Twenty Minute Moderate-Intensity Post-Dinner Exercise Reduces the Postprandial Glucose Response in Chinese Patients with Type 2 Diabetes

Abstract

BACKGROUND Postprandial hyperglycemia and glycemic fluctuations are significant cardiovascular disease risk factors for patients with type 2 diabetes. We investigated the effects of a single session of post-dinner moderate-intensity exercise on the postprandial glycemic response compared with a non-exercise condition in a study population of Chinese patients with type 2 diabetes. MATERIAL AND METHODS This randomized crossover self-controlled pilot study involved 29 patients with type 2 diabetes who participated in post-dinner exercise days using non-exercise days as a control. The interstitial glucose level was monitored using a continuous glucose monitoring system, with a standardized diet and medication. For the non-exercise control days, patients pursued normal daily activities but refrained from unusual strenuous physical activity. On the exercise days, participants walked on a treadmill for 20 minutes after dinner, with a heart rate reserve of 40%. RESULTS Post-dinner moderate-intensity exercise reduced the 2-hour postprandial glucose spike, mean glucose level, and peak glucose level compared to the control condition. The cumulative glucose total area under the curve during 1-hour post-exercise was lower with exercise than under the control condition. The 12-hour standard deviation of blood glucose and the coefficient variation of glucose were significantly lower in the with exercise day compared to the control day, although the 12-hour mean amplitude of glycemic fluctuations did not reach statistical significance. No nocturnal hypoglycemia subsequently occurred on the exercise day. CONCLUSIONS A short session of moderate-intensity post-dinner exercise can improve postprandial hyperglycemia and glycemic excursions in Chinese patients with type 2 diabetes, with no potential hypoglycemia risk at a later period.

Figure 1

The average CGM values (A) and the average postprandial CGM glucose change from baseline (B) for moderate-intensity exercise (MIE) condition and non-exercise as control (CON) condition during the postprandial dinner period. Time 0 represents the time of first bite. Post-dinner exercise began half an hour after first bite and lasted 20 minutes (light blue squares). * Significantly different compared with the control condition (P<0.05).

Figure 2

(A) 2-h postprandial glucose spike (difference between peak postprandial glucose and pre-dinner glucose), (B) 2-h postprandial peak glucose, (C) 2-h postprandial mean glucose, and (D) the glucose area under the curve (AUC) during 1-h after exercise. Data are estimated means ±SD (n=29 individuals). * Significantly lower compared with the control condition (P<0.05).