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Exercise at lunchtime: effect on glycemic control and oxidative stress in middle-aged men with type 2 diabetes

Abstract

Purpose

Postprandial hyperglycemia and glycemic oscillations have been associated with increased oxidative stress. We sought to investigate the effect of two walking exercise protocols performed during lunchtime on glycemic control and oxidative stress in type 2 diabetic (T2D) patients.

Methods

Nine T2D patients participated in three randomized crossover trials; a control trial (Con), with participants having a standard lunch followed by their normal daily activities and two exercise trials (ContEx and Splitex). In ContEx, subjects performed 40 min of brisk walking 40 min after lunch, whereas in SplitEx the walking exercise was divided in two 20-min isoenergetic bouts, before and 40 min after meal. 24-h glycemic control was monitored by continuous glucose monitoring. 24-h urinary levels of 8-iso PGF2ɑ were measured as a marker of oxidative stress.

Results

SplitEx resulted in less time spent in moderate hyperglycemia after lunch vs ContEx (42.4 ± 38.7 % vs 68.2 ± 32.7 %, P = 0.04). ContEx reduced hyperglycemic time after breakfast consumed the morning after the exercise session (58.3 ± 29.6 Con vs 40.2 ± 33.4 % ContEx, P = 0.02). Compared with Con, 24-h urinary isoprostanes were decreased both in ContEx (−68 %, P = 0.02) and SplitEx (−63 %, P = 0.04).

Conclusions

Splitting an exercise session into two bouts, pre- and post-lunch, affects mainly the glycemic response to lunch, while a single-continuous isoenergetic session exerts its effect later in the 24-h period. Both exercise modalities effectively attenuate systemic oxidative stress with similar overall benefits.

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Abbreviations

AUC:

Total area under the curve

Con:

Control trial

CGM:

Continous glucose monitoring

CONGA:

Continuous overlapping net glycemic action

ContEx:

Continous exercise

HbA1c:

Glycated hemoglobin

HRmax:

Maximal heart rate

HRR:

Heart rate reserve

iAUC:

Integrated area under the curve

MAGE:

Mean amplitude of glycemic excursions

RER:

Respiratory exchange ratio

RM-ANOVA:

Repeated measures analysis of variance

SplitEx:

Split exercise

SD-BGRC:

Standard deviation of blood glucose rate of change

T2D:

Type 2 diabetic patients

8-iso PGF2ɑ:

8-iso prostaglandin F2α

VO2 max:

Maximal oxygen uptake

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Acknowledgments

We thank Doctor Federico Quinzi for the help in data analysis and Doctor Tittania Musella for helping with patient recruitment and Medtronic Inc. for kindly providing the CGM devices. The study was supported by a grant from the University of Rome “Foro Italico” (112013).

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Correspondence to Massimo Sacchetti.

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The authors declare that they have no conflict of interest.

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L. Di Luigi and M. Sacchetti contributed equally.

Communicated by Fabio Fischetti.

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Haxhi, J., Leto, G., di Palumbo, A.S. et al. Exercise at lunchtime: effect on glycemic control and oxidative stress in middle-aged men with type 2 diabetes. Eur J Appl Physiol 116, 573–582 (2016). https://doi.org/10.1007/s00421-015-3317-3

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Keywords

  • Exercise timing
  • Postprandial hyperglycemia
  • Brisk walking
  • Urinary isoprostanes
  • Continuous glucose monitoring