Table 1.

A chronologically-ordered listing of studies that have contributed to our current understanding of the acute effect of exercise on insulin sensitivity in different human populations

Study	Participants	Exercise			Insulin sensitivity assessment		Exercise effect
		Mode	Volume	Intensity	Time post-exercise	Method
Devlin and Horton (1985) [52]	Obese IGT or hyperinsulinemia untrained males (n = 6) vs. lean healthy untrained males (n = 6)	Cycle	2 min on/3 min off to limit of tolerance (obese, 33 ± 2 min; lean, 66 ± 3 min)	85% ${\dot{\text{V}}\text{o}}_{2\max }$	12–16 h	EHC	↑ Insulin sensitivity post bout for obese, but not for lean
Devlin et al. (1987) [53]	T2D untrained males (n = 5)	Cycle	2 min on/3 min off to limit of tolerance (41 ± 10 min)	85% ${\dot{\text{V}}\text{o}}_{2\max }$	12–16 h	EHC	↑ Insulin sensitivity post bout
Mikines et al. (1988) [54]	Healthy untrained young males (n = 7)	Cycle	60 min	150 W	0 h, 48 h, 120 h	EHC	↑ Insulin sensitivity at 48 h post bout; ↔ insulin sensitivity at 120 h post bout
Richter et al. (1989) [55]	Healthy young RA males (n = 6)	One-legged knee-extensor exercise	60 min	75% Wmax	4 h	EHC	↑ Insulin sensitivity post bout for exercised, but not for rested leg
Young et al. (1989) [56]	Healthy trained males post ≥40 h detraining (n = 7) vs. healthy RA males (n = 7)	Cycle	40 min	~40% ${\dot{\text{V}}\text{o}}_{2\max }$	14 h	OGTT	↓ I-AUC/↔ G-AUC post bout for untrained so that they were no longer different vs. trained who displayed superior I-AUC pre bout that was unchanged post bout; no difference between conditions
		Cycle	40 min	~80% ${\dot{\text{V}}\text{o}}_{2\max }$		(I-AUC/G-AUC)
Burnstein et al. (1990) [57]	Obese T2D non-AA males (n = 3) and females (n = 3) vs. obese NG non-AA males (n = 2) and females (n = 5) vs. lean healthy non-AA males (n = 6)	Treadmill	60 min	HR = 150–160 bpm	60 min	EHC	↑ Insulin sensitivity post bout for obese T2D and NG; ↔ insulin sensitivity post bout for lean
Kjaer et al. (1990) [58]	Healthy sedentary males (n = 7) vs. T2D sedentary males (n = 7)	Cycle	7 min  + 3 min  + 2 min	~60% ${\dot{\text{V}}\text{o}}_{2\max }$	24 h	EHC	↑ Insulin sensitivity post bout for T2D, but not for healthy
				~100% ${\dot{\text{V}}\text{o}}_{2\max }$
				~110% ${\dot{\text{V}}\text{o}}_{2\max }$
Fluckey et al. (1994) [59]	Young healthy untrained males (n = 3) and females (n = 4) vs. older T2D untrained males (n = 3) and females (n = 4)	Machine full-body resistance exercise	3 sets/exercise × 10 reps or to failure if it occurred sooner	50, 75 and 100% of calculated	18 h	OGTT(I-AUC/G-AUC)	↓ I-AUC/↔ G-AUC post bout for both groups
				10-RM
Ben Ezra et al. (1995) [60]	Healthy untrained females (n = 24)	Treadmill	~87 min	~40% ${\dot{\text{V}}\text{o}}_{2\max }$	15–17 h	OGTT	↔ I-AUC/↔ G-AUC post bout for MIE; ↓ I-AUC/↔ G-AUC post bout for HIE
			~50 min	~70% ${\dot{\text{V}}\text{o}}_{2\max }$		(I-AUC/G-AUC)
Braun et al. (1995) [61]	Obese T2D untrained females (n = 8)	Treadmill	143 ± 23 min (3 bouts over 2 days)	50 ± 2% ${\dot{\text{V}}\text{o}}_{2\max }$	~18 h	IST	↑ Insulin sensitivity post bout for both conditions; no difference between conditions
			90 ± 8 min (3 bouts over 2 days)	74 ± 3% ${\dot{\text{V}}\text{o}}_{2\max }$
