ECSS Paris 2023: OP-MH29
INTRODUCTION: While the optimal timing for exercise to control glucose levels remains unclear, especially regarding the long-term effects of exercise timing, this study aims to investigate the long-term effect of exercise timing in relation to meal times—specifically, pre-meal and post-meal exercise—on glucose homeostasis in young adults with overweight and obesity using continuous glucose monitoring (CGM). METHODS: A randomized controlled study was conducted on 34 overweight and obese young adults aged 18 to 35 who underwent a 10-week intervention with different exercise timings. The pre-meal exercise group performed at least 30 minutes of moderate-intensity (65% HRmax) aerobic exercise within 60 minutes before a meal, while the post-meal exercise group performed the same within 0-90 minutes after a meal, five times a week. The exercise intervention was conducted at a smart health station with at least two supervised exercise sessions per week and three self-exercise sessions, monitored by a heart rate belt. The primary outcome was 24-hour continuous glucose levels measured via CGM (SIBIONICS), with secondary outcomes being physical and mental health indicators. Participants maintained their usual dietary habits during the intervention and wore an actiGraph 3X accelerometer to monitor physical activity levels before and after the intervention. Paired t-tests were used for within-group comparisons, and covariance analysis was used for between-group comparisons. RESULTS: There were no significant differences in 24-hour mean glucose (98.23±3.16 vs. 97.77±4.22 mg/dL), mean amplitude of glucose fluctuation (MAGE, 31.87±4.37 vs. 33.12±6.82), coefficient of variation of glucose (CV%, 15.68±1.50% vs. 16.92±3.50%) and continuous overall glycemic effect (CONGA,15.37±2.34 vs. 16.11±3.21 mg/dL) between or within the pre-meal and post-meal exercise groups (all p ＞0.05). However, the hypoglycemia index significantly decreased in the pre-meal exercise group (p = 0.039). Regarding mental health indicators, only the pre-meal exercise group showed a significant improvement in mindfulness awareness. After the intervention, both groups increased their daily moderate-intensity physical activity time and reduced their sedentary time. CONCLUSION: A 10-week pre- or post-meal exercise intervention did not significantly affect 24-hour continuous glucose levels. Compared to post-meal exercise, pre-meal exercise may reduce the risk of hypoglycemia in young adults with overweight and obesity.
Read CV Xiaoyuan ZhangECSS Paris 2023: OP-MH29
INTRODUCTION: Exercise interventions play a pivotal role in managing type 2 diabetes (T2D), yielding significant benefits in glycemic regulation. Despite the role that exercise time, volume, frequency, and consistency play in exercise prescription for T2D interventions, research is still discrepant on what metric(s) might have a more potent effect on improving glycemic regulation. The purpose of the present study was to explore the relationship between exercise metrics (duration, volume, frequency, and consistency) and markers of glycemic regulation [HbA1c and continuous glucose monitoring (CGM) metrics including mean 24-hour glucose, glycemic variability, and eA1c] after a 26-week mHealth intervention. METHODS: This was a secondary analysis of the MOTIVATE T2D trial (NCT04653532); an RCT investigating the feasibility of an mHealth exercise intervention. Inactive individuals with newly diagnosed (<2 years) T2D (N= 58) completed blood and 14-day CGM testing before (T0) and after (T1) a 26-week mHealth exercise intervention. HbA1c was assessed using a lab-based point-of-care machine (Afinion 2, Abbot Inc.). CGM analysis was performed at T0 and T1 using an online no-code webtool called Diametrics (diametrics.org). Participants were asked to wear a fitness watch during the 26-week tailored intervention, and raw exercise data from each recorded session were extracted. Exercise metrics (duration, volume, frequency, and consistency) were calculated across i) the total 26-weeks; ii) the first 13 weeks (where personalized support and changes were provided); iii) the last 13 weeks (where support was reduced) of the intervention and were compared to the CGM metrics at T1. A linear model was used to examine the predictors of mean 24-hour glucose, glycemic variability (SD, CV), HbA1c, and eA1c at T1. RESULTS: Average duration (57 ± 36 minutes) of each exercise session significantly predicted HbA1c (β = -0.23 (0.07), P = 0.002), 24-hour mean glucose (β = -0.03 (0.01), P = 0.01), eA1c (β = -0.02 (0.01), P = 0.01), and glucose standard deviation (β = -0.01 (0.0), P = 0.003) at T1. Exercise minutes (duration) accumulated during the first 13 weeks of the intervention (2931 ± 3362 minutes) were also a significant predictor of HbA1c (β = -0.001 (0.0), P = 0.01), 24-hour mean glucose (β = -0.002 (0.0), P = 0.01), eA1c (β = -0.0001 (0.0), P = 0.01), and standard deviation (β = -0.005 (0.0), P = 0.03). CONCLUSION: Average exercise session duration and total exercise minutes accumulated during the first 13 weeks of the intervention predicted HbA1c, mean 24-hour glucose, eA1c, and glucose standard deviation at the end of a 26-week mHealth exercise intervention. These findings suggest that accumulating more minutes (duration) of exercise is an important metric for improving glucose regulation in people with newly diagnosed type 2 diabetes, especially in the early phases of an exercise intervention.
Read CV Jonathan LowECSS Paris 2023: OP-MH29
INTRODUCTION: While previous research has explored the individual effects of aerobic and resistance training on anxiety and depression in individuals with type 2 diabetes, the combined impact of these exercise modalities remains underexplored. This study examines the effectiveness of a 24-week combined aerobic and resistance training program in reducing anxiety and depression scores in this population. METHODS: The study involved 43 inactive women aged 39 to 70 years with type 2 diabetes. Participants were assigned to a combined aerobic and resistance training (n=31) or a sedentary control group (n=12). Participants in the training group engaged in supervised combined exercise training sessions three times a week over 24 weeks. Beck Anxiety Inventory (BAI) and Beck Depression Inventory-II (BDI) were used to determine depression and anxiety scores. RESULTS: At baseline both groups scored similarly on the BAI and BDI. After 24 weeks, the trained group showed significant reductions in anxiety scores (12 weeks: 5.96 ± 2.88; 24 weeks: 4.83 ± 1.42), whereas the control group exhibited increased anxiety (12 weeks: 15.25 ± 5.86; 24 weeks: 19.41 ± 1.08). Significant differences were observed between groups. The trained group maintained stable depression scores (12 weeks: 5.51 ± 2.71; 24 weeks: 5.58 ± 3.59), while the control group’s scores increased (12 weeks: 15.58 ± 6.12; 24 weeks: 19.58 ± 0.99). Significant differences between groups were observed at 12 weeks (p = 0.001) and 24 weeks (p = 0.000). CONCLUSION: The training program significantly reduced anxiety and stabilized depression in the trained group compared to the control group. These findings highlight the programs effectiveness in managing anxiety and depression over time.
Read CV Meriam DenguezliECSS Paris 2023: OP-MH29