Morning exercise and pre-breakfast metformin interact to reduce glycaemia in people with Type 2 Diabetes: a randomized crossover trial
Abstract
Abstract Exercise is recommended in the treatment of Type 2 Diabetes and can improve insulin sensitivity [1]. However, previous evidence suggests that exercise at different times of the day in people with type 2 diabetes may have opposing outcomes on glycaemia [2]. Metformin is the most commonly prescribed initial pharmacological intervention in Type 2 Diabetes, and may alter adaptions to exercise [3]. It is unknown if there is an interaction between metformin and diurnal exercise outcomes. We aimed to investigate glycaemic outcomes of moderate intensity morning vs. evening exercise in people with type 2 diabetes being prescribed metformin monotherapy. We hypothesised that evening exercise would be more efficacious than morning exercise at lowering glycaemia. In this study, nine male and nine females with type 2 diabetes undergoing metformin monotherapy (age 61±2 year, mean±SEM) completed a 16-week crossover trial including 2- week baseline recording, six weeks randomly assigned to a morning exercise (7-10am) or evening exercise (4-7pm), and a two-week wash-out period. Exercise arms consisted of 30 minutes of walking at 70% of estimated max-HR every other day. Glucose levels were measured with continuous glucose monitors and activity measured by wrist-worn monitors. Food-intake was recorded by 4-day food diaries during baseline, first and last 2 weeks of each exercise arm. There was no difference in exercise intensity, total caloric intake, or total physical activity between…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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