Exercise and 24-h glycemic control: Equal effects for all type 2 diabetes patients?

Journal article


Van Dijk, Jan Willem, Manders, Ralph J. F., Canfora, Emanuel E., van Mechelen, Willem, Hartgens, Fred, Stehouwer, Coen D. A. and Van Loon, Luc J.C.. (2013). Exercise and 24-h glycemic control: Equal effects for all type 2 diabetes patients? Medicine and Science in Sports and Exercise. 45(4), pp. 628 - 635. https://doi.org/10.1249/MSS.0b013e31827ad8b4
AuthorsVan Dijk, Jan Willem, Manders, Ralph J. F., Canfora, Emanuel E., van Mechelen, Willem, Hartgens, Fred, Stehouwer, Coen D. A. and Van Loon, Luc J.C.
Abstract

VAN DIJK, J.-W., R. J. F. MANDERS, E. E. CANFORA, W. VAN MECHELEN, F. HARTGENS, C. D. A. STEHOUWER, and L. J. C. VAN LOON. Exercise and 24-h Glycemic Control: Equal Effects for All Type 2 Diabetes Patients? Med. Sci. Sports Exerc., Vol. 45, No. 4, pp. 628–635, 2013. Purpose: We assessed the effect of a single bout of moderate-intensity exercise on subsequent 24-h glycemic control in 60 type 2 diabetes patients. Moreover, we examined whether individual responses to exercise were related to subjects_ baseline characteristics, including age, body mass index, diabetes duration, exercise performance, medication, and HbA1c content. Methods: Sixty type 2 diabetes patients (insulin-treated, n = 23) participated in a randomized crossover experiment. Patients were studied on two occasions for 3 d under strict dietary standardization but otherwise free-living conditions. Parameters of glycemic control (means [95% confidence interval]) were assessed by continuous glucose monitoring over the 24-h period after a single bout of moderate-intensity endurance-type exercise or no exercise at all (control). Results: Type 2 diabetes patients experienced hyperglycemia (blood glucose 910 mmolILj1 ) for as much as 8:16 h:min (6:44 to 9:48 h:min) per day. The prevalence of hyperglycemia was reduced by 31% to 5:38 h:min (3:17 to 7:00 h:min) over the 24-h period after the exercise bout (P G 0.001). Moreover, exercise lowered average blood glucose concentrations by 0.9 mmolILj1 (0.7 to 1.2) and reduced glycemic variability (P G 0.05). The response to exercise showed considerable variation between subjects and correlated positively with HbA1c levels (r = 0.38, P G 0.01). Nevertheless, even well-controlled patients with an HbA1c level below 7.0% (n = 28) achieved a 28% reduction in the daily prevalence hyperglycemia after exercise (P G 0.01). Conclusions: A single bout of moderate-intensity exercise substantially improves glycemic control throughout the subsequent day in insulin- and non–insulin-treated type 2 diabetes patients. Of all baseline characteristics, only subjects_ HbA1c level is related to the magnitude of response to exercise. Nevertheless, the present study demonstrates that even well-controlled patients benefit considerably from the blood glucose-lowering properties of daily exercise.

KeywordsType 2 Diabetes Mellitus; Exercise; Glycemic control; Postprandial; Hyperglycemia; Glycemic variability; Continuous Glucose monitoring
Year2013
JournalMedicine and Science in Sports and Exercise
Journal citation45 (4), pp. 628 - 635
PublisherLippincott Williams & Wilkins
ISSN0195-9131
Digital Object Identifier (DOI)https://doi.org/10.1249/MSS.0b013e31827ad8b4
Scopus EID2-s2.0-84878818920
Page range628 - 635
Research GroupMary MacKillop Institute for Health Research
Publisher's version
File Access Level
Controlled
Place of publicationUnited States
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