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

doi:10.1249/MSS.0000000000002165

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 journal › Article › Academic › peer-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 language	English
Pages (from-to)	720-728
Number of pages	9
Journal	Medicine and Science in Sports and Exercise
Volume	52
Issue number	3
DOIs	https://doi.org/10.1249/MSS.0000000000002165
Publication status	Published - 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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10.1249/MSS.0000000000002165

Cite this

@article{330ab889c07f49cbac0fc6ace248e1c0,

title = "Impact of Exercise-Nutritional State Interactions in Patients with Type 2 Diabetes",

abstract = "IntroductionThis 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. MethodsTwenty-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. ResultsExercise 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. ConclusionsEndurance-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.",

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

author = "Kenneth Verboven and Inez Wens and Frank Vandenabeele and An Stevens and Bert Celie and Bruno Lapauw and Paul Dendale and {van Loon}, {Luc J. C.} and Patrick Calders and Dominique Hansen",

note = "Funding Information: The authors thank all patients who participated and H. Francois (Maastricht University) for his assistance during the intervention. The authors thank University Biobank Limburg (UBiLim, Jessa Hospital, Belgium) for their technical support in sample handling and storage. This work was supported by the King Baudouin Fund, which provided a personal Yvonne and Jacques Francois de Meurs grant to Dominique Hansen. The authors declare that they have no conflict of interest in relation to this work. The results of the present study do not constitute endorsement by the American College of Sports Medicine. The results presented are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation. Publisher Copyright: {\textcopyright} Lippincott Williams & Wilkins.",

year = "2020",

month = mar,

doi = "10.1249/MSS.0000000000002165",

language = "English",

volume = "52",

pages = "720--728",

journal = "Medicine and Science in Sports and Exercise",

issn = "0195-9131",

publisher = "LIPPINCOTT WILLIAMS & WILKINS",

number = "3",

}

TY - JOUR

T1 - Impact of Exercise-Nutritional State Interactions in Patients with Type 2 Diabetes

AU - Verboven, Kenneth

AU - Wens, Inez

AU - Vandenabeele, Frank

AU - Stevens, An

AU - Celie, Bert

AU - Lapauw, Bruno

AU - Dendale, Paul

AU - van Loon, Luc J. C.

AU - Calders, Patrick

AU - Hansen, Dominique

N1 - Funding Information: The authors thank all patients who participated and H. Francois (Maastricht University) for his assistance during the intervention. The authors thank University Biobank Limburg (UBiLim, Jessa Hospital, Belgium) for their technical support in sample handling and storage. This work was supported by the King Baudouin Fund, which provided a personal Yvonne and Jacques Francois de Meurs grant to Dominique Hansen. The authors declare that they have no conflict of interest in relation to this work. The results of the present study do not constitute endorsement by the American College of Sports Medicine. The results presented are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation. Publisher Copyright: © Lippincott Williams & Wilkins.

PY - 2020/3

Y1 - 2020/3

N2 - IntroductionThis 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. MethodsTwenty-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. ResultsExercise 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. ConclusionsEndurance-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.

AB - IntroductionThis 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. MethodsTwenty-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. ResultsExercise 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. ConclusionsEndurance-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.

KW - EXERCISE

KW - GLYCEMIC CONTROL

KW - NUTRITIONAL STATUS

KW - TYPE 2 DIABETES MELLITUS

KW - SUBSTRATE OXIDATION

KW - INSULIN-RESISTANCE

KW - AEROBIC EXERCISE

KW - PLASMA-GLUCOSE

KW - INTERVENTION

KW - METAANALYSIS

KW - MELLITUS

KW - MEAL

KW - REST

KW - TIME

U2 - 10.1249/MSS.0000000000002165

DO - 10.1249/MSS.0000000000002165

M3 - Article

C2 - 31652237

SN - 0195-9131

VL - 52

SP - 720

EP - 728

JO - Medicine and Science in Sports and Exercise

JF - Medicine and Science in Sports and Exercise

IS - 3

ER -