title: Does a single bout of resistance or aerobic exercise after insulin dose reduction modulate glycaemic control in type 2 diabetes? A randomised cross-over trial.
abstract: OBJECTIVE
  Regular exercise is advocated for individuals with type 2 diabetes, without fully understanding the acute (0-72h post-exercise) glycaemic response. This study assessed post-exercise glycaemic profiles of non-exercising individuals with insulin treated type 2 diabetes, following resistance and aerobic exercise.
  
  
  METHODS
  Randomised cross-over trial.
  
  
  METHODS
  Fourteen individuals with insulin treated type 2 diabetes (9 males, 5 females) aged 58.1±7.1 years (HbA1c: 8.0±0.6%) were allocated to single sessions of resistance (six whole-body exercises, three sets, 8-10 repetitions, 70% 1RM) and aerobic (30min cycling, 60% VO2peak) exercise, 7-days apart, with the day prior to the first exercise day of each intervention being the control condition. Immediately prior to exercise, insulin dosage was halved and breakfast consumed. Continuous glucose monitoring was undertaken to determine area under the curve and glucose excursions.
  
  
  RESULTS
  Blood glucose initially increased (0-2h) following both resistance and aerobic exercise (p<0.001), peaking at 12.3±3.4mmolL(-1) and 12.3±3.3mmolL(-1), respectively. Area under the glucose curve was not statistically different over any of the 24h periods (p=0.12), or different in response to resistance (222±41mmolL(-1)24h(-1)) or aerobic (211±40 mmolL(-1)24h(-1)) exercise (p=0.56). Incidence of hyperglycaemia did not differ between exercise modes (p=0.68). Hypoglycaemic events were identified in three and four participants following resistance and aerobic exercise respectively: these did not require treatment.
  
  
  CONCLUSIONS
  Glycaemic response is not different between exercise modes, although 50% insulin dose reduction prior to exercise impairs the expected improvement. A common clinical recommendation of 50% insulin dose reduction does not appear to cause adverse glycaemic events.
authors.affiliation: Discipline of Exercise Physiology, La Trobe Rural Health School, La Trobe University, Australia; Physiotherapy Department, Austin Hospital, Austin Health, Australia; Discipline of Exercise Sciences, School of Medical Sciences, RMIT University, Australia. Electronic address: b.gordon@latrobe.edu.au.
authors.forename: Brett A
authors.initials: BA
authors.lastname: Gordon
authors.affiliation: Discipline of Exercise Sciences, School of Medical Sciences, RMIT University, Australia.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Bird
authors.affiliation: Endocrinology and Diabetes, St. Vincent's Hospital & University of Melbourne, Australia.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: MacIsaac
authors.affiliation: Discipline of Exercise Sciences, School of Medical Sciences, RMIT University, Australia.
authors.forename: Amanda C
authors.initials: AC
authors.lastname: Benson
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000628:therapy; D004305:Dose-Response Relationship, Drug; D015444:Exercise; D005260:Female; D038321:Glycemic Index; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage* / Q000097:blood; D008297:Male; D008875:Middle Aged; D055070:Resistance Training
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Continuous glucose monitoring; Exercise therapy; Glucose; Hyperglycemia; Hypoglycemic agents; Resistance training