Effects of exercising before breakfast on the health of T2DM patients—A randomized controlled trial

Abstract

This is the first study to examine whether training before breakfast in the overnight‐fasted state is more effective in improving the health of patients with type 2 diabetes mellitus (T2DM) than after breakfast in the fed state. Thirty T2DM patients (60 ± 8 years, 33.7 ± 4.6 kg/m2) were randomly assigned to the F group (training in the overnight‐fasted state (n = 15)) and to the C group (training in the fed state (control group, n = 15)). All patients completed an 8‐week combined endurance/strength training program. Physical training significantly increased time to physical exhaustion during an endurance test (+10.4%), power output during strength tests (chest presses: +36.7% and seated rows: +37.8%), and fat‐free mass (+1.7 kg). Body fat mass (−1.9 kg), glycated hemoglobin (HbA1c) values (absolute change: −0.3%), serum insulin values (−2.5 microU/mL), the homeostatic model assessment for insulin resistance (HOMA‐IR) index (−1.1), and circulating triglyceride levels (−31 mg/dL) decreased significantly from pre‐ to post‐training. The training had no effect on body mass index, serum fasting glucose, total cholesterol, low‐density lipoprotein/high‐density lipoprotein ratio or interleukin (IL)‐6, IL‐10 and tumor necrosis factor (TNF)α levels. Analyses of variance revealed no time × group interaction for any variable (P > .05). The training was effective in improving the health of T2DM patients. However, the preliminary study's data do not provide any evidence that the nutritional state (overnight‐fasted or fed) in regular physical training plays a significant role for training‐induced adaptations in T2DM patients. Full trials (using other training protocols as well) should be conducted to gain further knowledge about the relevance of pre‐exercise breakfast ingestion.

Acute and Chronic Effects of Exercise on Continuous Glucose Monitoring Outcomes in Type 2 Diabetes: A Meta-Analysis

“…One potential explanation could be that, in the absence of exogenous fuels, fasting exercise must rely to a greater extent on endogenous fuels (e.g., intramuscular lipids and glycogen) and that these changes may favor an increase in insulin sensitivity. The first two longer-term training studies comparing fasting exercise to postprandial exercise in T2D have been recently published (71,72). These longer-terms studies did not support a more favorable effect of fasting exercise compared to postprandial exercise.…”

“…These longer-terms studies did not support a more favorable effect of fasting exercise compared to postprandial exercise. However, the postprandial exercise was performed shortly after breakfast (not in the afternoon) in both of these studies (71,72). It is currently difficult to understand to what extent the effects of fasting exercise are due to fasting itself or to the time of day (i.e., diurnal variations).…”

Movement is Improvement: The Therapeutic Effects of Exercise and General Physical Activity on Glycemic Control in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…1 PRISMA flow diagram depicting the study selection process disease (CAD) [31], or newly diagnosed type 2 DM patients [32], had received their diagnosis 5-8 months earlier [26] or \ 5 years earlier [33], or were female participants only [34], sedentary patients with 5 years of diagnosis [35], elderly patients with peripheral neuropathy [28], or overweight, dysregulated, and sedentary patients [36]. Most of the studies recruited participants with HbA1c levels of 6.4-7.0 [26,30,32,[37][38][39][40][41][42][43][44], followed by levels of C 6.5 [27,45,46], 7.0-10.0 [34], 7.2-9.0 [28,31,33,47], 10.0-11.0 [48,49], or 7.0-11.0 [36].…”

Effects of a Combined Endurance/Strength Training Program on Circulating Irisin Levels in Overweight/Obese Men and Women with Type 2 Diabetes Mellitus

“…This study adds results to the findings of another study that was recently conducted (clinical trial registration ID number: DRKS00011714) [10]. Irisin levels were only determined in overweight/obese T2DM patients (n = 29) who were selected from the initial cohort.…”

“…Irisin levels were only determined in overweight/obese T2DM patients (n = 29) who were selected from the initial cohort. The following procedures were performed at T1 (3-5 days pre-training) and T2 (3-5 days after the 8-week training intervention) as already described in the method section of the recently published paper [10]: venous blood was collected after a 12-h overnight fast and before medication intake in the early morning (serum samples were stored at -80° C until further analysis). Thereafter, a bioelectric impedance analysis was performed to determine body fat and muscle mass.…”