Effect of a single vs multiple bouts of exercise on glucose control in women with type 2 diabetes

Department of Exercise Science, Syracuse University, Syracuse, NY 13244, USA.
Metabolism (Impact Factor: 3.89). 09/2005; 54(8):989-94. DOI: 10.1016/j.metabol.2005.02.015
Source: PubMed


The Surgeon General and Centers for Disease Control and Prevention have recommended that multiple bouts of exercise can be accumulated throughout the day in lieu of the more traditional single, longer bout of exercise. Yet, conclusive evidence does not exist suggesting these 2 training modes provide similar health-related benefits on metabolic control, especially in individuals with type 2 diabetes. The purpose of this study was to determine if differences exist in glucose control when preceded by one 30-minute or three 10-minute bouts of exercise in women with type 2 diabetes. Nine individuals with type 2 diabetes (53 +/- 6 years old) and 6 control women (49 +/- 4 years old) completed 3 randomly ordered oral glucose tolerance tests (OGTTs). Two of the OGTTs were preceded the day prior by moderate exercise (approximately 60% of Vo2peak), either one 30-minute or three 10-minute bouts, whereas the third OGTT was used as a control day with no exercise performed 3 days prior. Glucose and insulin were measured every 30 minutes for 4 hours during the OGTT. Individuals with type 2 diabetes exhibited a greater overall glucose response than the controls (P < .05), but the glucose response to the OGTT was not different between the 3 conditions within each group (2-hour glucose: multiple bout, 14.3 +/- 3.2 vs 5.0 +/- 1.7; single bout, 14.1 +/- 3.0 vs 4.7 +/- 1.5; control day, 14.6 +/- 2.7 vs 4.9 +/- 4.9 mmol/L). Glucose area under the curve analysis resulted in similar findings. As expected, the group with type 2 diabetes had greater fasting insulin levels compared with the control group for all exercise conditions (multiple bout: 4.5 +/- 1.2 vs 0.3 +/- 0.2; single bout: 6.4 +/- 1.6 vs 0.9 +/- 0.4; control day: 5.7 +/- 1.8 vs 1.5 +/- 0.6 pmol/L; P < .05). Exercise or no exercise did not alter the insulin response to the OGTT for either group. Despite a higher glucose response to the glucose load in T2D, an acute exercise bout (single or multiple bouts) did not appear to alter glucose control the following day in either the individuals with type 2 diabetes or the control group.

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Available from: Tracy Baynard, Jan 29, 2016
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    • "In healthy individuals, postprandial glucose tolerance has been shown to be increased, unchanged, or decreased in the hours after a single bout of aerobic exercise (Nazar et al. 1987; Pestell et al. 1993; King et al. 1995; Bonen et al. 1998; Rose et al. 2001; Roberts et al. 2013). In contrast , in prediabetic and T2D subjects postprandial glucose tolerance after a single bout of exercise has been found to be improved in some studies (Nazar et al. 1987; Oberlin et al. 2014; Rynders et al. 2014), while unchanged in others (Rogers et al. 1988; Larsen et al. 1997; Baynard et al. 2005; Venables et al. 2007), but a deterioration of oral glucose tolerance immediately following exercise has never been found. As such, it appears that the immediate effect of a single bout of exercise on postprandial plasma glucose levels differ between healthy and diabetic subpopulations suggesting that it may be dependent on the subject's underlying glycemic state. "
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    ABSTRACT: We investigated glucose tolerance and postprandial glucose fluxes immediately after a single bout of aerobic exercise in subjects representing the entire glucose tolerance continuum. Twenty-four men with normal glucose tolerance (NGT), impaired glucose tolerance (IGT), or type 2 diabetes (T2D; age: 56 ± 1 years; body mass index: 27.8 ± 0.7 kg/m2, P > 0.05) underwent a 180-min oral glucose tolerance test (OGTT) combined with constant intravenous infusion of [6,6-2H2]glucose and ingestion of [U-13C]glucose, following 1 h of exercise (50% of peak aerobic power) or rest. In both trials, plasma glucose concentrations and kinetics, insulin, C-peptide, and glucagon were measured. Rates (mg kg−1 min−1) of glucose appearance from endogenous (RaEndo) and exogenous (oral glucose; RaOGTT) sources, and glucose disappearance (Rd) were determined. We found that exercise increased RaEndo, RaOGTT, and Rd (all P < 0.0001) in all groups with a tendency for a greater (~20%) peak RaOGTT value in NGT subjects when compared to IGT and T2D subjects. Accordingly, following exercise, the plasma glucose concentration during the OGTT was increased in NGT subjects (P < 0.05), while unchanged in subjects with IGT and T2D. In conclusion, while a single bout of moderate-intensity exercise increased the postprandial glucose response in NGT subjects, glucose tolerance following exercise was preserved in the two hyperglycemic groups. Thus, postprandial plasma glucose responses immediately following exercise are dependent on the underlying degree of glycemic control.
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    • "A continuous walking treadmill protocol was used to assess peak aerobic capacity (VO 2peak) , as previously described (Baynard et al. 2005). Treadmill speed began at 2.5 mph and 0% grade with speed increases of 0.5 mph in 2-min intervals, until 3.5 mph was reached after which percent 123 grade was elevated by 2% until volitional fatigue was reached. "
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