Type 2 diabetes (T2D) patients are advisable exercise together with dietary and behavior modifications. In reality, exercise is an independent treatment that may prevent, delay, or reverse T2D.

A recent American Journal of Medicine Open study compared aerobic, resistance, and concurrent exercise, which is the mix of each aerobic and resistance exercise, to find out its effect on insulin sensitivity and cardiometabolic health. Moreover, the researchers assessed whether the intensity or timing of exercise throughout the day influences optimal effects on glucose control.

Study: The importance of exercise for glycemic control in type 2 diabetes. Image Credit: Gorodenkoff / Shutterstock.com

Exercise and T2D

Clinicians recommend increased physical activity improves glucose levels and helps manage glycemia inside a given range. Individuals at a high risk of T2D are advised to do physical activity of either 150 minutes every week of moderate-intensity exercise or vigorous-intensity aerobic exercise for 75 minutes each week. Increased physical activity and a low-fat food regimen promote weight reduction, which reduces T2D risk by roughly 45%.

Haemoglobin A1C (HbA1C) indicates the typical blood glucose levels for eight to 12 weeks. Notably, a discount in body weight by 2-10% between one and 4 years results in a discount in HbA1c by 0.2-1.0%.

The U.S. Diabetes Prevention Program (DPP) revealed that a rise in physical activity of half-hour every day not only decreased the cumulative incidence of diabetes by 58% in prediabetics but additionally reduced the incidence of recent T2D cases.

A recent study has indicated that caloric restriction through dietary modification and exercise in individuals with T2D improved insulin sensitivity and glucose tolerance. An oral glucose tolerance test (OGTT) revealed that the mix of dietary modifications and physical activity yielded higher results as in comparison with practicing either one in all the interventions alone.

Only two weeks of exercise was linked with an improvement in glucagon-like peptide-1 (GLP-1), which was related to improved pancreatic β-cell function. A high-intensity interval exercise suppressed acylated ghrelin and increased satiety. Due to this fact, the addition of exercise to caloric restriction improves quality of life.

Combining exercise and caloric restriction has also been shown to diminish visceral fat. In reality, previous studies found that individuals practicing high-resistance exercise lost the best amount of visceral fat as in comparison with other types of exercise.

Weight reduction is a big predictor of T2D prevention. Recent estimates indicate that a 4% weight reduction with 150 minutes each week of physical activity causes a discount in HbA1c by 0.2%. Several studies have indicated that exercise positively influences glucoregulatory effects through weight loss-dependent-and-independent mechanisms.

T2D conditions could be reversed through exercise. One previous study reported that 12 months of high-intensity exercise can reverse and normalize blood glucose in prediabetics and patients with T2D. One other study has shown that two weeks of high-intensity interval or moderate continuous exercise can reverse prediabetic conditions.

Short-term high-intensity interval training (HIIT) for over two weeks decreased the typical glucose reading substantially. Nevertheless, all individuals with hyperglycemia don’t respond favorably to exercise. 

How does exercise timing influence the health advantages?

Recently, researchers have investigated favorable exercise timing, resembling the time of day and before/after meals, for optimal glycemic control. This may assist in long-term glycemic control and postprandial glucose spikes across the day.

To this end, scientists considered circadian physiology, which influences glucose homeostasis. A wide range of physiologic processes, resembling glucose tolerance, body temperature, circulating insulin, and adipose tissue-related hormones, are related to circadian physiology.

In healthy individuals, these processes collectively worsen within the afternoon and evening as in comparison with the morning. Considering this commentary, some studies have indicated that the consumption of smaller meals during dinner could possibly be more useful than traditional large dinner meals.

T2D patients have a disrupted circadian rhythm, which could possibly be improved with exercise. Diurnal oscillations indicate that glucose metabolism is healthier at specific times of the day and that incorporating exercise in these timings will yield optimal glycemic control.

Some studies have shown that for each individuals with or without T2D, physical activity within the afternoon or evening could possibly be more useful for glucose sensitivity and circulating glucose as in comparison with similar levels of exercise within the morning. Nevertheless, morning exercise was found to be higher for weight management and activity adherence.

Postprandial exercise has been related to higher glucose control by attenuating acute glycemic spikes, regardless of exercise intensity or type. An extended duration of physical activity revealed more significant health advantages.

Exercising half-hour before a meal reduced postprandial blood glucose in patients with T2D or insulin resistance. As well as, moderate-intensity cycling before carbohydrate intake improved postprandial insulin sensitivity and reduced lipemia in obese men.

A temporary exercise, resembling three sets of one-minute light-intensity jogging or resistance exercise, after meals, blunted glucose spikes. It is crucial to interrupt sedentary behavior with physical activity to experience quality of life.