Exercise-induced improvement of glycemic fluctuation and its relationship with fat and muscle distribution in type 2 diabetes.

Dan Liu, Ying Zhang, Qian Wu, Rui Han, Di Cheng, Liang Wu, Jingyi Guo, Xiangtian Yu, Wenli Ge, Jiacheng Ni, Yaohui Li, Tianshu Ma, Qichen Fang, Yufei Wang, Yan Zhao, Yanan Zhao, Biao Sun, Huating Li, Weiping Jia

Journal: Journal of diabetes 2024;16(4):e13549

PMID: 38584275

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Plain Language Summary

Exercise plays a crucial role in managing type 2 diabetes (T2DM). However, the impact of exercise on blood glucose fluctuation and its relationship with body fat and muscle distribution remains an area of interest. The aim of this study was to investigate the effect of combined aerobic and resistance exercise training on blood glucose fluctuation in type 2 diabetes patients and explore the predictors of exercise-induced glycaemic response. This study was a two-arm randomised controlled trial with an exercise group and a control group. The study included 50 patients with T2DM. Results showed that: - exercise training led to decreased 24-hour blood glucose fluctuations in the exercise group. - baseline visceral fat area and mid-thigh muscle area were significant predictors of glycaemic variability changes. Authors concluded that acute combined aerobic and resistance exercise training could improve glycemic fluctuation in T2D patients, and baseline fat and muscle distribution play a role in this effect.

Abstract

AIMS

Management of blood glucose fluctuation is essential for diabetes. Exercise is a key therapeutic strategy for diabetes patients, although little is known about determinants of glycemic response to exercise training. We aimed to investigate the effect of combined aerobic and resistance exercise training on blood glucose fluctuation in type 2 diabetes patients and explore the predictors of exercise-induced glycemic response.

MATERIALS AND METHODS

Fifty sedentary diabetes patients were randomly assigned to control or exercise group. Participants in the control group maintained sedentary lifestyle for 2 weeks, and those in the exercise group specifically performed combined exercise training for 1 week. All participants received dietary guidance based on a recommended diet chart. Glycemic fluctuation was measured by flash continuous glucose monitoring. Baseline fat and muscle distribution were accurately quantified through magnetic resonance imaging (MRI).

RESULTS

Combined exercise training decreased SD of sensor glucose (SDSG, exercise-pre vs exercise-post, mean 1.35 vs 1.10 mmol/L, p = .006) and coefficient of variation (CV, mean 20.25 vs 17.20%, p = .027). No significant change was observed in the control group. Stepwise multiple linear regression showed that baseline MRI-quantified fat and muscle distribution, including visceral fat area (β = -0.761, p = .001) and mid-thigh muscle area (β = 0.450, p = .027), were significantly independent predictors of SDSG change in the exercise group, as well as CV change.

CONCLUSIONS

Combined exercise training improved blood glucose fluctuation in diabetes patients. Baseline fat and muscle distribution were significant factors that influence glycemic response to exercise, providing new insights into personalized exercise intervention for diabetes.

Address: Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.; Clinical Research Center, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.; School of Sports Science and Physical Education, Nanjing Normal University, Nanjing, China.; Department of Kinesiology, Nanjing Sport Institute, Nanjing, China.; Department of Sports and Health Science, Nanjing Sport Institute, Nanjing, China.

DOI: 10.1111/1753-0407.13549