Timing of resistance exercise and cardiometabolic outcomes in adults with prediabetes: a secondary analysis

Abstract

The objective of this study was to explore whether the time of day (AM vs. PM) resistance exercise is performed influences glucose and insulin concentrations, body composition, and muscular strength in adults with prediabetes. A secondary data analysis was conducted using data from the "Resist Diabetes" study, a phase II exercise intervention. Participants (age: 59.9 ± 5.4 yr; BMI: 33 ± 3.7 kg/m²) with prediabetes and overweight or obesity were categorized into AM (n = 73) or PM (n = 80) exercisers based on when they completed all of their supervised exercise sessions during a 12-wk, 2×/wk resistance exercise intervention. Blood glucose and insulin derived from oral glucose tolerance tests, body composition, and muscular strength were assessed pre- and post resistance exercise training. Inverse propensity score weighting approach was used to estimate the efficacy of AM versus PM exercise on the change of clinical responses. Paired samples t test was used to compare pre-/post-outcomes within AM and PM groups. No differences between AM and PM exercisers were detected in the change in glucose or insulin area under the curve (AUC), body composition, or muscular strength. When exploring within-group changes, PM exercisers reduced glucose AUC (change: -800.6 mg/dL·120 min; P = 0.01), whereas no significant change was detected for AM exercisers (change: -426.9 mg/dL·120 min; P = 0.26). Only AM exercisers increased fat-free mass (change: 0.6 kg; P = 0.001). The time of day resistance exercise is performed may have some impact on glucose concentrations and body composition response. Future randomized clinical trials are needed to understand how exercise timing influences cardiometabolic outcomes in at-risk adults.NEW & NOTEWORTHY In this secondary analysis, there was no difference between AM and PM exercisers in blood glucose, insulin, body composition, or muscular strength following 12 wk of supervised exercise. However, examining within-group changes, glucose area under the curve (AUC) was significantly reduced in PM exercisers, but not in AM exercisers.

Keywords: aging; exercise timing; prediabetes; resistance exercise.

FIG 1:. Distribution Of Exercise Training Times

Distribution of exercise start time. The x-axis displays the time of day on a 24- hour clock (0600= 6am; 1800= 6pm). The y-axis displays the number of participants who started their exercise sessions during the specified hour. Black bars represent AM exercisers. Greys bars represent PM exercisers.

Fig 2:. Glucose and Insulin After 3 Months of AM or PM Resistance Exercise

Blood glucose and insulin concentrations in response to 12 weeks of AM and PM resistance exercise. Total AUC change from pre to post test for glucose (Fig 2A) and insulin (Fig 2B). Graphs comparing the pre and post test OGTT outcomes for AM glucose (Fig 1C), AM insulin (FIG 1D), PM glucose (Fig 2E) and PM Insulin (Fig 2F). Black colors represent AM exercise. Grey colors represent PM exercise. Shapes represent the mean value. Solid lines represent baseline values. Dashed lines represent the post-test values. *p<0.05 within-group comparison. Whisker bars represent SEM.