with shorter exercise durations.
Combined Training
Combining aerobic and resistance training appears to offer the most comprehensive benefits. This approach not only improves insulin secretion but also enhances multiple metabolic markers, making it a highly effective strategy for older adults.
Mechanisms of Action
Exercise exerts its benefits through multiple pathways. These include enhanced skeletal muscle GLUT4 expression and mitochondrial function, reduced visceral and ectopic adiposity, suppression of chronic low-grade inflammation, and improved β-cell insulin secretion. Understanding these mechanisms can help refine exercise prescriptions for better outcomes.
Practical Implications for Older Adults
When designing exercise interventions for older adults, it is crucial to consider the intensity, frequency, and duration of the exercises. These factors determine the dose-response characteristics and can significantly impact the effectiveness of the intervention.
Future Research Directions
Future research should focus on large-scale, long-term clinical trials and mechanistic studies. These studies are essential to refine exercise prescriptions, clarify dose-response relationships, and characterize the unique metabolic adaptations of the elderly population.
Conclusion
Exercise remains a cornerstone in managing glucose metabolism in older adults. By understanding the effects of different exercise modalities and their mechanisms, healthcare providers can better tailor interventions to improve health outcomes in this population.
🔗 **Fuente:** https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2025.1702669/full