Over 37 million Americans have diabetes, and 90-95% of that population are diagnosed with type 2 diabetes. Lifestyle interventions, reminiscent of a healthy weight loss plan and a daily physical activity program, are methods to administer diabetes.

A recent study from a collaboration of investigators at Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system, and Joslin Diabetes Center, a part of Beth Israel Lahey Health, uses data from the Look AHEAD (Motion for Health in Diabetes) study, a randomized controlled trial that compared an intensive lifestyle intervention with diabetes support and education in patients diagnosed with type 2 diabetes and obese or obesity to trace the event of heart problems over time. In the present study, the research team assessed whether physical activity at certain times of day was related to greater improvement in blood glucose control. Their findings suggest patients with type 2 diabetes who were physically energetic within the afternoon had the most important improvements after one yr within the trial. The team’s results are published in Diabetes Care.

On this study, we shown that adults with type 2 diabetes had the best improvement in glucose control after they were most energetic within the afternoon. We’ve known that physical activity is useful, but what our study adds is a recent understanding that timing of activity could also be necessary too.”

Jingyi Qian, PhD, Co-corresponding Writer and  Division of Sleep and Circadian Disorders, Brigham.

Physicians recommend that patients with diabetes take part in regular physical activity as a way to administer their blood glucose levels. Elevated blood glucose levels can put individuals with type 2 diabetes susceptible to heart disease, vision impairment, and kidney disease.

The team analyzed physical activity data from the primary and fourth years of the Look AHEAD study, which included data from over 2,400 participants. In the course of the study, participants wore a waist accelerometry recording device to measure physical activity. When the Brigham and Joslin team reviewed the information from yr 1, they determined that those that engaged in moderate-to-vigorous physical activity within the afternoon had the best reduction in blood glucose levels. Upon comparing the information from yr 4, the afternoon group maintained a discount in blood glucose levels. As well as, the afternoon group also had the very best likelihood of stopping their glucose-lowering/diabetes medications.

The Brigham and Joslin team note that their investigation has limitations; for instance, their study is observational and doesn’t measure confounding aspects like sleep and dietary intake.

In future studies, the team may test their findings experimentally to analyze the underlying mechanisms that will explain why time of day of activity may influence blood glucose control. From this, the team may find a way to supply specific physical activity recommendations for patients.

Timing does appear to matter. Going forward, we can have more data and experimental evidence for patients to offer more personalized recommendations.”

Roeland Middelbeek, MD, Co-corresponding Writer and Assistant Investigator, Joslin Diabetes Center.

Source:

Brigham and Women’s Hospital

Journal reference:

Qian, J., et al. (2023) Association of Timing of Moderate-to-Vigorous Physical Activity With Changes in Glycemic Control Over 4 Years in Adults With Type 2 Diabetes From the Look AHEAD Trial. Diabetes Care. doi.org/10.2337/dc22-2413.