Maintenance of plasma glucose variability after an acute session of aerobic exercise despite changes in insulin and glucagon-like peptide-1 levels in type 2 diabetes

Arch Endocrinol Metab. 2022 May 25;66(3):324-332. doi: 10.20945/2359-3997000000482. Epub 2022 May 25.

Abstract

Objective: The present study aimed to evaluate glucose variability and hormonal responses during and after an aerobic exercise session performed after breakfast in type 2 diabetes patients treated with metformin.

Methods: In this quasi-experimental study individuals underwent clinical and laboratory evaluations and maximal exercise test. After two weeks an aerobic exercise session (30 minutes at 60%-70% of the peak heart rate) was performed. At rest, during and after the exercise session, glucose variability (mean amplitude glucose excursions, glucose coefficient of variation, and glucose standard deviation) and levels of plasma glucose, insulin, glucagon, and glucagon-like-peptide-1 were evaluated.

Results: Thirteen patients were enrolled in the study. Plasma glucose increased at 15 minutes during the exercise session (244.6 ± 61.9 mg/dL), and decreased at 60 min after exercise (195.6 ± 50.0 mg/dL). Glucose variability did not show any difference before and after exercise. Insulin levels at 15 min [27.1 μU/mL (14.2-42.1)] and 30 min [26.3 μU/mL (14.6-37.4)] during the exercise were higher than those at fasting [11.2 μU/mL (6.7-14.9)] but decreased 60 minutes after exercise (90 minutes) [16.6 μU/mL (8.7-31.7)]. Glucagon levels did not show any difference. GLP-1 levels increased at 30 min [7.9 pmol/L (7.1-9.2)] during exercise and decreased 60 min after exercise (90 minutes) [7.7 pmol/L (6.8-8.5)].

Conclusion: Subjects with type 2 diabetes presented expected changes in insulin, glucagon and GLP-1 levels after breakfast and a single aerobic exercise session, not accompanied by glycemic variability changes.

Keywords: Blood glucose; diabetes mellitus; glycemic variability; hormones.

MeSH terms

  • Aged
  • Blood Glucose* / analysis
  • Diabetes Mellitus, Type 2* / blood
  • Exercise Test
  • Exercise* / physiology
  • Female
  • Glucagon / blood
  • Glucagon-Like Peptide 1* / blood
  • Humans
  • Hypoglycemic Agents* / therapeutic use
  • Insulin* / blood
  • Male
  • Metformin* / therapeutic use
  • Middle Aged

Substances

  • Glucagon-Like Peptide 1
  • Blood Glucose
  • Insulin
  • Metformin
  • Hypoglycemic Agents
  • Glucagon

Grants and funding

This study was supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (Capes) – Finance Code 001. This research was also financially supported by Novartis®. Novartis® provided glucagon and GLP-1 assay kits but did not play any role in the study design, methodology, data management or analysis, or the decision to publish.