Blood Sugar: There is a Better Time for Walking

In active cases, exercise improves blood glucose control, reduces cardiovascular risk, contributes to weight loss, and improves well-being.(1,2) We even know that comfortable walking and activities of similar exertion work.(3) Guidelines for the management of diabetes universally recommend exercise plans. Some guidelines include suggestions for several blocks of exercise throughout the day to improve adherence. However, the University of Otago’s Andrew Reynolds noticed that none of the guidelines included advice about exactly when to exercise.(4)

The increase in blood sugar immediately after eating a meal contributes considerably to the overall hyperglycemia of type 2 diabetes.(5) Andrew Reynolds and his research colleagues hypothesized that exercising immediately after meals would do more to control blood sugar than exercising at other times. To test this theory, they had 41 people with type 2 diabetes exercise one way for two weeks and then exercise a different way in a separate two-week period. Either they exercised for 30 minutes per day or they walked for 10 minutes, three times per day, within 5 minutes of each meal. Adherence and overall activity were measured by accelerometry. Walking after meals proved 12% to 22% more effective at controlling blood sugar (with more effectiveness in the evenings). The advice to walk 10 minutes after each meal also resulted in greater overall activity compared to requests to exercise 30 minutes per day, because people were more adherent to the former. The improved blood sugar management was attributed more to the timing than to the differences in activity levels.

 

The timing of walks may increase the effectiveness of physical activity for the control of diabetes.    

 

References

1. Chen L, Pei JH, Kuang J, Chen HM, Chen Z, Li ZW, Yang HZ. Effect of lifestyle intervention in patients with type 2 diabetes: a meta-analysis. Metabolism. 2015 Feb 1; 64 (2): 338-47.
2. Lin X, Zhang X, Guo J, Roberts CK, McKenzie S, Wu WC, Liu S, Song Y. Effects of exercise training on cardiorespiratory fitness and biomarkers of cardiometabolic health: a systematic review and meta‐analysis of randomized controlled trials. Journal of the American Heart Association. 2015 Jun 25; 4 (7) :e002014.
3. Hu FB, Sigal RJ, Rich-Edwards JW, Colditz GA, Solomon CG, Willett WC, Speizer FE, Manson JE. Walking compared with vigorous physical activity and risk of type 2 diabetes in women: a prospective study. JAMA. 1999 Oct 20;282(15):1433-9.
4. Reynolds AN, Mann JI, Williams S, Venn BJ. Advice to walk after meals is more effective for lowering postprandial glycaemia in type 2 diabetes mellitus than advice that does not specify timing: a randomised crossover study. Diabetologia. 2016 Dec 1;59(12):2572-8.
5. Woerle HJ, Neumann C, Zschau S, Tenner S, Irsigler A, Schirra J, Gerich JE, Göke B. Impact of fasting and postprandial glycemia on overall glycemic control in type 2 diabetes: importance of postprandial glycemia to achieve target HbA1c levels. Diabetes Research and Clinical Practice. 2007 Aug 1;77(2):280-5.