Perseghin et al. (1996) [62]	Young lean non-HPA non-excessively sedentary male (n = 6) and female (n = 2) offspring of T2D vs. young lean non-HPA non-excessively sedentary males (n = 3) and females (n = 5) with no T2D family history	Stair climbing	3 × 15 min	~65% ${\dot{\text{V}}\text{o}}_{2\max }$	48 h	HHC	↑ Insulin sensitivity post bout for both groups
Wojtaszewski et al. (2000) [63]	Healthy young males (n = 7)	One-legged knee-extensor exercise	60 min	75–95% Wmax	4 h	EHC	↑ Insulin sensitivity post bout for exercised, but not rested leg
Chapman et al. (2002) [64]	Sedentary PM females (n = 10)	Machine full-body resistance exercise	3 sets × 10 reps or failure if sooner	50, 75 and 100% calculated 10-RM	14 h	IVGTT (minimal model)	↔ Insulin sensitivity post bout
Fenicchia et al. (2004) [65]	Healthy untrained females (n = 8) vs. T2D untrained females (n = 7)	Free weight and machine full-body resistance exercise	3 sets × 8–12 reps to failure	80% 3-RM	12–24 h	OGTT	↔ I-AUC/↓ G-AUC post bout for T2D; ↔ I-AUC/↔ G-AUC post bout for healthy
						(I-AUC/G-AUC)
Koopman et al. (2005) [66]	Healthy untrained males (n = 12)	Machine leg resistance exercise	8 sets × 10 reps	75%	24 h	ITT	↑ Insulin sensitivity post bout
				1-RM		(ΔBG16-4)
						and
						HOMA
O’Gorman et al. (2006) [67]	Obese T2D males (n = 6) and females (n = 2) vs. obese NGT males (n = 6) and females (n = 1)	Cycle	60 min	~75% ${\dot{\text{V}}\text{o}}_{2\text{peak}}$	16 h	EHC	↔ Insulin sensitivity post single bout (acute effect); ↑ insulin sensitivity post final bout of 7 performed over 7 days (chronic effect)
Zhang et al. (2006) [68]	MS sedentary males (n = 10)	Treadmill	60 min	~40% ${\dot{\text{V}}\text{o}}_{2\max }$	14–20 h	Post fat-meal	↔ Insulin sensitivity post bout/fat meal for MIE; ↑ insulin sensitivity post bout/fat meal for both HIE
			60 min	~60% ${\dot{\text{V}}\text{o}}_{2\max }$		HOMA
			60 min	~70% ${\dot{\text{V}}\text{o}}_{2\max }$
Howlett et al. (2007) [69]	RA males (n = 8)	Machine leg resistance exercise	3 sets × 10–12 reps	80% 1-RM	0 h	EHC	↓ Insulin sensitivity post single bout (acute effect); ↔ insulin sensitivity post final bout of 4 performed over 7 days (chronic effect)
Schenk and Horowitz (2007) [70]	Healthy inactive females (n = 8)	Treadmill +	45 min +	66 ± 1% ${\dot{\text{V}}\text{o}}_{2\text{peak}}$	15–18 h	IVGTT (minimal model)	↑ Insulin sensitivity (i.e. removal of lipid-induced impairment + enhancement vs. baseline) in response to overnight lipid infusion post bout
		cycle	45 min
Magkos et al. (2008) [71]	Healthy RA males (n = 30)	Cycle or treadmill	30, 60, 90 or 120 min	61–63 ± 2% ${\dot{\text{V}}\text{o}}_{2\text{peak}}$	12 h	HOMA	↑ Insulin sensitivity post bout for ≥900 kcal expenditure; ↔ insulin sensitivity post bout for <900 kcal expenditure
Brestoff et al. (2009) [72]	Healthy RA young males (n = 8) and females (n = 5)	Cycle	3 × 15 min	~75% ${\dot{\text{V}}\text{o}}_{2\text{peak}}$	12–16 h	OGTT	↑ Insulin sensitivity post bout for 75% ${\dot{\text{V}}\text{o}}_{2\text{peak}}$; ↔ insulin sensitivity post all-out
		Cycle	5 × 30 s	All-out		(Matsuda) and HOMA
Black et al. (2010) [73]	IFG sedentary males (n = 12) and females (n = 5)	Free weight and machine full-body resistance exercise	1 set or 4 sets × 12–15 reps/exercise	65% 1-RM	24 h	HOMA	↑ Insulin sensitivity post bout for all protocols; 85% 1-RM > 65% 1-RM and 4 sets > 1 set
