Type 2 diabetics who were physically active in the afternoon experienced a significant drop in blood sugar.

More than 37 million Americans have diabetes, and 90-95% of this population is diagnosed with type 2 diabetes. Lifestyle interventions, such as eating a healthy diet and a regular program of physical activity, are ways to manage diabetes.

A new study from a collaboration of investigators at Brigham and Women’s Hospital, a founding member of Brigham and Women’s Health Care System Joslin Diabetes Center, part of Beth Israel Lahey Health, uses data from the Look AHEAD (Action for Health in Diabetes) study, a trial Randomized controlled trial comparing an intensive lifestyle intervention and diabetes support and education in patients diagnosed with type 2 diabetes and overweight or obese to track the progression of cardiovascular disease over time. In the current study, the research team evaluated whether physical activity at certain times of the day was associated with greater improvement in blood glucose control. Their findings indicate that patients with type 2 diabetes who were physically active in the afternoon had the greatest improvement after one year in the trial. The team’s results are published in Diabetic care.

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

Jingyi Qian, PhD, associate co-author and division of Sleep and Circadian Disorders, Brigham and Women’s Health.

Doctors recommend that people with diabetes participate in regular physical activity as a way to control their blood sugar levels. High blood glucose levels can put people with type 2 diabetes at risk of heart disease, poor eyesight, 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 accelerometer tape recorder to measure physical activity. When Brigham and Jocelyn’s team reviewed the data from year one, they determined that those who did moderate to vigorous physical activity in the afternoon had the greatest decreases in blood glucose levels. When comparing data from year 4, the afternoon group maintained lower blood glucose levels. In addition, the afternoon group also had the greatest chance of discontinuing glucose-lowering/diabetes medication.

Brigham and Jocelyn’s team notice that their investigation has limits; For example, their study is observational and does not measure confounding factors such as sleep and nutritional intake.

In future studies, the team may test their findings experimentally to investigate the underlying mechanisms that might explain why time of daily activity affects blood glucose control. Based on this, the team may be able to make specific physical activity recommendations for patients.

Timing doesn’t seem to matter. Going forward, we may have more data and empirical evidence for patients to provide more personalized recommendations.”

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


Brigham and Women’s Hospital

Journal reference:

Qian, c. et al. (2023) Association of timing of moderate-to-vigorous physical activity with changes in glycemic control over 4 years in adults with type 2 diabetes from the Look AHEAD trial. Diabetic care. doi.org/10.2337/dc22-2413.

Type 2 diabetics who were physically active in the afternoon experienced a significant drop in blood sugar.

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