Diabetes: Whom exercise protects - and who doesn't!

Diabetes: Whom exercise protects - and who doesn't!

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Gut flora decides whether exercise protects against diabetes

Exercise is often recommended with high blood sugar levels to prevent the transition to diabetes - but with varying degrees of success. Researchers at the University of Hong Kong and the Leibniz Institute for Natural Product Research and Infection Biology in Jena have now jointly deciphered why regular sport prevents the disease in many people, but can even promote diabetes in some.

The development of type 2 diabetes is often a gradual process in which blood sugar levels have increased for a long time before the actual disease is diagnosed. This stage is known as so-called prediabetes. In general, regular exercise is considered a possible approach to prevent the transition to diabetes. However, according to the new study, the intestinal flora seems to be decisive for whether sport can protect against diabetes.

Permanently increased blood sugar level is a warning sign

The causes of diabetes are often an unhealthy diet and insufficient exercise, although the development of type 2 diabetes can be recognized early on by a permanently elevated blood sugar level. At this stage, the limit values ​​for the diagnosis of diabetes are not yet exceeded, but this so-called prediabetes should be taken seriously as warning signals and it is important to actively counteract it.

Sport cannot help some people

People with prediabetes usually receive the doctor's recommendation to exercise regularly, because the movement to type II diabetes can often be prevented or delayed with sufficient exercise. But this does not always apply. "A certain proportion of those affected have so-called training resistance: sport has no effect on them or even promotes the development of diabetes," reports the research team.

Gut microbiome examined

Together with researchers from the University of Hong Kong, systems biologist Gianni Panagiotou from the Leibniz Institute for Natural Product Research and Infection Biology examined the intestinal microbiome of 39 men with prediabetes who responded positively to sports and compared it to samples from people who had no effect on exercise showed. The results were published in the trade magazine "Cell Metabolism".

Gut microbes affect the effect of the sport

First of all, it should be noted that there is a high degree of variability in the response of blood sugar levels to exercise, with a clear correlation between intestinal microbiome, exercise and blood sugar levels, the research team reports. "We were able to find out that this (variability) is dependent on the gut microbiome," said Panagiotou in a press release on the study results.

Altered functionality of the gut microbiome

The different effects of sport were evident both in the composition of the microbiome and in its functionality, the research team continues. For example, the gut microbiome of successfully treated patients contained more useful short-chain fatty acids, while those who did not respond showed more metabolically harmful compounds.

In a control experiment, the researchers also transferred the gut microbiome of the differently reacting patients to obese mice, and only those mice that had received the microbiome of successfully treated patients showed positive effects.

Personalized therapy approaches possible

In recent years it has become increasingly clear how far-reaching the impact of the intestinal flora on human health actually is. The researchers have now shown that the effects of exercise therapy in diabetes prevention are also influenced by the intestinal microbes. An examination of the intestinal microbiome could presumably predict how well prediabetics respond to movement, and the new findings make it possible to “develop personalized therapeutic approaches in the future,” Panagiotou sums up. (fp)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters


  • Leibniz Institute for Natural Product Research and Infection Biology e. V. - Hans Knöll Institute (HKI): Exercise protects against diabetes - but how? (published November 29, 2019),
  • Yan Liu, Yao Wang, Yueqiong Ni, Cynthia KYCheung, Karen SLLam, Yu Wang, Zhengyuan Xia, Dewei Ye, Jiao Guo, Michael Andrew Tse, Gianni Panagiotou, Aimin Xu: Gut Microbiome Fermentation Determines the Efficacy of Exercise for Diabetes Prevention ; in: Cell Metabolism (published 11/27/2019),

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