			1 set or 4 sets × 6–8 reps/exercise	85% 1-RM
Hasson et al. (2010) [74]	Healthy sedentary black males (n = 4) and females (n = 7) vs. healthy sedentary white males (n = 4) and females (n = 6)	Treadmill	4 × 15 min	75% HRmax	12–15 h	EHC	↔ Insulin sensitivity post bout for both groups
Manders et al. (2010) [75]	T2D sedentary males (n = 10)	Cycle	60 min	35% Wmax	24 h	OGTT	↓ 24-h average glucose concentration post 35% Wmax; ↔ 24-h average glucose concentration post 70% Wmax
						(OGIS)
		Cycle	30 min	70% Wmax		and
						HOMA
Newsom et al. (2010) [76]	Healthy sedentary males (n = 9)	Treadmill +	45 min +	60–65% ${\dot{\text{V}}\text{o}}_{2\text{peak}}$	24 h	IVGTT (minimal model)	↔ Insulin sensitivity post bout when energy and carbohydrate balance were maintained and when carbohydrate balance was maintained with energy deficit; ↑ insulin sensitivity post bout when energy balance was maintained with carbohydrate deficit
		Cycle	45 min
Richards et al. (2010) [77]	Healthy sedentary/RA young males (n = 2) and females (n = 7)	Cycle	4 × 30 s	All-out	72 h	EHC	↔ Insulin sensitivity post single bout (acute effect); ↑ insulin sensitivity post final bout of 6 performed over 14 days (chronic effect)
Short et al. (2012) [78]	Healthy young RA/non-RA (n = 4/7) males (n = 4) and females (n = 7)	Treadmill +	15 min +	75% HRmax	1 h, 17 h	IVGTT (Minimal Model) and MMTT (Matsuda)	↑ Insulin sensitivity in response to meal post bout at 1 h, but not 17 h
		cycle + video-game boxing	15 min + 15 min
Newsom et al. (2013) [79]	Obese sedentary males (n = 3) and females (n = 8)	Treadmill + cycle	70 ± 3 min	51% ${\dot{\text{V}}\text{o}}_{2\text{peak}}$	19 h	EHC	↑ Insulin sensitivity post bout for MIE; ↔ insulin sensitivity post bout for HIE; no difference between conditions; Δ insulin sensitivity correlated with Δ fatty-acid disappearance from plasma
			54 ± 2 min	66% ${\dot{\text{V}}\text{o}}_{2\text{peak}}$
Whyte et al. (2013) [80]	Overweight/obese sedentary males (n = 10)	Cycle	4 × 30 s	All out	18–22 h	OGTT (Matsuda) and HOMA	↑ Insulin sensitivity post bout when work was performed in one continuous bout; ↔ insulin sensitivity post bout when work was performed in 4 bouts separated by 270 s
			1 × 198 ± 10 s	All out
De Matos et al. (2014) [81]	Lean healthy untrained males (n = 3) and females (n = 6) vs. obese-insulin sensitive healthy untrained males (n = 3) and females (n = 6) vs. obese-insulin resistant untrained males (n = 3) and females (n = 6)	Cycle	3 × 20 min	50% Wpeak	30 min	Biopsy (western blot for measurement of protein expression of cellular stressors related to insulin resistance; no direct measurement of insulin sensitivity)	↓ JNK post bout for obese-insulin resistant; ↔ JNK post bout for healthy lean and obese-insulin sensitive; ↓ p-IRS-1ser612 post-bout for obese-insulin resistant and obese-insulin sensitive; ↔ p-IRS-1ser612 for healthy lean; ↑HSP70 post-bout main effect
Nelson and Horowitz (2014) [48]	Overweight/obese male (n = 5) and female (n = 7) exercisers post 72 h detraining vs. overweight/obese male (n = 5) and female (n = 7) non-exercisers	Treadmill	60 min	70% APMHR	24 h	OGTT (Matsuda)	↑ Insulin sensitivity post bout for non-exercisers so that they were no longer different vs. exercisers who displayed superior insulin sensitivity pre-bout that was unchanged post bout
