title: One bout of exercise alters free-living postprandial glycemia in type 2 diabetes.
abstract: OBJECTIVE
  Elevated postprandial glycemic (PPG) excursions are significant risk factors for cardiovascular disease in type 2 diabetes patients. In this study, we tested if and for how many meals a single bout of exercise would reduce PPG responses to subsequent meals in type 2 diabetes (T2D) patients using a continuous glucose monitor system (CGMS).
  
  
  METHODS
  We recruited nine sedentary (<30 min·wk(-1) of exercise) individuals with T2D (mean ± SD; body mass index = 36.0 ± 1.1 kg·m(-2), age = 60.3 ± 1.0 yr, HbA1c = 6.3% ± 0.2%). The subjects consumed a eucaloric diet (51% carbohydrate, 31% fat, and 18% protein) consisting of three meals, identical in composition, for a 2-d period while wearing a continuous glucose monitor system in two different conditions (exercise [EX], one 60-min bout at 60%-75% of heart rate reserve performed before breakfast), vs a sedentary [SED] condition). We quantified 24-h average glucose, PPG area under the curve (AUC; 4-h glucose AUC after meals), and PPG-2 h (2 h postprandial glucose).
  
  
  RESULTS
  EX significantly reduced average [glucose] during the first 24-h period (P = 0.03). EX caused a reduction in PPG-AUC (P = 0.02) for all of the meals during the 2 d (main effect between conditions). A comparison between the EX and the SED conditions at each meal revealed that EX reduced PPG-AUC after the second meal of day 1 (lunch) (P = 0.04). PPG-2 h was not significantly different between EX and SED.
  
  
  CONCLUSIONS
  Although a single EX bout does lower 24-h average [glucose], it only significantly lowered PPG-AUC at the second meal after the bout, suggesting that daily exercise may be needed to most effectively improve PPG at the advent of exercise training in T2D patients.
authors.affiliation: 1Departments of Nutrition and Exercise Physiology and Internal Medicine, University of Missouri, Columbia, MO; 2Division of Cardiology, Duke University Medical Center, Durham, NC; 3Division of Endocrinology, University of Missouri, Columbia, MO; 4Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO; and 5Harry S Truman Memorial VA Hospital, Columbia, MO.
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Oberlin
authors.forename: Catherine R
authors.initials: CR
authors.lastname: Mikus
authors.forename: Monica L
authors.initials: ML
authors.lastname: Kearney
authors.forename: Pamela S
authors.initials: PS
authors.lastname: Hinton
authors.forename: Camila
authors.initials: C
authors.lastname: Manrique
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Leidy
authors.forename: Jill A
authors.initials: JA
authors.lastname: Kanaley
authors.forename: R Scott
authors.initials: RS
authors.lastname: Rector
authors.forename: John P
authors.initials: JP
authors.lastname: Thyfault
mesh_terms: D019540:Area Under Curve; D001786:Blood Glucose / Q000378:metabolism*; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D019518:Postprandial Period; D013997:Time Factors
chemical_list: D001786:Blood Glucose