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Effect of moderate-intensity exercise versus activities of daily living on 24-hour blood glucose homeostasis in male patients with type 2 diabetes
van Dijk J-W, Venema M, van Mechelen W, Stehouwer CDA, Hartgens F, van Loon LJC
Diabetes Care 2013 Nov;36(11):3448-3453
clinical trial
3/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To investigate the impact of activities of daily living (ADL) versus moderate-intensity endurance-type exercise on 24-h glycemic control in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: Twenty males with type 2 diabetes participated in a randomized crossover study consisting of three experimental periods of 3 days each. Subjects were studied under sedentary control conditions, and under conditions in which prolonged sedentary time was reduced either by three 15-min bouts of ADL (postmeal strolling about 3 METs) or by a single 45-min bout of moderate-intensity endurance-type exercise (about 6 METs). Blood glucose concentrations were assessed by continuous glucose monitoring, and plasma insulin concentrations were determined in frequently sampled venous blood samples. RESULTS: Hyperglycemia (glucose > 10 mmol/L) was experienced for 6 h 51 min +/- 1 h 4 min per day during the sedentary control condition and was significantly reduced by exercise (4 h 47 min +/- 1 h 2 min; p < 0.001), but not by ADL (6 h 2 min +/- 1 h 16 min; p = 0.67). The cumulative glucose incremental areas under the curve (AUCs) of breakfast, lunch, and dinner were, respectively, 35 +/- 5% (p < 0.001) and 17 +/- 6% (p < 0.05) lower during the exercise and ADL conditions compared with the sedentary condition. The insulin incremental AUCs were, respectively, 33 +/- 4% (p < 0.001) and 17 +/- 5% (p < 0.05) lower during the exercise and ADL conditions compared with the sedentary condition. CONCLUSIONS: When matched for total duration, moderate-intensity endurance-type exercise represents a more effective strategy to improve daily blood glucose homeostasis than repeated bouts of ADL. Nevertheless, the introduction of repeated bouts of ADL during prolonged sedentary behavior forms a valuable strategy to improve postprandial glucose handling in patients with type 2 diabetes.
Copyright American Diabetes Association. Reprinted with permission from The American Diabetes Association.

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