Project R-4580

Exercise training in the fasted vs. postprandial state to augment the clinical benefits of long-term in exercise intervention in type 2 diabetes patients (Research)

In the care of persons with type 2 diabetes (T2DM), exercise intervention is considered a cornerstone. Structured long-term exercise training in persons with T2DM leads to an important improvement in blood glucose control, which leads to a reduction in risk of cardiovascular disease and elevation of life expectancy. In recent decades, it is pursued to further optimize the clinical benefits of exercise intervention in persons with T2DM. A greater improvement in blood glucose control is achieved in persons with T2DM when prolonging exercise intervention, adding resistance (strength) exercises on top of endurance exercises, and exercising more frequently. Despite the promising improvement in the clinical effectiveness of exercise intervention in persons with T2DM, room for further improvement remains present. In this regard, optimalisation of timing of exercise remains to be achieved. Currently, an intense debate in ongoing when persons with T2DM should exercise: in fasting condition (before breakfast) or in postprandial condition (after breakfast)? Exercise training in fasting condition could lead to a reduction in fatty acids and/or improvement in fatty acid oxidation capacity in skeletal muscles. On the other hand, exercise training after breakfast would prevent the excessive increase in blood glucose concentrations that is typically present in T2DM. Both mechanisms would thus lead to an improvement in blood glucose control in the long term in persons with T2DM. Therefore, it remains to be examined whether the greatest improvement in blood glucose control in persons with T2DM results from a long-term exercise intervention in which exercise sessions are executed in the fasted (before breakfast) or postprandial state (after breakfast).

01 May 2013 - 30 September 2014