Short‐term exercise training reduces glycaemic variability and lowers circulating endothelial microparticles in overweight and obese women at elevated risk of type 2 diabetes

Abstract

Exercise is recognized as a frontline therapy for the prevention and treatment of type 2 diabetes (T2D) but the optimal type of exercise is not yet determined. We compared the effects of high-intensity interval training (HIIT) with moderate-intensity continuous training (MICT) for improvement of continuous glucose monitoring (CGM)-derived markers of glycaemic variability, and biomarkers of endothelial cell damage (CD31+ and CD62+ endothelial microparticles (EMPs)) within a population at elevated risk of developing T2D. Fifteen inactive overweight or obese women were randomized to 2 weeks (10-sessions) of progressive HIIT (n = 8, 4-10X 1-min @ ∼90% peak heart rate, 1-min rest periods) or MICT (n = 7, 20-50 min of continuous activity at ∼65% peak heart rate). Prior and three days post-training, fasting blood samples were collected. Both HIIT and MICT improved glycaemic variability as measured by CGM standard deviation (HIIT: 0.82 ± 0.39 vs. 0.72 ± 0.33 mmol/L; MICT: 0.82 ± 0.19 vs. 0.62 ± 0.16 mmol/L, pre vs. post) and mean amplitude of glycaemic excursions (MAGE; HIIT: 1.98 ± 0.81 vs. 1.41 ± 0.90; MICT; 1.98 ± 0.43 vs. 1.65 ± 0.48, pre vs. post) with no difference between groups. CD62+ EMPs were lower following HIIT (187.7 ± 65 vs. 174.9 ± 55, pre vs. post) and MICT (170 ± 60 vs. 160.3 ± 59, pre vs. post) with no difference between groups. There was no change in 24-h mean glucose or CD31+ EMPs. Two weeks of both HIIT or MICT similarly decreased glycaemic variability and CD62+ EMPs in overweight/ obese women at elevated risk of T2D.

The effects of dapagliflozin, metformin or exercise on glycaemic variability in overweight or obese individuals with prediabetes (the PRE-D Trial): a multi-arm, randomised, controlled trial

“…In contrast to what we expected, exercise was not superior to treatment with dapagliflozin in reducing glycaemic variability, potentially because the exercise intensity in our study was too low to result in improvements in glycaemic variability of the magnitude observed in other studies [20,21]. The PRE-D Trial was designed to investigate on-treatment effects on glycaemic variability (6 weeks) in addition to assessing both short-term (13 weeks) and longer-term (26 weeks) physiological post-treatment adaptations.…”

“…Glycaemic variability is an important aspect of glycaemic control, which is associated with morbidity and mortality in type 2 diabetes [18,19]; however, whether this extends to people with prediabetes is yet unknown. Exercise has previously been shown to reduce glycaemic variability in individuals with type 2 diabetes or who are at increased risk for developing the disease [20,21]. We hypothesised that after 13 weeks of treatment, exercise would be superior to the pharmacological interventions and dapagliflozin would be superior to metformin in reducing glycaemic variability.…”

Comprehensive elaboration of glycemic variability in diabetic macrovascular and microvascular complications

“…SGLT2 inhibitors 15 patients with T1DM Improved TIR and the mean glucose level and SD [121] interval training and moderate-intensity continuous training decreased GV and endothelial cell damage in obese women at elevated risk of T2DM [108]. Of note, both aerobic and eccentric exercise reduced GV in healthy individuals, which might be mediated by inflammatory cytokines and stress oxidative markers [109].…”

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

“…• Population. Studies that were not exclusively conducted in adults with T2D (10)(11)(12)(13)(14) were excluded. Of these, the study by Newton and White (12) was included in our first metaanalyses, but excluded this time because the age range was from 14 to 20 years old.…”