Afternoon exercise is more efficacious than morning exercise at improving blood glucose levels in individuals with type 2 diabetes: a randomised crossover trial

Mladen Savikj, Brendan Gabriel, Petter S Alm, Jonathon A. B. Smith, Kenneth Caidahl, Marie Björnholm, Tomas Fritz, Anna Crook, Juleen R. Zierath, Harriet Wallberg-Henriksson* (Corresponding Author)

*Corresponding author for this work

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17 Citations (Scopus)

Abstract

Aims/hypothesis
Exercise is recommended for the treatment and prevention of type 2 diabetes. However, the most effective time of day to achieve beneficial effects on health remains unknown. We aimed to determine whether exercise training at two distinct times of day would have differing effects on 24 h blood glucose levels in men with type 2 diabetes.

Methods
Eleven men with type 2 diabetes underwent a randomised crossover trial. Inclusion criteria were 45–68 years of age and BMI between 23 and 33 kg/m2. Exclusion criteria were insulin treatment and presence of another systemic illness. Researchers were not blinded to the group assignment. The trial involved 2 weeks of either morning or afternoon high-intensity interval training (HIIT) (three sessions/week), followed by a 2 week wash-out period and a subsequent period of the opposite training regimen. Continuous glucose monitor (CGM)-based data were obtained.

Results
Morning HIIT increased CGM-based glucose concentration (6.9 ± 0.4 mmol/l; mean ± SEM for the exercise days during week 1) compared with either the pre-training period (6.4 ± 0.3 mmol/l) or afternoon HIIT (6.2 ± 0.3 mmol/l for the exercise days during week 1). Conversely, afternoon HIIT reduced the CGM-based glucose concentration compared with either the pre-training period or morning HIIT. Afternoon HIIT was associated with elevated thyroid-stimulating hormone (TSH; 1.9 ± 0.2 mU/l) and reduced T4 (15.8 ± 0.7 pmol/l) concentrations compared with pre-training (1.4 ± 0.2 mU/l for TSH; 16.8 ± 0.6 pmol/l for T4). TSH was also elevated after morning HIIT (1.7 ± 0.2 mU/l), whereas T4 concentrations were unaltered.

Conclusions/interpretation
Afternoon HIIT was more efficacious than morning HIIT at improving blood glucose in men with type 2 diabetes. Strikingly, morning HIIT had an acute, deleterious effect, increasing blood glucose. However, studies of longer training regimens are warranted to establish the persistence of this adverse effect. Our data highlight the importance of optimising the timing of exercise when prescribing it as treatment for type 2 diabetes.
Original languageEnglish
Pages (from-to)233-237
Number of pages5
JournalDiabetologia
Volume62
Early online date13 Nov 2018
DOIs
Publication statusPublished - Feb 2019

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    Savikj, M., Gabriel, B., Alm, P. S., Smith, J. A. B., Caidahl, K., Björnholm, M., Fritz, T., Crook, A., Zierath, J. R., & Wallberg-Henriksson, H. (2019). Afternoon exercise is more efficacious than morning exercise at improving blood glucose levels in individuals with type 2 diabetes: a randomised crossover trial. Diabetologia, 62, 233-237. https://doi.org/10.1007/s00125-018-4767-z