Aerobic and Combined Exercise Sessions Reduce Glucose Variability in Type 2 Diabetes: Crossover Randomized Trial

Abstract

PurposeTo evaluate the effects of aerobic (AER) or aerobic plus resistance exercise (COMB) sessions on glucose levels and glucose variability in patients with type 2 diabetes. Additionally, we assessed conventional and non-conventional methods to analyze glucose variability derived from multiple measurements performed with continuous glucose monitoring system (CGMS).MethodsFourteen patients with type 2 diabetes (56±2 years) wore a CGMS during 3 days. Participants randomly performed AER and COMB sessions, both in the morning (24 h after CGMS placement), and at least 7 days apart. Glucose variability was evaluated by glucose standard deviation, glucose variance, mean amplitude of glycemic excursions (MAGE), and glucose coefficient of variation (conventional methods) as well as by spectral and symbolic analysis (non-conventional methods).ResultsBaseline fasting glycemia was 139±05 mg/dL and HbA1c 7.9±0.7%. Glucose levels decreased immediately after AER and COMB protocols by ∼16%, which was sustained for approximately 3 hours. Comparing the two exercise modalities, responses over a 24-h period after the sessions were similar for glucose levels, glucose variance and glucose coefficient of variation. In the symbolic analysis, increases in 0 V pattern (COMB, 67.0±7.1 vs. 76.0±6.3, P = 0.003) and decreases in 1 V pattern (COMB, 29.1±5.3 vs. 21.5±5.1, P = 0.004) were observed only after the COMB session.ConclusionsBoth AER and COMB exercise modalities reduce glucose levels similarly for a short period of time. The use of non-conventional analysis indicates reduction of glucose variability after a single session of combined exercises.Trial RegistrationAerobic training, aerobic-resistance training and glucose profile (CGMS) in type 2 diabetes (CGMS exercise). ClinicalTrials.gov ID: NCT00887094.

Influence of Acute Bouts of Exercise on Blood Glucose in Type 2 Diabetic Patients, as Measured by Continuous Glucose Monitoring Systems

“…Similarly, in our study [20] we did not detect a significant change in blood glucose AUC over a 48-h period following a session of moderate resistance exercise, in a group of trained diabetic patients performing regular physical activity. Similar findings were reported by Figueira et al [24] after a session of more vigorous exercise, either combined or aerobic alone.…”

“…Conversely, Bacchi et al [20] did not show a decrease in HBGI, a parameter which summarizes both duration and extent of hyperglycemia, in the 24-h period after a single bout of either aerobic or resistance exercise. Consistent with these findings, Figueira et al [24] did not detect differences in hyperglycemia episodes in the 24-h period following a session of aerobic or combined exercise, as compared with a non-exercise day.…”

“…More recently, Figueira et al [24] compared the effects of more vigorous aerobic vs combined training. They reported that blood glucose was similarly reduced during the sessions with both the exercise modalities, as compared to a non-exercise day, and that it returned to baseline levels about 3 hours after exercise.…”

Inspiratory muscle loading: a new approach for lowering glucose levels and glucose variability in patients with Type 2 diabetes

“…Physical exercise reduces glycaemia and glucose variability in diabetes , but the effects of diaphragm muscle contractions induced by inspiratory loading are still unknown. Accordingly, we aimed to compare glucose levels and glucose variability after aerobic, combined exercise and inspiratory muscle‐loading exercise in patients with Type 2 diabetes.…”

Efectos del ejercicio físico en los factores de riesgo cardiovascular que constituyen el síndrome metabólico: una alternativa para reducir su tendencia

“…Los niveles de glucosa se mantienen casi inalterados estadísticamente, probablemente porque los efectos sean transitorios 43 ; como Figueira et al 31 lo demostraron, una sesión de ejercicio aeróbico mejoraba las concentraciones de glucosa hasta por 4 horas en sujetos con diabetes tipo 2 50,51 . Además, parece ser que los diabéticos se benefician más que los prediabéticos, particularmente cuando se mide la hemoglobina glucosilada (HbA1c); este indicador expresa el control glucémico entre 8 y 12 semanas 32 .…”