INSR and Impaired glucose tolerance: Firstly, although physical activity and exercise improves insulin sensitivity through a direct effect on the muscle (enhancement of insulin receptor autophsophorylation [36], increase in GLUT-4 content [37] and glucose transport-phosphorylation [38], and a reduction in visceral obesity [39], neither the exercise nor the control group exhibited impaired glucose tolerance (exercise = 5.04 ± 0.50; control = 5.11 ± 0.52 mmol/L) at baseline that would have required intervention modification.