title: Effect of moderate-intensity exercise versus activities of daily living on 24-hour blood glucose homeostasis in male patients with type 2 diabetes.
abstract: OBJECTIVE
  To investigate the impact of activities of daily living (ADL) versus moderate-intensity endurance-type exercise on 24-h glycemic control in patients with type 2 diabetes.
  
  
  METHODS
  Twenty 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 >10 mmol/L) was experienced for 6 h 51 min ±1 h 4 min per day during the sedentary control condition and was significantly reduced by exercise (4 h 47 min ± 1 h 2 min; P < 0.001), but not by ADL (6 h 2 min ± 1 h 16 min; P = 0.67). The cumulative glucose incremental areas under the curve (AUCs) of breakfast, lunch, and dinner were, respectively, 35 ± 5% (P < 0.001) and 17 ± 6% (P < 0.05) lower during the exercise and ADL conditions compared with the sedentary condition. The insulin incremental AUCs were, respectively, 33 ± 4% (P < 0.001) and 17 ± 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.
authors.affiliation: Corresponding author: Luc J.C. van Loon, l.vanloon@maastrichtuniversity.nl.
authors.forename: Jan-Willem
authors.initials: JW
authors.lastname: van Dijk
authors.forename: Maarten
authors.initials: M
authors.lastname: Venema
authors.forename: Willem
authors.initials: W
authors.lastname: van Mechelen
authors.forename: Coen D A
authors.initials: CD
authors.lastname: Stehouwer
authors.forename: Fred
authors.initials: F
authors.lastname: Hartgens
authors.forename: Luc J C
authors.initials: LJ
authors.lastname: van Loon
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000628:therapy*; D015444:Exercise; D005081:Exercise Therapy; D006706:Homeostasis; D006801:Humans; D006943:Hyperglycemia / Q000097:blood; D007328:Insulin / Q000097:blood; D008297:Male; D062407:Meals; D008875:Middle Aged; D019518:Postprandial Period
chemical_list: D001786:Blood Glucose; D007328:Insulin
references.citation: Diabetes Care. 2008 Aug;31(8):1473-8
references.pmid: 18540046
references.citation: Med Sci Sports Exerc. 2011 Aug;43(8):1575-81
references.pmid: 21681120
references.citation: Diabetologia. 2009 Jan;52(1):17-30
references.pmid: 18941734
references.citation: Diabetes Care. 2005 Oct;28(10):2361-6
references.pmid: 16186263
references.citation: Sports Med. 2001 Feb;31(2):101-14
references.pmid: 11227978
references.citation: Arch Intern Med. 2012 Mar 26;172(6):494-500
references.pmid: 22450936
references.citation: Med Sci Sports Exerc. 2006 Feb;38(2):201-7
references.pmid: 16531885
references.citation: Appl Physiol Nutr Metab. 2009 Dec;34(6):1087-92
references.pmid: 20029518
references.citation: Diabetes Care. 1998 Jul;21(7):1167-72
references.pmid: 9653614
references.citation: Med Sci Sports Exerc. 2006 Dec;38(12):2037-44
references.pmid: 17146308
references.citation: Diabetes Care. 2002 Oct;25(10):1845-50
references.pmid: 12351489
references.citation: Diabetologia. 2008 Mar;51(3):398-401
references.pmid: 18183362
references.citation: Diabetes Care. 2010 Jan;33 Suppl 1:S62-9
references.pmid: 20042775
references.citation: Annu Rev Med. 1998;49:235-61
references.pmid: 9509261
references.citation: BMJ. 2000 Aug 12;321(7258):405-12
references.pmid: 10938048
references.citation: Diabetologia. 2012 May;55(5):1417-23
references.pmid: 22311420
references.citation: J Clin Endocrinol Metab. 2006 Mar;91(3):813-9
references.pmid: 16352690
references.citation: Diabetes Care. 2012 May;35(5):976-83
references.pmid: 22374636
references.citation: Diabetes Care. 2008 Apr;31(4):661-6
references.pmid: 18252901
references.citation: Diabetes Care. 2010 Dec;33(12):e147-67
references.pmid: 21115758
references.citation: Diabetologia. 2012 Mar;55(3):636-43
references.pmid: 22186981
references.citation: J Immigr Minor Health. 2012 Oct;14(5):816-22
references.pmid: 22270150
references.citation: Med Sci Sports Exerc. 2012 May;44(5):793-9
references.pmid: 22051572
references.citation: Diabetes Care. 2007 Jun;30(6):1384-9
references.pmid: 17473059
references.citation: Arch Intern Med. 2012 Sep 24;172(17):1285-95
references.pmid: 22868663
references.citation: PLoS One. 2012;7(11):e49297
references.pmid: 23185314
references.citation: JAMA. 2011 Jun 15;305(23):2448-55
references.pmid: 21673296
references.citation: Clin Sci (Lond). 2006 Aug;111(2):119-26
references.pmid: 16613586
references.citation: Med Sci Sports Exerc. 2010 Feb;42(2):219-25
references.pmid: 19927038
references.citation: Diabetes Obes Metab. 2012 Jun;14(6):575-7
references.pmid: 22268455
references.citation: Diabetologia. 2012 May;55(5):1273-82
references.pmid: 22124605
references.citation: Am J Physiol Gastrointest Liver Physiol. 2012 Jul 15;303(2):G155-68
references.pmid: 22517770
references.citation: Diabetes Res Clin Pract. 2011 Jul;93(1):31-7
references.pmid: 21497935
references.citation: Diabetologia. 1999 Aug;42(8):926-31
references.pmid: 10491751
references.citation: Diabetologia. 2009 Sep;52(9):1789-97
references.pmid: 19370339
references.citation: Diabetes Care. 2010 Jan;33 Suppl 1:S11-61
references.pmid: 20042772
references.citation: Diabetes Care. 2012 May;35(5):948-54
references.pmid: 22399700