When to exercise to further improve blood sugar in patients with type 2 diabetes

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A study by researchers at Brigham and Women’s Hospital and the Joslin Diabetes Center suggests that afternoon physical activity can significantly improve blood sugar control in patients with type 2 diabetes. data from the Look AHEAD study, the team found that people who were most active in the afternoon had the greatest reduction in blood sugar and were the most likely to stop diabetes medication.

In an analysis of the Look AHEAD study, researchers from the Brigham and Joslin Diabetes Center found that participants who were physically active in the afternoon had greater blood sugar reductions than those who were most active at other times. times of the day.

More than 37 million Americans have diabetes, and 90-95% of this population is diagnosed with type 2 diabetes. Lifestyle interventions, such as a healthy diet and a regular exercise program, are diabetes management methods. A new study from a collaboration between researchers at Brigham and Women’s Hospital, a founding member of the Mass General Brigham Health System, and the Joslin Diabetes Center, part of Beth Israel Lahey Health, uses data from Look AHEAD (Action for Health in Diabetes) study, a randomized controlled trial that compared intensive lifestyle intervention with diabetes support and education in patients diagnosed with type 2 diabetes and overweight or obesity to follow development of

“In this study, we showed that adults with type 2 diabetes had the greatest improvement in blood sugar control when they were most active in the afternoon,” said co-corresponding author Jingyi. Qian, PhD, from the Division of Sleep and Circadian Disorders at the hospital. Brigham. “We know that physical activity is beneficial, but what our study adds is new understanding that the timing of activity may also matter.”

Doctors recommend that patients with diabetes participate in regular physical activity as a method of managing their blood sugar levels. High blood sugar can put people with type 2 diabetes at risk for heart disease, visual impairment and kidney disease.

The team analyzed physical activity data from the first and fourth years of the Look AHEAD study, which included data from more than 2,400 participants. During the study, participants wore an accelerometer recording device at the waist to measure physical activity. When Brigham and Joslin’s team looked at Year 1 data, they determined that those who engaged in moderate-to-vigorous physical activity in the afternoon had the greatest reduction in blood sugar. Comparing 4 year data, the afternoon group maintained a reduction in blood sugar. Additionally, the afternoon group also had the highest odds of stopping their glucose-lowering/diabetic medications.

Brigham and Joslin’s team note that their investigation has limitations; for example, their study is observational and does not measure confounders like sleep and food intake.

In future studies, the team could test their findings experimentally to investigate the underlying mechanisms that may explain why time of day of activity may influence blood sugar control. From there, the team may be able to provide patient-specific physical activity recommendations.

“Timing seems to matter,” said co-corresponding author Roeland Middelbeek, MD, associate researcher at the Joslin Diabetes Center. “In the future, we may have more data and experimental evidence for patients to give more personalized recommendations.”

Reference: “Association of timing of moderate-to-vigorous physical activity with changes in glycemic control over 4 years in adults with type 2 diabetes from the Look AHEAD trial” by Jingyi Qian, Qian Xiao, Michael P. Walkup, Mace Coday, Melissa L. Erickson, Jessica Unick, John M. Jakicic, Kun Hu, Frank AJL Scheer, Roeland JW Middelbeek and Look AHEAD Research Group, May 25, 2023, Diabetic treatments.
DOI: 10.2337/dc22-2413

This study was funded by the National Heart, Lung, and Blood Institute (K99-HL-148500, R01-HL140574), the National Institute on Aging (RF1AG059867 and RF1AG064312), and the National Institute of Diabetes and Digestive and Kidney Diseases (K23 -DK114550). The Look AHEAD study was supported by the Department of Health and Human Services through the following cooperative agreements from the

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