Regulation of Insulin Action by Diet and Exercise

The regulation of the cellular actions of the hormone insulin is essential to the maintenance of macronutrient metabolism, body weight regulation, and a surprisingly diverse range of other integrative physiologic functions. Because of the diverse targets of insulin action, any dysfunction in insulin is likely to have systemic consequences. Although type 1 and type 2 diabetes are the most obvious clinical consequences of impaired insulin synthesis and insulin action, respectively, there are also subclinical disorders that attend defects in the function of insulin. In humans and horses, the “metabolic syndrome” is characterized by a cluster of metabolic sequelae that arise as a result of insulin resistance. Importantly, both diet and exercise can regulate insulin action and can thus be leveraged as treatment tools to prevent and treat the metabolic syndrome. The aim of this review is to characterize the integrative biology of insulin action and to describe the role of diet and exercise in regulating tissue responsiveness to insulin.