***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Carbohydrate metabolism was assessed in 20 glucose-intolerant subjects before and after 12 wk on a high-carbohydrate diet ( HC ) or the diet combined with exercise training ( HC-EX ) .  The diet provided 60 % of energy as carbohydrate and 20 % as fat . Neither treatment altered fasting glucose or insulin concentrations or their response to a meal . During a glucose clamp ( 216 pmol insulin/L ) glucose disposal increased from 13.2 + /- 0.83 to 14.6 + /- 0.83 mumol.kg fat-free mass-1.min-1 ( P < 0.05 ) in both groups . During more pronounced hyperinsulinemia ( 654 pmol/L ) glucose disposal did not change significantly ( 49.9 + /- 3.8 to 50.7 + /- 3.8 mumol.kg fat-free mass-1.min-1 ) . Muscle glycogen increased in the HC-EX group ( 78.5 + /- 8.1 to 161.1 + /- 15.7 mmol glucose/kg muscle ) , with no changes in the HC group . These results do not support the recommendation to increase the dietary carbohydrate content for improving postpr and ial glucose metabolism or insulin action in glucose-intolerant adults unless combined with exercise training , which promotes muscle glycogen storage Circulating adiponectin is reduced in disorders associated with insulin resistance . This study was conducted to determine whether an exercise/diet intervention would alter adiponectin multimer distribution and adiponectin receptor expression in skeletal muscle . Impaired glucose-tolerant older ( > 60 yr ) obese ( BMI 30 - 40 kg/m(2 ) ) men ( n = 7 ) and women ( n = 14 ) were r and omly assigned to 12 wk of supervised aerobic exercise combined with either a hypocaloric ( ExHypo , approximately 500 kcal reduction , n = 11 ) or eucaloric diet ( ExEu , n = 10 ) . Insulin sensitivity was determined by the euglycemic ( 5.0 mM ) hyperinsulinemic ( 40 mU x m(-2 ) x min(-1 ) ) clamp . Adiponectin multimers [ high ( HMW ) , middle ( MMW ) , and low molecular weight ( LMW ) ] were measured by nondenaturing Western blot analysis . Relative quantification of adiponectin receptor expression through RT-PCR was determined from skeletal muscle biopsy sample s. Greater weight loss occurred in ExHypo compared with ExEu subjects ( 8.0 + /- 0.6 vs. 3.2 + /- 0.6 % , P < 0.0001 ) . Insulin sensitivity improved postintervention in both groups ( ExHypo : 2.5 + /- 0.3 vs. 4.4 + /- 0.5 mg x kg FFM(-1 ) x min(-1 ) , and ExEu : 2.9 + /- 0.4 vs. 4.1 + /- 0.4 mg x kg FFM(-1 ) x min(-1 ) , P < 0.0001 ) . Comparison of multimer isoforms revealed a decreased percentage in MMW relative to HMW and LMW ( P < 0.03 ) . The adiponectin SA ratio ( HMW/total ) was increased following both interventions ( P < 0.05 ) and correlated with the percent change in insulin sensitivity ( P < 0.03 ) . Postintervention adiponectin receptor mRNA expression was also significantly increased ( AdipoR1 P < 0.03 , AdipoR2 P < 0.02 ) . These data suggest that part of the improvement in insulin sensitivity following exercise and diet may be due to changes in the adiponectin oligomeric distribution and enhanced membrane receptor expression To evaluate the effects of  endurance training  on the expression of monocarboxylate transporters ( MCT ) in human vastus lateralis muscle , we compared the amounts of MCT1 and MCT4 in total muscle preparations ( MU ) and sarcolemma-enriched ( SL ) and mitochondria-enriched ( MI ) fractions before and after training . To determine if changes in muscle lactate release and oxidation were associated with training-induced changes in MCT expression , we correlated b and densities in Western blots to lactate kinetics determined in vivo . Nine weeks of leg cycle endurance training [ 75 % peak oxygen consumption ( VO(2 peak ) ) ] increased muscle citrate synthase