title: Aerobic and combined exercise sessions reduce glucose variability in type 2 diabetes: crossover randomized trial.
abstract: OBJECTIVE
  To evaluate the effects of aerobic (AER) or aerobic plus resistance exercise (COMB) sessions on glucose levels and glucose variability in patients with type 2 diabetes. Additionally, we assessed conventional and non-conventional methods to analyze glucose variability derived from multiple measurements performed with continuous glucose monitoring system (CGMS).
  
  
  METHODS
  Fourteen patients with type 2 diabetes (56±2 years) wore a CGMS during 3 days. Participants randomly performed AER and COMB sessions, both in the morning (24 h after CGMS placement), and at least 7 days apart. Glucose variability was evaluated by glucose standard deviation, glucose variance, mean amplitude of glycemic excursions (MAGE), and glucose coefficient of variation (conventional methods) as well as by spectral and symbolic analysis (non-conventional methods).
  
  
  RESULTS
  Baseline fasting glycemia was 139±05 mg/dL and HbA1c 7.9±0.7%. Glucose levels decreased immediately after AER and COMB protocols by ∼16%, which was sustained for approximately 3 hours. Comparing the two exercise modalities, responses over a 24-h period after the sessions were similar for glucose levels, glucose variance and glucose coefficient of variation. In the symbolic analysis, increases in 0 V pattern (COMB, 67.0±7.1 vs. 76.0±6.3, P = 0.003) and decreases in 1 V pattern (COMB, 29.1±5.3 vs. 21.5±5.1, P = 0.004) were observed only after the COMB session.
  
  
  CONCLUSIONS
  Both AER and COMB exercise modalities reduce glucose levels similarly for a short period of time. The use of non-conventional analysis indicates reduction of glucose variability after a single session of combined exercises.
  
