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Minimal effect of walking before dinner on glycemic responses in type 2 diabetes: outcomes from the multi-site E-PAraDiGM study

Rees, Jordan L., Chang, Courtney R., François, Monique E., Marcotte-Chénard, Alexis, Fontvieille, Adeline, Klaprat, Nika D., Dyck, Rebecca A., Funk, Deanna R., Snydmiller, Gary, Bastell, Kent , Godkin, Florence E., Dubé, Marie-Christine, Riesco, Eléonor, McGavock, Jon M., Yardley, Jane E., Sigal, Ronald J., Gibala, Martin J., Weisnagel, S. John, Prado, Carla M., Jung, Mary, Manders, Ralph, Lee, Terry, Singer, Joel, Boulé, Normand G. and Little, Jonathan P. (2019) Minimal effect of walking before dinner on glycemic responses in type 2 diabetes: outcomes from the multi-site E-PAraDiGM study Acta Diabetologica, 56 (7). pp. 755-765.

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To examine the effect of walking before dinner on 24-h glycemic control in individuals with type 2 diabetes using the standardized multi-site Exercise-Physical Activity and Diabetes Glucose Monitoring (E-PAraDiGM) Protocol.


Eighty participants were studied under two conditions (exercise vs. non-exercise control) separated by 72 h in a randomized crossover design. Each condition lasted 2 days during which standardized meals were provided. Exercise consisted of 50 min of treadmill walking at 5.0 km/h before the evening meal, while control involved 50 min of sitting. The primary outcome measure was mean glucose during the 24-h period following exercise (or sitting) measured by continuous glucose monitoring.


Of the 80 participants who were initially randomized, 73 completed both exercise and control. Sixty-three participants [29 males, 34 females; age = 64 ± 8 years, body mass index = 30.5 ± 6.5 kg/m2 and HbA1c = 51 ± 8 mmol/mol (6.8 ± 0.7%), mean ± SD] complied with the standardized diets and had complete continuous glucose monitoring data. Exercise did not affect mean 24-h glucose compared to control (0.03 mmol/L; 95% CI − 0.17, 0.22, P = 0.778) but individual differences between conditions ranged from − 2.8 to +1.8 mmol/L. Exercise did not affect fasting glucose, postprandial glucose or glucose variability. Glucose concentrations measured by continuous glucose monitoring were reduced during the 50 min of walking in exercise compared to sitting in control (− 1.56 mmol/L; 95% CI − 2.18, − 0.95, p ˂ 0.001).


Contrary to previous acute exercise studies, 50 min of walking before dinner in the E-PAraDiGM protocol did not affect 24-h glucose profiles. However, highly heterogeneous responses to exercise were observed.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine
Authors :
Rees, Jordan L.
Chang, Courtney R.
François, Monique E.
Marcotte-Chénard, Alexis
Fontvieille, Adeline
Klaprat, Nika D.
Dyck, Rebecca A.
Funk, Deanna R.
Snydmiller, Gary
Bastell, Kent
Godkin, Florence E.
Dubé, Marie-Christine
Riesco, Eléonor
McGavock, Jon M.
Yardley, Jane E.
Sigal, Ronald J.
Gibala, Martin J.
Weisnagel, S. John
Prado, Carla M.
Jung, Mary
Lee, Terry
Singer, Joel
Boulé, Normand G.
Little, Jonathan P.
Date : July 2019
DOI : 10.1007/s00592-019-01358-x
Copyright Disclaimer : © Springer-Verlag Italia S.r.l., part of Springer Nature 2019
Uncontrolled Keywords : Continuous glucose monitoring; Glycemic control; Type 2 diabetes; Physical activity; Walking
Depositing User : Clive Harris
Date Deposited : 22 Aug 2019 07:41
Last Modified : 21 Nov 2019 10:45

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