Timing of Exercise Affects Glycemic Control in Type 2 Diabetes Patients Treated with Metformin

Abstract

Objective The purpose of the study was to examine the acute effects of the timing of exercise on the glycemic control during and after exercise in T2D. Methods This study included 26 T2D patients (14 women and 12 men) who were treated with metformin. All patients were tested on four occasions: metformin administration alone (Metf), high-intensity interval training (HIIT) performed at 30 minutes (EX30), 60 minutes (EX60), and 90 minutes (EX90) postbreakfast, respectively. Glucose, insulin, and superoxide dismutase (SOD) activity were examined. Results Glucose decreased significantly after the exercise in EX30, EX60, and EX90. Compared with Metf, the decline in glucose immediately after the exercise was larger in EX30 (−2.58 mmol/L; 95% CI, −3.36 to −1.79 mmol/L; p < 0.001), EX60 (−2.13 mmol/L; 95% CI, −2.91 to −1.34 mmol/L; p < 0.001), and EX90 (−1.87 mmol/L; 95% CI, −2.65 to −1.08 mmol/L; p < 0.001), respectively. Compared with Metf, the decrease in insulin was larger in EX30 and EX60 (both p < 0.001). Conclusions Timing of exercise is a factor to consider when prescribing exercise for T2D patients treated with metformin. This trial is registered with ChiCTR-IOR-16008469 on 13 May 2016.

The Effect of Timing of Exercise and Eating on Postprandial Response in Adults: A Systematic Review

“…Seventeen studies met the inclusion criteria for this systematic review (Table 1). These studies included adults with T2D [17,18,20,21,[23][24][25][26][27][28][29], as well as healthy [30][31][32][33] individuals and those with overweight/obesity and no reported comorbidities [19,34]. In terms of the interventions, included studies examined the effect of exercise performed relative to a meal on PP metabolic response.…”

“…Fifteen studies included moderate-intensity aerobic exercise, three examined high-intensity training [17,18,21], and only one consisted of resistance exercise [26]. Furthermore, ten studies investigated exercise relative to breakfast/morning meal [17,[19][20][21]25,28,[31][32][33][34], four included dinner/evening meal [23,26,27,29], and three examined exercise performed at several time points throughout the day [18,24,30]. In this review, the results were organized by time of day of performing exercise relative to meal consumption to maintain a focus on the timing and order of these activities.…”

“…Studies that investigated the effect of time of exercise performance relative to a breakfast/morning meal on glycemic response were designed to examine PP glycemic response after acute intake of a standardized meal. These interventions included participants with T2D [17,20,21,25,28] and/or overweight/obese [19,34] as well as healthy individuals [31][32][33].…”

“…A considerable number of studies have examined the association between timing of exercise relative to a single meal or over a single day with health [17][18][19][20][21]. Joint consideration of the timing of these two behaviors is critical in the context of their potential synergistic relationship with long-term health.…”

Effect of exercise on key pharmacokinetic parameters related to metformin absorption in healthy humans: A pilot study

“…Researchers maintain that some questions have to be answered to clarify this matter, such as what dose of metformin should be combined with exercise, what type of exercise should be combined with metformin, and what the timing of exercise should be relative to metformin administration and breakfast consumption. 11,25 Besides, these questions, however, we believe that the issue should be approached pharmacokinetically in order to determine the optimal timing of exercise.…”