  
  BACKGROUND
  Aerobic training, aerobic-resistance training and glucose profile (CGMS) in type 2 diabetes (CGMS exercise). ClinicalTrials.gov ID: NCT00887094.
authors.affiliation: Exercise Pathophysiology Research Laboratory, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Franciele R
authors.initials: FR
authors.lastname: Figueira
authors.forename: Daniel
authors.initials: D
authors.lastname: Umpierre
authors.forename: Karina R
authors.initials: KR
authors.lastname: Casali
authors.forename: Pedro S
authors.initials: PS
authors.lastname: Tetelbom
authors.forename: Nicoli T
authors.initials: NT
authors.lastname: Henn
authors.forename: Jorge P
authors.initials: JP
authors.lastname: Ribeiro
authors.forename: Beatriz D
authors.initials: BD
authors.lastname: Schaan
mesh_terms: D001786:Blood Glucose; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000378:metabolism* / Q000628:therapy; D015444:Exercise; D005081:Exercise Therapy; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D005947:Glucose
references.citation: Diabetes Care. 1999 Oct;22(10):1647-54
references.pmid: 10526729
references.citation: Eur J Cardiovasc Prev Rehabil. 2009 Feb;16(1):53-9
references.pmid: 19188808
references.citation: Ann Intern Med. 2007 Sep 18;147(6):357-69
references.pmid: 17876019
references.citation: J Clin Invest. 2000 Feb;105(3):311-20
references.pmid: 10675357
references.citation: J Appl Physiol (1985). 2008 Dec;105(6):1967-74
references.pmid: 18845784
references.citation: Med Sci Sports Exerc. 2006 Dec;38(12):2037-44
references.pmid: 17146308
references.citation: Antioxid Redox Signal. 2005 Jan-Feb;7(1-2):256-68
references.pmid: 15650413
references.citation: Diabetes Care. 2011 Jul;34(7):1469-74
references.pmid: 21602430
references.citation: Crit Rev Immunol. 2002;22(3):165-82
references.pmid: 12498381
references.citation: Acta Diabetol. 2009 Mar;46(1):55-61
references.pmid: 18818862
references.citation: Diabetes. 2005 Jun;54(6):1615-25
references.pmid: 15919781
references.citation: Eur J Clin Invest. 2005 Dec;35(12):745-51
references.pmid: 16313250
references.citation: Circulation. 1991 Aug;84(2):482-92
references.pmid: 1860193
references.citation: Lancet. 1998 Sep 12;352(9131):837-53
references.pmid: 9742976
references.citation: IEEE Trans Biomed Eng. 2001 Nov;48(11):1282-91
references.pmid: 11686627
references.citation: Free Radic Biol Med. 2001 Sep 15;31(6):745-53
references.pmid: 11557312
references.citation: Diabetes. 1970 Sep;19(9):644-55
references.pmid: 5469118
references.citation: Diabetes Care. 2011 Jul;34(7):1605-9
references.pmid: 21610126
references.citation: Diabetes Care. 2009 Oct;32(10):1901-3
references.pmid: 19549736
references.citation: Med Sci Sports Exerc. 2003 Aug;35(8):1381-95
references.pmid: 12900694
references.citation: Diabetes Technol Ther. 2006 Dec;8(6):627-35
references.pmid: 17109594
references.citation: JAMA. 2011 May 4;305(17):1790-9
references.pmid: 21540423
references.citation: Diabetes Technol Ther. 2005 Apr;7(2):253-63
references.pmid: 15857227
references.citation: JAMA. 2006 Apr 12;295(14):1681-7
references.pmid: 16609090
references.citation: Am J Physiol Endocrinol Metab. 2010 Apr;298(4):E815-23
references.pmid: 20071560
references.citation: J Appl Physiol (1985). 1998 Jul;85(1):133-8
references.pmid: 9655766
references.citation: Crit Care Med. 2005 Dec;33(12):2764-71
references.pmid: 16352958
references.citation: Am J Respir Crit Care Med. 2006 Aug 1;174(3):290-8
references.pmid: 16690981
references.citation: Med Biol Eng Comput. 2000 Mar;38(2):180-8
references.pmid: 10829411
references.citation: Diabetes Care. 2008 Nov;31(11):2198-202
references.pmid: 18650371
references.citation: J Biol Chem. 1994 May 20;269(20):14396-401
references.pmid: 8182045
references.citation: Diabetes Care. 2001 Nov;24(11):1858-62
references.pmid: 11679447
references.citation: Phys Rev E Stat Nonlin Soft Matter Phys. 2008 Jun;77(6 Pt 2):066204
references.pmid: 18643347
references.citation: J Appl Physiol (1985). 1995 Jan;78(1):17-22
references.pmid: 7713807
references.citation: BMJ. 2000 Aug 12;321(7258):405-12
references.pmid: 10938048
references.citation: Diabetes Metab Syndr Obes. 2008 Aug 11;1:3-11
references.pmid: 21437151
references.citation: J Appl Physiol (1985). 2010 Feb;108(2):334-42
references.pmid: 20007854
references.citation: Am J Physiol Endocrinol Metab. 2008 Feb;294(2):E401-7
references.pmid: 18042670
references.citation: J Diabetes Sci Technol. 2008 Nov;2(6):1061-5
references.pmid: 19885294
references.citation: J Appl Physiol (1985). 2005 Jul;99(1):338-43
references.pmid: 16036907
references.citation: Diabetes Res Clin Pract. 2012 Dec;98(3):e36-9
references.pmid: 23041227
references.citation: JAMA. 2010 Nov 24;304(20):2253-62
references.pmid: 21098771
references.citation: Phys Rev Lett. 2005 Nov 4;95(19):198102
references.pmid: 16384029
references.citation: Acta Diabetol. 2012 Dec;49 Suppl 1:S171-7
references.pmid: 22547264
references.citation: Am J Physiol Regul Integr Comp Physiol. 2008 Aug;295(2):R550-7
references.pmid: 18495836
references.citation: Diabetes Technol Ther. 2011 Sep;13(9):921-8
references.pmid: 21714681