Patients with type 2 diabetes who exercised in the afternoon showed greater reductions in blood sugar

More than 37 million Americans have diabetes, and 90-95% of that population are diagnosed with type 2 diabetes. Lifestyle interventions, such as a healthy diet and a regular physical activity program, are methods of managing diabetes.

A new study from a collaboration of 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 the Look AHEAD (Action for Health in Diabetes) study , a randomized controlled trial that compared an intensive lifestyle intervention with diabetes support and education in patients diagnosed with type 2 diabetes and overweight or obesity to track the development of cardiovascular disease over time. In the current study, the research team assessed whether physical activity at certain times of the day was associated with greater improvement in blood glucose control. Their findings suggest that patients with type 2 diabetes who were physically active in the afternoon had the greatest improvements after one year in the study. The team’s results are published in diabetes care.

In this study, we showed that adults with type 2 diabetes had the greatest improvement in glucose control when they were most active in the afternoon. We know that physical activity is beneficial, but what our study adds is a new understanding that activity time may also be important.”

Jingyi Qian, PhD, Co-corresponding author, Division of Sleep and Circadian Disorders, Brigham.

Doctors recommend that patients with diabetes participate in regular physical activity as a method to control their blood glucose levels. Elevated blood glucose levels 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 a waist accelerometry recording device to measure physical activity. When Brigham and Joslin’s team reviewed the year 1 data, they determined that those who engaged in moderate to vigorous physical activity in the afternoon had the greatest reduction in blood glucose levels. When comparing data from the 4th year, the afternoon group maintained the reduction in glycemia. In addition, the afternoon group also had the highest chance of discontinuing their glucose-lowering/diabetes medications.

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

In future studies, the team may test their findings experimentally to investigate underlying mechanisms that may explain why the time of day of activity can influence blood glucose control. From there, the team can provide specific physical activity recommendations for patients.

Time seems to matter. In the future, we may have more data and experimental evidence for patients to provide more personalized recommendations.”

Roeland Middelbeek, MD, co-corresponding author and assistant investigator, Joslin Diabetes Center.


Brigham and Women’s Hospital

Newspaper reference:

Qian, J. and others (2023) Association of duration of moderate-to-vigorous physical activity with changes in glycemic control over 4 years in adults with type 2 diabetes from the Look AHEAD study. diabetes care.

Patients with type 2 diabetes who exercised in the afternoon showed greater reductions in blood sugar

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