title: Effects of postmeal exercise on postprandial glucose excursions in people with type 2 diabetes treated with add-on hypoglycemic agents.
abstract: OBJECTIVE
  Type 2 diabetes treatment primarily focuses on reducing hyperglycemia, including postprandial glucose excursions. Hypoglycemic agents are used clinically to lower fasting and postprandial glucose. Metformin is the first-line therapy; however, if metformin is inadequate then 'add-on' hypoglycemic agents are implemented. Postmeal exercise has been shown to lower postprandial glucose. The aim of this study was to assess if postmeal exercise provides additional glucose-lowering benefit, beyond medication alone, in those on add-on hypoglycemic agents.
  
  
  METHODS
  Postprandial glucose excursions in eight participants with type 2 diabetes (Age: 60±10.7, HbA1C: 7.9±2.3) being treated with add-on hypoglycemic agents were assessed during both drug-treated sedentary and drug-treated postmeal exercise conditions. Continuous glucose monitoring was used to assess peak and area under the glucose curve (AUC) during exercise, as well as peak within a 2-h time window, 2-h total and 2-h incremental AUC after a standardized breakfast meal. Postmeal exercise consisted of 3×10-min intervals of treadmill walking at 50% maximal oxygen uptake.
  
  
  RESULTS
  Glucose peak (drug only: 13.8±3.7, drug/exercise: 9.9±2.7mmol/L; p=0.02) and AUC (drug only: 500±136, drug/exercise: 357±89mmol/L×40min; p=0.03) were reduced during postmeal exercise. Breakfast 2-h incremental AUC was also reduced (drug only: 585±291, drug/exercise: 330±294; p=0.047).
  
  
  CONCLUSIONS
  Post-breakfast exercise lowered glucose during the exercise bout, although this effect was not sustained on later meals.
authors.affiliation: Department of Pathobiology, Cleveland Clinic Foundation, Cleveland, OH, United States. Electronic address: ericksm@ccf.org.
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Erickson
authors.affiliation: School of Health and Exercise Science, University of British Columbia Okanagan, Kelowna, BC, Canada.
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Little
authors.affiliation: College of Public Health, University of Georgia, Athens, GA, United States.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Gay
authors.affiliation: Department of Kinesiology, University of Georgia, Athens, GA, United States.
authors.forename: Kevin K
authors.initials: KK
authors.lastname: McCully
authors.affiliation: Department of Kinesiology, University of Georgia, Athens, GA, United States.
authors.forename: Nathan T
authors.initials: NT
authors.lastname: Jenkins
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000187:drug effects; D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy / Q000628:therapy*; D004359:Drug Therapy, Combination; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D008297:Male; D062407:Meals; D008687:Metformin / Q000008:administration & dosage*; D008875:Middle Aged; D019518:Postprandial Period
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D008687:Metformin
keywords: Continuous glucose monitoring; Hypoglycemic agents; Postmeal exercise; Postprandial glucose excursions; Type 2 diabetes