Time-of-day moderate-to-vigorous physical activity and all-cause mortality in individuals with type 2 diabetes

Association of circadian rest-activity rhythms with cardiovascular disease and mortality in type 2 diabetes

“…Together with previous studies, this study provides further evidence among the population with type 2 diabetes that extreme sleep timing, that might cause chronic misalignment between internal physiological timing and external behaviors, could play a significant role in health risk. However, we did not detect an association of M10 onset (start time of physical activity) with cardiovascular outcomes and mortality among people with type 2 diabetes, which is consistent with a recent study [32] reporting that the time of day of moderate-to-vigorous physical activity was not associated with all-cause mortality among individuals with type 2 diabetes. However, Qian et al reported that morning and evening moderate to vigorous physical activity had higher cardiorespiratory fitness than the mixed group while null findings were observed with cardiovascular risk measured by the Framingham risk score in the entire sample of adults with type 2 diabetes, and their associations varied by sex [33].…”

Associations of timing of physical activity with all-cause and cause-specific mortality in a prospective cohort study

“…A cross-sectional study found that the morning MVPA timing group had the highest CVD risk score among males with type 2 diabetes 20 . A cohort study based on patients with type 2 diabetes found no significant difference in all-cause mortality risk between the before and after 13:00 MVPA time groups 26 . These previous studies defined time windows using equally spaced intervals (which do not appear to be clinically driven 27 ) or in an arbitrary manner.…”

“…In contrast, the current study captured the full spectrum of objectively measured MVPA in free-living settings 20 , which is vital for defining the MVPA timing phenotype. To date, only a few studies using accelerometers have explored the long-term health effects of MVPA timing and they were conducted among patients with type 2 diabetes 20 , 26 . A cross-sectional study found that the morning MVPA timing group had the highest CVD risk score among males with type 2 diabetes 20 .…”

The importance of exercise for glycemic control in type 2 diabetes

“…Practically speaking, though, activity should be encouraged whenever the patient is consistently able to fit in their schedule. Indeed, a retrospective cohort study 78 of the National Health and Nutrition Examination Survey (NHANES) reported that physical activity amount, regardless of timing, was associated with lower all-cause mortality in men and women. Thus, considering exercise timing to foster engagement and adherence is seemingly most relevant for glycemic benefit.…”

“…A consensus statement from ACSM 81 concluded that current evidence suggests postprandial exercise provides better glucose control by attenuating acute glycemic spikes, regardless of exercise intensity or type, with a longer duration (≥45 min) providing the most consistent benefits. 78 However, it should be mentioned that, of studies, only Francois et al. 82 showed that “exercise snacking” (6 × 1 min intense incline walking at 90% HRmax on a treadmill) 30 min before a meal reduced 3-h postprandial blood glucose after breakfast and dinner among patients with T2D or insulin resistance, compared to traditional 30 min moderate-intensity (60% HRmax).…”