1997 Sir William Refshauge Lecture. Skeletal muscle glucose metabolism during exercise: implications for health and...

Skeletal muscle glucose uptake and metabolism are major determinants of whole body glucose metabolism in response to exercise and insulin stimulation. An understanding of the mechanisms responsible for increased muscle glucose uptake under these conditions is crucial for identifying strategies that enhance insulin action and exercise performance. Regular exercise, by favourably influencing the intramuscular determinants of glucose uptake, enhances insulin action. For this reason, it is recommended in the prevention and management of disease states that are characterised by insulin resistance ("metabolic syndrome"). Increased skeletal muscle glucose uptake, as a consequence of carbohydrate ingestion, maintains carbohydrate supply to contracting muscle, at a time when glycogen levels are reduced, and is associated with enhanced performance. Thus, both health and exercise performance are influenced by the metabolism of glucose within skeletal muscle.