activity ( + 75 % , P < 0.05 ) and percentage of type I myosin heavy chain ( + 50 % , P < 0.05 ) ; percentage of MU lactate dehydrogenase-5 ( M4 ) isozyme decreased ( -12 % , P < 0.05 ) . MCT1 was detected in SL and MI fractions , and MCT4 was localized to the SL . Muscle MCT1 contents were consistent among subjects both before and after training ; in contrast , MCT4 contents showed large interindividual variations . MCT1 amounts significantly increased in MU , SL , and MI after training ( + 90 % , + 60 % , and + 78 % , respectively ) , whereas SL but not MU MCT4 content increased after training ( + 47 % , P < 0.05 ) . Mitochondrial MCT1 content was negatively correlated to net leg lactate release at rest ( r = -0.85 , P < 0.02 ) . Sarcolemmal MCT1 and MCT4 contents correlated positively to net leg lactate release at 5 min of exercise at 65 % VO(2 peak ) ( r = 0.76 , P < 0.03 and r = 0 . 86 , P < 0.01 , respectively ) . Results support the conclusions that 1 ) endurance training increases expression of MCT1 in muscle because of insertion of MCT1 into both sarcolemmal and mitochondrial membranes , 2 ) training has variable effects on sarcolemmal MCT4 , and 3 ) both MCT1 and MCT4 participate in the cell-cell lactate shuttle , whereas MCT1 facilitates operation of the intracellular lactate shuttle OBJECTIVE To determine the efficacy of high-intensity progressive resistance training ( PRT ) on glycemic control in older adults with type 2 diabetes . RESEARCH DESIGN AND METHODS We performed a 16-week r and omized controlled trial in 62 Latino older adults ( 40 women and 22 men ; mean + /- SE age 66 + /- 8 years ) with type 2 diabetes r and omly assigned to supervised PRT or a control group .  Glycemic control , metabolic syndrome abnormalities , body composition , and muscle glycogen stores were determined before and after the intervention . RESULTS Sixteen weeks of PRT ( three times per week ) result ed in reduced plasma glycosylated hemoglobin levels ( from 8.7 + /- 0.3 to 7.6 + /- 0.2 % ) , increased muscle glycogen stores ( from 60.3 + /- 3.9 to 79.1 + /- 5.0 mmol glucose/kg muscle ) , and reduced the dose of prescribed diabetes medication in 72 % of exercisers compared with the control group , P = 0.004 - 0.05 . Control subjects showed no change in glycosylated hemoglobin , a reduction in muscle glycogen ( from 61.4 + /- 7.7 to 47.2 + /- 6.7 mmol glucose/kg muscle ) , and a 42 % increase in diabetes medications . PRT subjects versus control subjects also increased lean mass ( + 1.2 + /- 0.2 vs. -0.1 + /- 0.1 kg ) , reduced systolic blood pressure ( -9.7 + /- 1.6 vs. + 7.7 + /- 1.9 mmHg ) , and decreased trunk fat mass ( -0.7 + /- 0.1 vs. + 0.8 + /- 0.1 kg ; P = 0.01 - 0.05 ) . CONCLUSIONS PRT as an adjunct to st and ard of care is feasible and effective in improving glycemic control and some of the abnormalities associated with the metabolic syndrome among high-risk older adults with type 2 diabetes Hispanics are at increased risk of morbidity and mortality due to their high prevalence of diabetes and poor glycemic control . Strength training is the most effective lifestyle intervention to increase muscle mass but limited data is available in older adults with diabetes . We determined the influence of strength training on muscle quality ( strength per unit of muscle mass ) , skeletal muscle fiber hypertrophy , and metabolic control including insulin resistance ( Homeostasis Model Assessment –HOMA-IR ) , C-Reactive Protein ( CRP ) , adiponectin and Free Fatty Acid ( FFA ) levels in Hispanic older adults . Sixty-two community-dwelling Hispanics ( > 55 y ) with type 2 diabetes were r and omized to 16 weeks of strength training plus st and ard care ( ST group ) or st