Impact of Exercise-Nutritional State Interactions in Patients with Type 2 Diabetes

Kenneth Verboven*, Inez Wens, Frank Vandenabeele, An Stevens, Bert Celie, Bruno Lapauw, Paul Dendale, Luc J. C. van Loon, Patrick Calders, Dominique Hansen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Introduction

This study examines the role of nutritional status during exercise training in patients with type 2 diabetes mellitus by investigating the effect of endurance-type exercise training in the fasted versus the fed state on clinical outcome measures, glycemic control, and skeletal muscle characteristics in male type 2 diabetes patients. Methods

Twenty-five male patients (glycated hemoglobin (HbA1(c)), 57 +/- 3 mmol center dot mol(-1) (7.4% +/- 0.3%)) participated in a randomized 12-wk supervised endurance-type exercise intervention, with exercise being performed in an overnight-fasted state (n = 13) or after consuming breakfast (n = 12). Patients were evaluated for glycemic control, blood lipid profiles, body composition and physical fitness, and skeletal muscle gene expression. Results

Exercise training was well tolerated without any incident of hypoglycemia. Exercise training significantly decreased whole-body fat mass (-1.6 kg) and increased high-density lipoprotein concentrations (+2 mg center dot dL(-1)), physical fitness (+1.7 mL center dot min(-1)center dot kg(-1)), and fat oxidation during exercise in both groups (P-TIME <0.05), with no between-group differences (P-TIME x GROUP > 0.05). HbA1(c) concentrations significantly decreased after exercise training (P-TIME <0.001), with a significant greater reduction after consuming breakfast (-0.30% +/- 0.06%) compared with fasted state (-0.08% +/- 0.06%; mean difference, 0.21%; P-TIME x GROUP = 0.016). No interaction effects were observed for skeletal muscle genes related to lipid metabolism or oxidative capacity. Conclusions

Endurance-type exercise training in the fasted or fed state do not differ in their efficacy to reduce fat mass, increase fat oxidation capacity, and increase cardiorespiratory fitness and high-density lipoprotein concentrations or their risk of hypoglycemia in male patients with type 2 diabetes. HbA1(c) seems to be improved more with exercise performed in the postprandial compared with the postabsorptive state.

Original languageEnglish
Pages (from-to)720-728
Number of pages9
JournalMedicine and Science in Sports and Exercise
Volume52
Issue number3
DOIs
Publication statusPublished - Mar 2020

Keywords

  • EXERCISE
  • GLYCEMIC CONTROL
  • NUTRITIONAL STATUS
  • TYPE 2 DIABETES MELLITUS
  • SUBSTRATE OXIDATION
  • INSULIN-RESISTANCE
  • AEROBIC EXERCISE
  • PLASMA-GLUCOSE
  • INTERVENTION
  • METAANALYSIS
  • MELLITUS
  • MEAL
  • REST
  • TIME

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