title: Exercise and 24-h glycemic control: equal effects for all type 2 diabetes patients?
abstract: OBJECTIVE
  We assessed the effect of a single bout of moderate-intensity exercise on subsequent 24-h glycemic control in 60 type 2 diabetes patients. Moreover, we examined whether individual responses to exercise were related to subjects' baseline characteristics, including age, body mass index, diabetes duration, exercise performance, medication, and HbA1c content.
  
  
  METHODS
  Sixty type 2 diabetes patients (insulin-treated, n = 23) participated in a randomized crossover experiment. Patients were studied on two occasions for 3 d under strict dietary standardization but otherwise free-living conditions. Parameters of glycemic control (means [95% confidence interval]) were assessed by continuous glucose monitoring over the 24-h period after a single bout of moderate-intensity endurance-type exercise or no exercise at all (control).
  
  
  RESULTS
  Type 2 diabetes patients experienced hyperglycemia (blood glucose >10 mmol·L) for as much as 8:16 h:min (6:44 to 9:48 h:min) per day. The prevalence of hyperglycemia was reduced by 31% to 5:38 h:min (3:17 to 7:00 h:min) over the 24-h period after the exercise bout (P < 0.001). Moreover, exercise lowered average blood glucose concentrations by 0.9 mmol·L (0.7 to 1.2) and reduced glycemic variability (P < 0.05). The response to exercise showed considerable variation between subjects and correlated positively with HbA1c levels (r = 0.38, P < 0.01). Nevertheless, even well-controlled patients with an HbA1c level below 7.0% (n = 28) achieved a 28% reduction in the daily prevalence hyperglycemia after exercise (P < 0.01).
  
  
  CONCLUSIONS
  A single bout of moderate-intensity exercise substantially improves glycemic control throughout the subsequent day in insulin- and non-insulin-treated type 2 diabetes patients. Of all baseline characteristics, only subjects' HbA1c level is related to the magnitude of response to exercise. Nevertheless, the present study demonstrates that even well-controlled patients benefit considerably from the blood glucose-lowering properties of daily exercise.
authors.affiliation: Department of Human Movement Sciences, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Jan-Willem
authors.initials: JW
authors.lastname: Van Dijk
authors.forename: Ralph J F
authors.initials: RJ
authors.lastname: Manders
authors.forename: Emanuel E
authors.initials: EE
authors.lastname: Canfora
authors.forename: Willem Van
authors.initials: WV
authors.lastname: Mechelen
authors.forename: Fred
authors.initials: F
authors.lastname: Hartgens
authors.forename: Coen D A
authors.initials: CD
authors.lastname: Stehouwer
authors.forename: Luc J C
authors.initials: LJ
authors.lastname: Van Loon
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000628:therapy*; D015444:Exercise / Q000502:physiology*; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000517:prevention & control; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D013997:Time Factors
chemical_list: D001786:Blood Glucose