Effects of Resistance Training on Endotoxemia and Mental Health in Adults with Type 2 Diabetes

Type 2 Diabetes (T2D) is a metabolic disease that consists of two main characteristics. These two characteristics are pancreatic beta-cell dysfunction and insulin resistance. Recent estimates show that a little over 500 million adults aged 20 to79 years currently have diabetes. The number of adults diagnosed with diabetes is estimated to go up by 2030 and 2045. 90% of all global cases of diabetes are T2D. T2D is considered a lifestyle disease. Many factors, such as obesity, age, physical inactivity, and family history of T2D contribute to the increased risk of developing T2D. Recently, the gut microbiome has been implicated to play a role in the development of T2D. There is evidence that the composition of the gut microbiota differs in those with T2D versus those without. Research has looked at an endotoxin named lipopolysaccharide (LPS) as a molecular marker of inducing inflammation in the body. Endotoxemia, which is the presence of LPS in the bloodstream, is higher in those with T2D versus those without. LPS is a glycolipid derived from gram-negative bacteria and interacts with the Cluster of Differentiation 14/Toll-Like Receptor 4/Myeloid Differentiation Factor 2 (CD14/TLR4/MD2) receptor complex found on immune cells. This interaction induces a molecular cascade that leads to increased concentrations of Tumor Necrosis Factor alpha (TNF-α) and Interleukin 6 (IL-6), among others and leads to increased concentrations of C-reactive protein (CRP), an inflammatory protein that indicates inflammation. This interaction may also occur in the central nervous system (CNS), which is known as neuroinflammation. Existing evidence indicates that neuroinflammation may play a role in inducing mental health disorders, such as depression and anxiety. Chronic, low-grade inflammation has been shown to induce insulin resistance and eventually T2D. Exercise is a method used to improve systemic inflammation, insulin resistance, and endotoxemia. Three studies looked at aerobic only or combination training, and its effects on endotoxemia, but no studies have looked at the effects of resistance training only on endotoxemia and mental health in adults with T2D.