Low-Intensity Exercise Reduces the Prevalence of Hyperglycemia in Type 2 Diabetes

Manders, Ralph; Dijk, Jan-Willem van; Loon, Luc J. C. van

doi:10.1249/mss.0b013e3181b3b16d

Cited by 143 publications

(122 citation statements)

References 37 publications

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“…The number of participants required to detect a clinically relevant difference in 24 h glucose profiles between the activity regimens was calculated based on a similar study [17] with three study arms (sedentary, low-intensity exercise and high-intensity exercise), in which the mean ± SD 24 h glucose was 8.7 ± 2.1 mmol/l during the high-intensity exercise regimen. Using these data, and assuming equal SDs in each of our regimens, a correlation between repeated measurements of 0.5 and a Bonferroni corrected two-sided alpha of 0.017 (=0.05/3), it was calculated that 19 participants were needed to detect a mean difference of 1.7 mmol/l in 24 h glucose between the activity regimens, with a power of 80%, using a paired-samples t test.…”

Section: Methodsmentioning

confidence: 99%

Breaking sitting with light activities vs structured exercise: a randomised crossover study demonstrating benefits for glycaemic control and insulin sensitivity in type 2 diabetes

et al. 2016

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Aims/hypothesis We aimed to examine the effects of breaking sitting with standing and light-intensity walking vs an energy-matched bout of structured exercise on 24 h glucose levels and insulin resistance in patients with type 2 diabetes. Methods In a randomised crossover study, 19 patients with type 2 diabetes (13 men/6 women, 63 ± 9 years old) who were not using insulin each followed three regimens under free-living conditions, each lasting 4 days: (1) Sitting: 4415 steps/day with 14 h sitting/day; (2) Exercise: 4823 steps/day with 1.1 h/day of sitting replaced by moderate-to vigorous-intensity cycling (at an intensity of 5.9 metabolic equivalents [METs]); and (3) Sit Less: 17,502 steps/day with 4.7 h/day of sitting replaced by standing and light-intensity walking (an additional 2.5 h and 2.2 h, respectively, compared with the hours spent doing these activities in the Sitting regimen). Blocked randomisation was performed using a block size of six regimen orders using sealed, non-translucent envelopes. Individuals who assessed the outcomes were blinded to group assignment. Meals were standardised during each intervention. Physical activity and glucose levels were assessed for 24 h/day by accelerometry (activPAL) and a glucose monitor (iPro2), respectively. The incremental AUC (iAUC) for 24 h glucose (primary outcome) and insulin resistance (HOMA2-IR) were assessed on days 4 and 5, respectively. Results The iAUC for 24 h glucose (mean ± SEM) was significantly lower during the Sit Less intervention than in Sitting (1263 ± 189 min × mmol/l vs 1974 ± 324 min × mmol/l; p = 0.002), and was similar between Sit Less and Exercise (Exercise: 1383 ± 194 min × mmol/l; p = 0.499). Exercise failed to improve HOMA2-IR compared with Sitting (2.06 ± 0.28 vs 2.16 ± 0.26; p = 0.177). In contrast, Sit Less (1.89 ± 0.26) significantly reduced HOMA2-IR compared with Exercise (p = 0.015) as well as Sitting (p = 0.001). Conclusions/interpretation Breaking sitting with standing and light-intensity walking effectively improved 24 h glucose levels and improved insulin sensitivity in individuals with type 2 diabetes to a greater extent than structured exercise. Thus, our results suggest that breaking sitting with standing and light-intensity walking may be an alternative to structured exercise to promote glycaemic control in patients type 2 diabetes.

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Section: Methodsmentioning

confidence: 99%

Breaking sitting with light activities vs structured exercise: a randomised crossover study demonstrating benefits for glycaemic control and insulin sensitivity in type 2 diabetes

et al. 2016

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“…Recent data have shown in sedentary type 2 diabetic adults that a lowintensity exercise can reduce the prevalence of hyperglycemia. 103 Moreover, a population-based study in children demonstrated that higher levels of PA were associated with lower blood pressure, and that volume was more important than intensity. 104 In light of these controversies, there is an urgent need for research studies focusing on the metabolic Physical activity as a therapeutic tool in pediatrics P Brambilla et al effects of low-intensity PA in children with MS risk.…”

Section: What Kind Of Pa To Treat the Ms In Children?mentioning

confidence: 99%

Physical activity as the main therapeutic tool for metabolic syndrome in childhood