and ard care alone ( CON group ) . Skeletal muscle biopsies and biochemical measures were taken at baseline and 16 weeks . The ST group show improved muscle quality ( mean±SE : 28±3 ) vs CON ( -4±2 , p<0.001 ) and increased type I ( 860±252µm2 ) and type II fiber cross-sectional area ( 720±285µm2 ) compared to CON ( type I : -164±290µm2 , p=0.04 ; and type II : -130±336µm2 , p=0.04 ) . This was accompanied by reduced insulin resistance [ ST : median ( interquartile range ) -0.7(3.6 ) vs CON : 0.8(3.8 ) , p=0.05 ] ; FFA ( ST : -84±30µmol/L vs CON : 149±48µmol/L , p=0.02 ) ; and CRP [ ST : -1.3(2.9)mg/L vs CON : 0.4(2.3)mg/L , p=0.05 ] . Serum adiponectin increased with ST [ 1.0(1.8)µg/mL ] compared to CON [ -1.2(2.2)µg/mL , p<0.001  ] . Strength training improved muscle quality and whole-body insulin sensitivity . Decreased inflammation and increased adiponectin levels were related with improved metabolic control . Further studies are needed to underst and the mechanisms associated with these findings . However , these data show that strength training is an exercise modality to consider as an adjunct of st and ard of care in high risk population s with type 2 diabetes We examined the expression of the sodium-dependent glucose co-transporter system ( hSGLT3 ) in skeletal muscle of Hispanic older adults with type 2 diabetes . Subjects ( 65±8 yr ) were  r and omized  to resistance training ( 3x/wk , n=13 ) or st and ard of care ( controls , n=5 ) for 16 weeks . Skeletal muscle hSGLT3 and GLUT4 mRNA transcript levels were determined by real time RT-PCR . hSGLT3 transcripts increased by a factor of ten following resistance training compared to control subjects ( 0.10 , P=0.03 ) . There were no differences in GLUT4 mRNA expression levels between groups . Protein expression levels of these transporters were confirmed by immunohistochemistry and Western blotting . hSGLT3 after resistance exercise was found not to be co-localized with the nicotinic acetylcholine receptor . The change in hSGLT3 transcript levels in the vastus lateralis muscle was positively correlated with glucose uptake , as measured by the change in muscle glycogen stores ( r=0.53 , P=0.02 ) ; and with exercise intensity , as measured by the change in muscle strength ( r=0.73 , P=0.001 ) . Group assignment was be the only independent predictor of hSGLT3 transcript levels , explaining 68 % of its variability ( P=0.01 ) . Our data show that hSGLT3 , but not GLTU4 , expression was enhanced in skeletal muscle after 16 weeks of resistance training . This finding suggests that hSGLT3 , an insulin-independent glucose transporter , is activated with exercise and it may play a significant role in glycemic control with muscle contraction . The hSGLT3 exact mechanism is not well understood and requires further investigation . However its functional significance regarding a reduction of glucose toxicity and improvement of insulin resistance is the subject of ongoing research OBJECTIVE To determine the feasibility and the benefits of combined resistance and interval exercise training on phenotype characteristics and skeletal muscle function in deconditioned , type 2 diabetes ( T2D ) patients with polyneuropathy . DESIGN Short-term , single-arm intervention trial . METHODS Eleven male T2D patients ( age : 59.1+/-7.5 years ; body mass index : 32.2+/-4.0 kg/m2 ) performed progressive resistance and interval exercise training thrice a week for 10 weeks . Besides primary diabetes outcome measures , muscle strength ( MUST ) , maximal workload capacity 
    Output:
    
Beneficial adaptations to exercise were seen primarily in muscle fiber area and capillary density , glycogen , glycogen synthase and GLUT4 protein expressions .