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Short-term cold acclimation improves insulin sensitivity in patients with type 2 diabetes mellitus


Cold exposure may be a potential therapy for diabetes by increasing brown adipose tissue (BAT) mass and activity. Here we report that 10 d of cold acclimation (14–15 °C) increased peripheral insulin sensitivity by 43% in eight type 2 diabetes subjects. Basal skeletal muscle GLUT4 translocation markedly increased, without effects on insulin signaling or AMP-activated protein kinase (AMPK) activation and only a minor increase in BAT glucose uptake.

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Figure 1: Glucose uptake in the supraclavicular BAT region before and after cold acclimation and WAT beiging.
Figure 2: Insulin sensitivity and skeletal muscle GLUT4 localization before and after cold acclimation.

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We thank K. Jardon, E. Broeders, D. Van Moorsel, K. Jansen, M. Visser, R. Hensgens and R. Wierts (Maastricht University Medical Center) for assistance during the experiments and H. Aydeniz, E. Kornips, J. Stegen, W. Sluijsmans, L. Donselaar (Maastricht University Medical Center), W. Wickenhagen (VU University Medical Center Amsterdam) and M. Ackermans (Academic Medical Center Amsterdam) for assistance with the biochemical analyses. The technical support of P. Schoffelen, L. Wouters and M. Souren (Maastricht University Medical Center) is highly appreciated. This work was supported by the EU FP7 project DIABAT (HEALTH-F2-2011-278373 to W.D.v.M.L.) and by the Netherlands Organization for Scientific Research (NWO) (TOP 91209037 to W.D.v.M.L). J.H. is supported by an NWO Vidi grant for innovative research (grant 917.14.358).

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Authors and Affiliations



M.J.W.H. was responsible for study design, data acquisition and data analysis and wrote the manuscript. J.H. contributed to the study design, data acquisition and data analysis. B.B. contributed to data analysis. A.A.J.J.v.d.L. contributed to the study design and data acquisition. J.J.v.d.D., M.V.B., M.K.C.H. and S.K. contributed to data acquisition and data analysis. G.S., J.A.J. and B.H. contributed to data acquisition. F.M.M., W.D.v.M.L. and P.S. contributed to the study design and interpretation of data. All authors contributed to the critical revision of the manuscript and approved the final version.

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Correspondence to Patrick Schrauwen.

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The authors declare no competing financial interests.

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Hanssen, M., Hoeks, J., Brans, B. et al. Short-term cold acclimation improves insulin sensitivity in patients with type 2 diabetes mellitus. Nat Med 21, 863–865 (2015).

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