221
8 Concluding Remarks
Exercise exerts beneficial cardiac effects and influences several metabolic changes
associated with diabetes. Different molecular mechanisms are obviously involved in
the myocardial responses to exercise. Evidence in the literature advocate that exer-
cise intervention is a potent tool in attenuating diabetic cardiomyopathy. The benefi-
cial effects of exercise on the diabetic myocardium include amendment of the
metabolic derangements, lipotoxicity and hyperglycemia-induced ROS-generating
pathways. Although studies have demonstrated the effect of exercise on several
pathways, other pathways have not yet been investigated. Experimental animal
models of diabetes can help in understanding the molecular pathways of the cardiac
responses to exercise and to develop new treatment strategies for diabetic
cardiomyopathy.
Conflict of Interest None
Fig. 12.6 Effects of exercise on Nrf2 and endogenous antioxidant defenses in the diabetic myo-
cardium. Sustained ROS in long-term diabetes impairs insulin signaling, reduces PI3K activity and
triggers ERK phosphorylation [ 20 ]. ROS reactive oxygen species, Nrf2 nuclear factor erythroid 2
related factor 2, ARE antioxidant responsive element, PI3K phosphoinositol 3-kinase, ERK extra-
cellular signal related kinase
12 Exercise Amaliorates Metabolic Disturbances and Oxidative Stress in Diabetic...