Little and often gives exercise benefits in Type 2 diabetes

By Eleanor McDermid

Sedentary, overweight adults with Type 2 diabetes can improve their cardiometabolic profile by engaging in very brief but regular periods of light walking or resistance exercise, research suggests.

The benefits were similar irrespective of which activity the study participants engaged in - for 3 minutes every 30 minutes - despite the resistance exercises requiring more energy expenditure.

"With the ubiquity of sedentary behaviors and the low adherence to structured exercise, these two approaches are practical strategies that may contribute toward reducing the risk of diabetes complications and cardiovascular complications", say Paddy Dempsey (Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia) and study co-authors.

They say that both forms of exercise were "well accepted" by the patients, so either can be used depending on the context, such as differing home or work environments, although they note that the two may have differing effects over the longer term.

The randomised crossover trial had three phases, with standardised food served before and during all three. The 24 study participants were aged an average of 62 years, had Type 2 diabetes and were all overweight or obese and habitually sedentary.

During the control phase, they sat in a chair for an uninterrupted 8 hours, barring toilet breaks. In the light walking phase, they walked for 3 minutes on a treadmill at 3.2 km/hour every 30 minutes.

The walking intervention had a significant impact on several metabolic indices, with the incremental area under the curve (iAUC) for glucose being 14.8 mmol/h per L, compared with 24.2 mmol/h per L in the uninterrupted sitting phase. Likewise, the iAUC was 2104 versus 3293 pmol/h per L for insulin and 11,504 versus 15,641 pmol/h per L for C-peptide.

In the resistance exercise phase, the participants undertook 3 minutes of half-squats, calf raises, gluteal contractions and knee raises. This had similar beneficial effects on their metabolic profile, with iAUCs of 14.7 mmol/h per L for glucose, 2066 pmol/h per L for insulin and 11,012 pmol/h per L for C-peptide.

Resistance exercise also significantly reduced the iAUC for triglycerides, to 2.9 mmol/h per L down from 4.8 mmol/h per L in the uninterrupted sitting phase. Light walking reduced it to 4.0 mmol/h per L, but this was not statistically significant.

The researchers say that the cardiometabolic benefits are similar to those reported for 45 minutes of moderate exercise, followed by a day of sitting.

"This is an important finding given the intermittent nature and low intensity of the activity bouts performed by our participants", they write in Diabetes Care.

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