Brambilla¹,

Pozzobon

Pietrobelli

2010

Int J Obes

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Physical activity (PA) and diet directly influence obesity and metabolic syndrome (MS) as important determinants of body composition. Understanding how PA relates to MS in youth is of great importance, and could offer a common strategy for clinical and public health approaches to control this condition. The underlying disorder of MS is a condition of insulin resistance, and a strong relationship between PA level and insulin sensitivity is clearly ascertained. The type, duration, frequency and intensity of PA affect fuel metabolism, in particular carbohydrate and lipid oxidation. The possible modulation of metabolism because of increased fat oxidation by PA is the basis for both prevention and restoration of insulin resistance and MS in obese children. In daily clinical practice, diet followed by pharmacologic treatment are usually the approaches taken, whereas PA is often considered just a suggestion. Although diet and PA have different effects on body composition, with both contributing to fat loss, only PA increases muscle mass and thus has a direct effect on metabolic function, expressed by changes in cardiovascular risk factors. Therefore, it is important to remember their complementary but different targets in daily clinical practice, such as body weight control for diet and metabolic health for PA. In this review, we have summarized the literature on the relationship between PA and MS in pediatrics. Then, we have analyzed the possibility of using PA for MS treatment, as an alternative to drugs, by discussing the results of intervention studies, reasons for low compliance to PA, related benefits, adherence difficulties and costs. Finally, we have tried to suggest recommendations for a multiple-step PA strategy in children and adolescents at risk for MS, by considering PA as the 'key' player in treatment.

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“…Of interest, the lack of an effect of exercise on postprandial hyperglycemia in IGT subjects in this study are in opposition to Rynders et al (2014), who showed that high-intensity exercise significantly attenuated late-phase AUC for postprandial glucose. The authors suggested that these differences might be related to the lower exercise intensity and subsequent lower insulin dependent or independent glucose disposal observed (Knudsen et al, 2014), although, high-intensity exercise in other acute studies have similarly shown no immediate effect (Gillen et al, 2012;Manders et al, 2010).…”

Section: Premeal Exercisementioning

confidence: 98%

“…While many studies indicate that acute exercise lowers postprandial glucose (Gillen et al, 2012;Heden et al, 2015;Larsen, Dela, Kjaer, & Galbo, 1997;Larsen, Dela, Madsbad, & Galbo, 1999;Poirier et al, 2000;van Dijk et al, 2012;Rynders et al, 2014), others show either mixed effects (Ho, Dhaliwal, Hills, & Pal, 2010;Manders, Van Dijk, & Van Loon, 2010;Oberlin et al, 2014) or no effect (Baynard, Franklin, Goulopoulou, Carhart Jr, & Kanaley, 2005;Gonzalez, Veasey, Rumbold, & Stevenson, 2013;Knudsen, Karstoft, Pedersen, van Hall, & Solomon, 2014;Morishima, Mori, Sasaki, & Goto, 2014;Rose, Howlett, King, & Hargreaves, 2001). The four studies that have investigated the effects of acute aerobic (Larsen et al, 1997;Larsen et al, 1999;Poirier et al, 2001) or resistance (Heden et al, 2015) postmeal exercise on glucose control have all indicated a decrease in glucose and insulin in the postprandial period.…”

Section: Postmeal Exercisementioning

confidence: 99%

“…For example, studies using continuous glucose monitors (CGM) to assess glucose kinetics over a 24-hour period have shown beneficial effects following both moderate (Manders et al, 2010;Oberlin et al, 2013;van Dijk et al, 2012) and high-intensity (Gillen et al, 2012;Manders et al, 2010) exercise before a meal. Of these, no study indicated an attenuation of blood glucose in the initial two-hour postprandial period.…”

Section: Premeal Exercisementioning

confidence: 99%

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Effects of Postmeal Walking on Postprandial Glucose Control and Oxidative Stress

Knurick

Johnston

2016

Medicine & Science in Sports & Exercise

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Background: Postprandial hyperglycemia can increase levels of oxidative stress and is an independent risk factor for complications associated with type 2 diabetes. Purpose:To evaluate the acute effects of a 15-min postmeal walk on glucose control and markers of oxidative stress following a high-carbohydrate meal.Methods: Ten obese subjects (55.0 ± 10.0 yrs) with impaired fasting glucose (107.1 ± 9.0 mg/dL) participated in this repeated measures trial. Subjects arrived at the laboratory following an overnight fast and underwent one of three conditions: 1) Test meal with no walking or fiber (CON), 2) Test meal with 10g fiber and no walking (FIB), 3) Test meal with no fiber followed by a 15-min treadmill walk at preferred walking speed (WALK).Blood samples were taken over four hours and assayed for glucose, insulin, thiobarbituric reactive substances (TBARS), catalase, uric acid, and total antioxidant capacity (TAC). A iii ACKNOWLEDGEMENTS

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Low-Intensity Exercise Reduces the Prevalence of Hyperglycemia in Type 2 Diabetes

Abstract: A single bout of LI, as opposed to HI, exercise substantially reduces the prevalence of hyperglycemia throughout the subsequent 24-h postexercise period in longstanding type 2 diabetes patients.

Cited by 143 publications

References 37 publications

Breaking sitting with light activities vs structured exercise: a randomised crossover study demonstrating benefits for glycaemic control and insulin sensitivity in type 2 diabetes

Breaking sitting with light activities vs structured exercise: a randomised crossover study demonstrating benefits for glycaemic control and insulin sensitivity in type 2 diabetes

Physical activity as the main therapeutic tool for metabolic syndrome in childhood

Effects of Postmeal Walking on Postprandial Glucose Control and Oxidative Stress

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