Melissa L Erickson1, Jonathan P Little2, Jennifer L Gay3, Kevin K McCully4, Nathan T Jenkins4. 1. Department of Pathobiology, Cleveland Clinic Foundation, Cleveland, OH, United States. Electronic address: ericksm@ccf.org. 2. School of Health and Exercise Science, University of British Columbia Okanagan, Kelowna, BC, Canada. 3. College of Public Health, University of Georgia, Athens, GA, United States. 4. Department of Kinesiology, University of Georgia, Athens, GA, United States.
Abstract
AIMS: Type 2 diabetes treatment primarily focuses on reducing hyperglycemia, including postprandial glucose excursions. Hypoglycemic agents are used clinically to lower fasting and postprandial glucose. Metformin is the first-line therapy; however, if metformin is inadequate then 'add-on' hypoglycemic agents are implemented. Postmeal exercise has been shown to lower postprandial glucose. The aim of this study was to assess if postmeal exercise provides additional glucose-lowering benefit, beyond medication alone, in those on add-on hypoglycemic agents. METHODS: Postprandial glucose excursions in eight participants with type 2 diabetes (Age: 60±10.7, HbA1C: 7.9±2.3) being treated with add-on hypoglycemic agents were assessed during both drug-treated sedentary and drug-treated postmeal exercise conditions. Continuous glucose monitoring was used to assess peak and area under the glucose curve (AUC) during exercise, as well as peak within a 2-h time window, 2-h total and 2-h incremental AUC after a standardized breakfast meal. Postmeal exercise consisted of 3×10-min intervals of treadmill walking at 50% maximal oxygen uptake. RESULTS: Glucose peak (drug only: 13.8±3.7, drug/exercise: 9.9±2.7mmol/L; p=0.02) and AUC (drug only: 500±136, drug/exercise: 357±89mmol/L×40min; p=0.03) were reduced during postmeal exercise. Breakfast 2-h incremental AUC was also reduced (drug only: 585±291, drug/exercise: 330±294; p=0.047). DISCUSSION: Post-breakfast exercise lowered glucose during the exercise bout, although this effect was not sustained on later meals.
AIMS: Type 2 diabetes treatment primarily focuses on reducing hyperglycemia, including postprandial glucose excursions. Hypoglycemic agents are used clinically to lower fasting and postprandial glucose. Metformin is the first-line therapy; however, if metformin is inadequate then 'add-on' hypoglycemic agents are implemented. Postmeal exercise has been shown to lower postprandial glucose. The aim of this study was to assess if postmeal exercise provides additional glucose-lowering benefit, beyond medication alone, in those on add-on hypoglycemic agents. METHODS: Postprandial glucose excursions in eight participants with type 2 diabetes (Age: 60±10.7, HbA1C: 7.9±2.3) being treated with add-on hypoglycemic agents were assessed during both drug-treated sedentary and drug-treated postmeal exercise conditions. Continuous glucose monitoring was used to assess peak and area under the glucose curve (AUC) during exercise, as well as peak within a 2-h time window, 2-h total and 2-h incremental AUC after a standardized breakfast meal. Postmeal exercise consisted of 3×10-min intervals of treadmill walking at 50% maximal oxygen uptake. RESULTS:Glucose peak (drug only: 13.8±3.7, drug/exercise: 9.9±2.7mmol/L; p=0.02) and AUC (drug only: 500±136, drug/exercise: 357±89mmol/L×40min; p=0.03) were reduced during postmeal exercise. Breakfast 2-h incremental AUC was also reduced (drug only: 585±291, drug/exercise: 330±294; p=0.047). DISCUSSION: Post-breakfast exercise lowered glucose during the exercise bout, although this effect was not sustained on later meals.
Authors: Matthew Munan; Camila L P Oliveira; Alexis Marcotte-Chénard; Jordan L Rees; Carla M Prado; Eléonor Riesco; Normand G Boulé Journal: Front Endocrinol (Lausanne) Date: 2020-08-04 Impact factor: 5.555