Big Blue Test poster: Immediate Impact of Exercise on Blood Glucose in People with Diabetes
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Big Blue Test poster: Immediate Impact of Exercise on Blood Glucose in People with Diabetes

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Diabetes Hands Foundation presented a poster abstract at the AADE in Philadelphia that uses the data collected during the 2012 Big Blue Test. ...

Diabetes Hands Foundation presented a poster abstract at the AADE in Philadelphia that uses the data collected during the 2012 Big Blue Test.

Our Big Blue Test scientific poster was awarded a big blue 1st place ribbon for “Immediate Impact of Exercise on Blood Glucose in People with Diabetes.”

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Big Blue Test poster: Immediate Impact of Exercise on Blood Glucose in People with Diabetes Big Blue Test poster: Immediate Impact of Exercise on Blood Glucose in People with Diabetes Presentation Transcript

  • Varying Durations and Intensities of Exercise and Blood Glucose Responses S.R. Colberg (Human Movement Sciences Dept., Old Dominion University), M.J. Hernandez (Diabetes Hands Foundation), F. Shahzad abstract During the 2012 Big Blue Test (run by the Diabetes Hands Foundation to raise awareness of the impact of exercise on diabetes control), participants anonymously entered their diabetes status, type of exercise done, intensity (moderate or vigorous), duration (10 or less, 11 to 19, 20 to 29, or 30 or more min), time elapsed since most recent meal, and blood glucose (BG) readings before and after the activity at www.bigbluetest.org. A total of 7,157 exercise-associated BG pairs (before/after) from persons with diabetes were included. Walking was the most frequent activity (48.5%), followed by other (non-specified) exercise (18.7%), running/jogging (11.9%), cycling (8.8%), conditioning machines (6.4%), and dancing (5.7%). Overall, mean BG levels were 31.3 mg/dl lower (±47.1) following any exercise, a decrease of 16.8%. Longer exercise times generally resulted in increasingly greater decreases in BG for moderate exercise (p<0.001), although results were mixed for vigorous (table). The largest decrease in BG occurred following 30 or more min of exercise undertaken 1 hr (-49.3±53.1 mg/dl) or 2 hr (-46.4±49.8) after the last meal (p<0.001). Overall, 75.8% of participants experienced a decrease in BG, 8.8% were unchanged (±5 mg/dl), and 15.4% had an increase. Thus, this year’s Big Blue Test confirms that participation in varying types, intensities, and durations of exercise generally lowers BG in most individuals, although exercise of longer duration is likely most effective. introduction For most people with any type of diabetes, engaging in physical activity has a blood glucose lowering effect and can assist in diabetes management.1 The Big Blue Test (BBT) is an online initiative run by the Diabetes Hands Foundation to raise awareness of the importance of physical activity in managing diabetes by asking diabetic individuals to participate in an activity and record their blood glucose levels pre- and post-exercise. In 2012, the third such initiative was undertaken. The purpose of the 2012 BBT was to collect specific data not just on the impact of exercise type on blood glucose levels, but also intensity and duration, in response to a single bout of activity. In addition, the glycemic impact of exercise timing with regard to intake of an individual’s last meal was also examined in both insulin and non-insulin users with diabetes. methods results • During the 2012 BBT, data were collected online through BigBlueTest.org or via the BBT iPhone app. Participants anonymously entered their diabetes status, type of exercise done, intensity, duration, time elapsed since most recent meal, and blood glucose readings before and after their physical activity. Participants were free to enter results from more than one bout of exercise, but data from each session were entered as a separate result. • Based on the frequency of exercise type responses given in the 2011 BBT, this year’s choices were limited to the following options: walking, running/jogging, cycling, conditioning machines, dancing, and other (non-specified). • Exercise intensity was reported as either moderate or vigorous. Exercise duration choices were as follows: 10 minutes or less, 11 to 19, 20 to 29, or 30 or more minutes. • Participants reported the timing of exercise following the last meal as one of the