Jonida Haxhi1,2, Gaetano Leto3, Alessandro Scotto di Palumbo1, Paola Sbriccoli1, Laura Guidetti1, Cristina Fantini1, Raffaella Buzzetti3, Daniela Caporossi1, Luigi Di Luigi1, Massimo Sacchetti4. 1. Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 6, Rome, Italy. 2. Department of Experimental Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy. 3. Department of Experimental Medicine, Sapienza University of Rome, Polo Pontino, Viale del Policlinico 155, Rome, Italy. 4. Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 6, Rome, Italy. massimo.sacchetti@uniroma4.it.
Abstract
PURPOSE:Postprandial hyperglycemia and glycemic oscillations have been associated with increased oxidative stress. We sought to investigate the effect of two walking exercise protocols performed during lunchtime on glycemic control and oxidative stress in type 2 diabetic (T2D) patients. METHODS:Nine T2D patients participated in three randomized crossover trials; a control trial (Con), with participants having a standard lunch followed by their normal daily activities and two exercise trials (ContEx and Splitex). In ContEx, subjects performed 40 min of brisk walking 40 min after lunch, whereas in SplitEx the walking exercise was divided in two 20-min isoenergetic bouts, before and 40 min after meal. 24-h glycemic control was monitored by continuous glucose monitoring. 24-h urinary levels of 8-iso PGF2ɑ were measured as a marker of oxidative stress. RESULTS: SplitEx resulted in less time spent in moderate hyperglycemia after lunch vs ContEx (42.4 ± 38.7% vs 68.2 ± 32.7%, P = 0.04). ContEx reduced hyperglycemic time after breakfast consumed the morning after the exercise session (58.3 ± 29.6 Con vs 40.2 ± 33.4% ContEx, P = 0.02). Compared with Con, 24-h urinary isoprostanes were decreased both in ContEx (-68%, P = 0.02) and SplitEx (-63%, P = 0.04). CONCLUSIONS: Splitting an exercise session into two bouts, pre- and post-lunch, affects mainly the glycemic response to lunch, while a single-continuous isoenergetic session exerts its effect later in the 24-h period. Both exercise modalities effectively attenuate systemic oxidative stress with similar overall benefits.
RCT Entities:
PURPOSE: Postprandial hyperglycemia and glycemic oscillations have been associated with increased oxidative stress. We sought to investigate the effect of two walking exercise protocols performed during lunchtime on glycemic control and oxidative stress in type 2 diabetic (T2D) patients. METHODS: Nine T2D patients participated in three randomized crossover trials; a control trial (Con), with participants having a standard lunch followed by their normal daily activities and two exercise trials (ContEx and Splitex). In ContEx, subjects performed 40 min of brisk walking 40 min after lunch, whereas in SplitEx the walking exercise was divided in two 20-min isoenergetic bouts, before and 40 min after meal. 24-h glycemic control was monitored by continuous glucose monitoring. 24-h urinary levels of 8-iso PGF2ɑ were measured as a marker of oxidative stress. RESULTS: SplitEx resulted in less time spent in moderate hyperglycemia after lunch vs ContEx (42.4 ± 38.7% vs 68.2 ± 32.7%, P = 0.04). ContEx reduced hyperglycemic time after breakfast consumed the morning after the exercise session (58.3 ± 29.6 Con vs 40.2 ± 33.4% ContEx, P = 0.02). Compared with Con, 24-h urinary isoprostanes were decreased both in ContEx (-68%, P = 0.02) and SplitEx (-63%, P = 0.04). CONCLUSIONS: Splitting an exercise session into two bouts, pre- and post-lunch, affects mainly the glycemic response to lunch, while a single-continuous isoenergetic session exerts its effect later in the 24-h period. Both exercise modalities effectively attenuate systemic oxidative stress with similar overall benefits.
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