Issue: August 2013
July 01, 2013
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Baseline glycemic state influences exercise-induced glycemic control

Issue: August 2013
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Recent data suggest that the extent of exercise-induced improvements in glycemic control might depend on glycemic levels prior to training.

According to a research letter published in JAMA Internal Medicine, these findings demonstrate that moderate-intensity aerobic exercise can improve glycemic control. However, patients with ambient hyperglycemia are more likely to be nonresponders, according to data.

Thomas P. J. Solomon, PhD, of the Centre of Inflammation and Metabolism, Copenhagen, Denmark, and colleagues studied body composition, aerobic fitness and glycemic control in 105 overweight or obese patients (mean BMI, 33 kg/m2; mean age, 61 years) with impaired glucose tolerance (n=56) or type 2 diabetes (n=49) before and after a 12- to 16-week aerobic exercise training period. Their goal was to determine whether the baseline pre-training glycemic state affected post-exercise changes in glycemic control.

The researchers observed significant improvements in body weight (−4.6 kg), whole-body adiposity (−1.9%), VO2max (0.23 L per minute), fasting plasma glucose (−0.35 mmol/L), and 2-hour OGTT (−0.8 mmol/L) following exercise training, according to data.

Although pre-training FPG levels did not affect exercise-induced changes in glycemic control, the researchers wrote that there was a nonlinear quadratic relationship between pre-training 2-hour OGTT and exercise-induced changes in the 2-hour glucose response (P=.06).

Furthermore, patients with a pre-training 2-hour OGTT level <13.1 mmol/L demonstrated greater exercise-induced decreases in 2-hour glucose level (P<.001) compared with patients with a pre-training 2-hour OGTT level >13.1 mmol/L who had less significant improvements in 2-hour glucose level (P=.07).

Patients with a pre-training HbA1c level <6.2% displayed an exercise-induced decrease in HbA1c (P=.005) compared with patients who had a pre-training HbA1c level >6.2% who demonstrated smaller exercise-induced improvements in HbA1c levels (P=.04), the researchers wrote.

“The clinical relevance of these new findings is paramount and highlights the need to understand the metabolic ‘nonresponder,’” they wrote.

Disclosure: The researchers report no relevant financial disclosures.