following: 30 minutes ago, 1 hour ago, 2 hours ago, or 3 (or more) hours ago. • Data were reported as mean ±SD and analyzed using ANOVA, with groups varying by analysis based on the factors considered. Significance was set at p<0.05. • A total of 7,157 exercise-associated blood glucose pairs (before/after exercise) from individuals with any type of diabetes were included (Table 1). • Walking was the most frequent activity (48.5%), followed by other exercise (18.7%), running/jogging (11.9%), cycling (8.8%), conditioning machines (6.4%), and dancing (5.7%). • Overall, walking resulted in the smallest decrease in blood glucose levels (-25.0 ±42.4 mg/dl) compared to other exercise (-33.5 ±50.0), running/jogging (-40.1 ±55.1), cycling (-42.4 ±48.8), conditioning machines (-35.9 ±48.8), and dancing (-37.4 ±45.3; p<0.05). • Mean blood glucose levels were lower (-31.3 ±47.1 mg/dl, or 16.8%) following all exercise (types, durations, and intensities). Moderate exercise resulted in a mean decrease of -32.7 ±44.1 mg/dl, whereas vigorous activity blood glucose decreased by -28.0 ±53.6 (p<0.05). • When considered by time after last meal and exercise duration for moderate activity only, longer durations resulted in lower blood glucose levels for all meal timings except for 3 or more hours afterwards (Table 2). • With all exercise included, longer exercise times resulted in increasingly greater decreases in blood glucose levels (p<0.05); results were similar after moderate exercise (p<0.001), although somewhat mixed for vigorous (Table 1). Table 1. MEAN CHANGE IN BLOOD GLUCOSE (mg/dl) BY EXERCISE INTENSITY AND DURATION 11 to 19 min 20 to 29 min 30 min or more • With all glucose pairs included in analyses, exercise undertaken 1 or 2 hours after the last meal led to a similar decrease in blood glucose (-40.1 ±47.2 and -40.1 ±45.9 mg/dl, respectively), but both were significantly more than exercise done either 30 minutes (-28.6 ±50.6) or 3 hours or more (-21.2 ±44.0) afterwards (p<0.05). • The largest decrease in blood glucose levels occurred following a duration of 30 or more minutes of either intensity of exercise undertaken 1 hour (-49.3 ±53.1 mg/dl) or 2 hours (-46.4 ±49.8) after the last meal (p<0.001), compared to 30 minutes (-34.3 ±53.5) or 3 hours or more (-19.6 ±47.0) afterwards. Table 2. MEAN CHANGE IN BLOOD GLUCOSE (mg/dl) BY TIMING OF LAST MEAL AND DURATION OF MODERATE EXERCISE results 10 min or less results 10 min or less 30 min ago -18.7 (48.4)∞†‡ 11 to 19 min 20 to 29 min 30 min or more -21.4 (39.7)∞†‡ -20.6 (46.4)∞†‡¥ -33.5 (49.8)*∞† All Exercise n=7,157 -17.9 (44.9)◦ -25.0 (34.4)◦ -30.9 (42.0)◦ -34.5 (51.7)◦ 1 hr ago -7.1 (45.9)∞† -29.9 (31.5)*∞† -31.7 (35.4)*∞† -47.2 (50.1)* Moderate n=5,051 -16.9 (43.8) -25.6 (32.9) -29.9 (40.2)* -39.0 (48.6)*∞† 2 hrs ago -22.3 (41.3)∞† -28.1 (31.5)*∞† -45.8 (46.8)* 3 (or more) hrs ago • Overall, 75.8% of participants experienced a decrease in blood glucose following exercise, 8.8% had unchanged levels (i.e., within 5 mg/dl), and 15.4% had an increase for all exercise (type, intensity, and duration) combined. conclusion The 2012 Big Blue Test confirms that participation in varying types, intensities, and durations of exercise generally lowers blood glucose levels in most individuals with diabetes, although exercise of longer duration (regardless of the intensity) is likely most effective in lowering them. The timing of exercise following the last meal also needs to be considered when anyone with diabetes undertakes any physical activity since elapsed time since eating may impact the usual glycemic responses to exercise. -17.1 (39.1)∞†‡ -21.5 (30.9)∞†‡¥ -27.7 (37.9)*∞† -29.4 (45.9)*∞† Vigorous n=2,106 -25.1 (51.4) -22.1 (40.8)‡ -36.1 (49.9)*∞¥ -27.6 (55.5)*‡ ◦For all exercise, all values differ from each other (p<0.05); for moderate and vigorous, *p<0.001 vs. 10 min or less mod, ∞p<0.001 vs. 11 to 19 min mod, †p<0.001 vs. 20 to 29 min mod; ‡p<0.001 vs. 30 min or more mod; ¥p<0.001 vs. 11 to 19 min vigorous. -37.2 (41.4)* *p<0.05 vs. 1 hr ago, 10 min or less, ∞p<0.001 vs. 1 hr ago, 30 or more min, †p<0.05 vs. 2 hrs ago, 30 or more min; ‡p<0.05 vs. 2 hrs ago, 20 to 29 min; ¥p<0.05 vs. 30 min ago, 30 min or more; all values are mean (SD). references Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR, Chasan-Taber L, Albright AL, Braun B; American College of Sports Medicine; American Diabetes Association. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care. 2010;33(12):e147-67. 1 www.bigbluetest.org