Exercise-induced improvement of glycemic fluctuation and its relationship with fat and muscle distribution in type 2 diabetes

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Pub Date : 2024-04-07 DOI:10.1111/1753-0407.13549

Dan Liu, Ying Zhang, Qian Wu, Rui Han, Di Cheng, Liang Wu, Jingyi Guo, Xiangtian Yu, Wenli Ge, Jiacheng Ni, Yaohui Li, Tianshu Ma, Qichen Fang, Yufei Wang, Yan Zhao, Yanan Zhao, Biao Sun, Huating Li, Weiping Jia

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Abstract

Aims

Management of blood glucose fluctuation is essential for diabetes. Exercise is a key therapeutic strategy for diabetes patients, although little is known about determinants of glycemic response to exercise training. We aimed to investigate the effect of combined aerobic and resistance exercise training on blood glucose fluctuation in type 2 diabetes patients and explore the predictors of exercise-induced glycemic response.

Materials and Methods

Fifty sedentary diabetes patients were randomly assigned to control or exercise group. Participants in the control group maintained sedentary lifestyle for 2 weeks, and those in the exercise group specifically performed combined exercise training for 1 week. All participants received dietary guidance based on a recommended diet chart. Glycemic fluctuation was measured by flash continuous glucose monitoring. Baseline fat and muscle distribution were accurately quantified through magnetic resonance imaging (MRI).

Results

Combined exercise training decreased SD of sensor glucose (SDSG, exercise-pre vs exercise-post, mean 1.35 vs 1.10 mmol/L, p = .006) and coefficient of variation (CV, mean 20.25 vs 17.20%, p = .027). No significant change was observed in the control group. Stepwise multiple linear regression showed that baseline MRI-quantified fat and muscle distribution, including visceral fat area (β = −0.761, p = .001) and mid-thigh muscle area (β = 0.450, p = .027), were significantly independent predictors of SDSG change in the exercise group, as well as CV change.

Conclusions

Combined exercise training improved blood glucose fluctuation in diabetes patients. Baseline fat and muscle distribution were significant factors that influence glycemic response to exercise, providing new insights into personalized exercise intervention for diabetes.

Abstract Image

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运动诱导 2 型糖尿病患者血糖波动的改善及其与脂肪和肌肉分布的关系

目的控制血糖波动对糖尿病患者至关重要。运动是糖尿病患者的一项重要治疗策略，但人们对运动训练血糖反应的决定因素知之甚少。我们旨在研究有氧运动和阻力运动联合训练对 2 型糖尿病患者血糖波动的影响，并探索运动诱导血糖反应的预测因素。材料与方法将 50 名久坐不动的糖尿病患者随机分配到对照组或运动组。对照组的参与者保持静坐生活方式 2 周，而运动组的参与者专门进行了 1 周的综合运动训练。所有参与者都根据推荐饮食表接受饮食指导。血糖波动通过闪光连续血糖监测仪进行测量。通过磁共振成像（MRI）对基线脂肪和肌肉分布进行了精确量化。结果联合运动训练降低了传感器血糖标度（SDSG，运动前与运动后，平均 1.35 与 1.10 mmol/L，p = .006）和变异系数（CV，平均 20.25 与 17.20%，p = .027）。对照组未观察到明显变化。逐步多元线性回归显示，基线 MRI 定量脂肪和肌肉分布，包括内脏脂肪面积（β = -0.761，p = .001）和大腿中部肌肉面积（β = 0.450，p = .027），是运动组 SDSG 变化和 CV 变化的重要独立预测因素。结论联合运动训练可改善糖尿病患者的血糖波动。基线脂肪和肌肉分布是影响运动血糖反应的重要因素，为糖尿病的个性化运动干预提供了新的见解。

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来源期刊

Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

2.20%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation. The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.