Rynders et al. (2014) [82]	Pre-T2D sedentary males (n = 9) and females (n = 9)	Cycle	40 ± 9 min	~50%${\dot{\text{V}}\text{o}}_{2\text{peak}}$~83% ${\dot{\text{V}}\text{o}}_{2\text{peak}}$	60 min	OGTT (Minimal Model)	↑ Insulin sensitivity post bout that was not different between conditions
			24 ± 5 min
Ortega et al. (2015) [83]	Healthy, young RA males (n = 10)	Cycle	4 × 30 s	All out	30 min, 24 h, 48 h	IVGTT	↑ Insulin sensitivity 30 min, 24 h and 48 h post bout for all conditions; all out ↑ > continuous ↑ at 30 min
			60 min	46 ± 3% ${\dot{\text{V}}\text{o}}_{2\text{peak}}$
			35 ± 2 min	77 ± 5% ${\dot{\text{V}}\text{o}}_{2\text{peak}}$
Malin et al. (2016) [84]	Pre-T2D middle-aged sedentary males (n = 7) and females (n = 8)	Treadmill	42 ± 2 min	68 ± 1% ${\dot{\text{V}}\text{o}}_{2\text{peak}}$	60 min	OGTT (Minimal Model)	↓ Insulin resistance-SM post bout that was not different between conditions; ↔ insulin resistance-HEP and insulin resistance-AT post bout for MIE; ↑ insulin resistance-HEP and insulin resistance-AT post bout for HIE
			24 ± 1 min	90 ± 1% ${\dot{\text{V}}\text{o}}_{2\text{peak}}$
Metcalfe et al. (2016) [85]	Healthy sedentary/RA young males (n = 8) and females (n = 6)	Cycle	3 × 15 min	76 ± 4% ${\dot{\text{V}}\text{o}}_{2\max }$	14–16 h	OGTT (Cederholm)	↔ Insulin sensitivity post bout for both conditions
			5 × 30 s	All out
Castleberry et al. (2019) [86]	Healthy inactive males (n = 10)	Treadmill	1 × 60 min	78 ± 6% ${\dot{\text{V}}\text{o}}_{2\max }$	12–14 h	OGTT (Matsuda)	↔ Insulin sensitivity post bout(s) for all conditions
			3 × 60 min (consecutive days)	78 ± 6% ${\dot{\text{V}}\text{o}}_{2\max }$
			3 × 60 min (alternate days)	77 ± 5% ${\dot{\text{V}}\text{o}}_{2\max }$

AA, athletically active; APMHR, age-predicted maximum heart rate; bpm, beats per minute; Cederholm, Cederholm index; Δ, change in variable, ΔBG_16-4, change in blood-glucose concentration from 4 to 16 min; EHC, euglycemic hyperinsulinemic clamp; G-AUC, glucose area under the curve; HHC, hyperglycemic hyperinsulinemic clamp; HIE, high-intensity exercise; HOMA, homeostatic model assessment; HPA, participates in heavy physical activity; HR, heart rate; HR_max, maximum heart rate; HSP70, heat shock protein 70; I-AUC, insulin area under the curve; IFG, impaired fasting glucose; IGT, impaired glucose tolerance; Insulin resistance-AT, adipose tissue insulin resistance; Insulin resistance-HEP, hepatic insulin resistance; Insulin resistance-SM, skeletal muscle Insulin resistance; IST, insulin suppression test; ITT, insulin tolerance test; IVGTT, intravenous glucose tolerance test; JNK, C-jun N-terminal kinase phosphorylation; Matsuda, Matsuda index; MIE, moderate-intensity exercise; MMTT, mixed meal tolerance test; MS, with metabolic syndrome; NG, normoglycemic; NGT, normal glucose tolerance; OGIS, oral glucose insulin sensitivity index; OGTT, oral glucose tolerance test; p-IRS-1^ser612, insulin receptor substrate 1 serine 612 phosphorylation; PM, postmenopausal; Pre-T2D, with prediabetes; RA, recreationally active; RM, repetition maximum; T2D, with type 2 diabetes mellitus; ${\dot{\text{V}}\text{o}}_{2\text{peak}}$, peak rate of oxygen uptake; ${\dot{\text{V}}\text{o}}_{2\max }$, maximum rate of oxygen uptake; W_max, maximum work rate.