Effect of moderate-intensity exercise versus activities of daily living on 24-hour blood glucose homeostasis in male patients with type 2 diabetes

摘要

OBJECTIVE-To investigate the impact of activities of daily living (ADL) versus moderateintensity endurance-type exercise on 24-h glycemic control in patients with type 2 diabetes. RESEARCH DESIGN AND METHODSdTwenty males with type 2 diabetes participated in a randomized crossover study consisting of three experimental periods of 3 days each. Subjects were studied under sedentary control conditions, and under conditions in which prolonged sedentary time was reduced either by three 15-min bouts of ADL (postmeal strolling, ;3 METs) or by a single 45-min bout of moderate-intensity endurance-type exercise (;6 METs). Blood glucose concentrations were assessed by continuous glucose monitoring, and plasma insulin concentrations were determined in frequently sampled venous blood samples. RESULTS-Hyperglycemia (glucose >10mmol/L)was experienced for 6 h 51min61h4min per day during the sedentary control condition and was significantly reduced by exercise (4 h 47 min61h2min; P < 0.001), but not by ADL (6 h 2 min61 h 16 min; P = 0.67). The cumulative glucose incremental areas under the curve (AUCs) of breakfast, lunch, and dinner were, respectively, 35 6 5% (P < 0.001) and 17 6 6% (P < 0.05) lower during the exercise and ADL conditions compared with the sedentary condition. The insulin incremental AUCs were, respectively, 33 6 4% (P < 0.001) and 17 6 5% (P < 0.05) lower during the exercise and ADL conditions compared with the sedentary condition. CONCLUSIONS-When matched for total duration, moderate-intensity endurance-type exercise represents a more effective strategy to improve daily blood glucose homeostasis than repeated bouts of ADL. Nevertheless, the introduction of repeated bouts of ADL during prolonged sedentary behavior forms a valuable strategy to improve postprandial glucose handling in patients with type 2 diabetes.