Exercise Snacks for Type 2 Diabetes

Overseen By Jonathan P Little, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of British Columbia

Must not be taking: Insulin, Beta-blockers, Statins

Disqualifiers: Severe hypoglycemia, Smoking, Cardiovascular, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

30 Participants Needed

Trial Summary

What is the purpose of this trial?

To conduct a randomized crossover trial to determine the acute impact of exercise snacks on glycemic control in physically inactive individuals living with type 2 diabetes using continuous glucose monitoring.

Will I have to stop taking my current medications?

No, you won't have to stop taking your current medications. The trial requires that you maintain your current medication doses during the study.

What data supports the effectiveness of the treatment Exercise Snacks for Type 2 Diabetes?

Research shows that regular physical activity, including high-intensity interval exercise and brief bouts of exercise, can improve blood sugar control, increase insulin sensitivity, and reduce risk factors for heart disease in people with type 2 diabetes. Exercise is a key part of managing type 2 diabetes and can lead to better overall health outcomes. ^{1 2 3 4 5}

Is it safe to participate in an 'Exercise Snacks' clinical trial for type 2 diabetes?

Exercise, including 'Exercise Snacks' or short bouts of activity, is generally safe for people with type 2 diabetes when done with proper guidance. It's important to monitor blood sugar levels before and after exercise to avoid low blood sugar (hypoglycemia) or high blood sugar (hyperglycemia). Consulting with a healthcare provider before starting an exercise program is recommended to ensure safety, especially for those with existing health conditions. ^{5 6 7 8 9}

How is the 'Exercise Snacks' treatment different from other treatments for type 2 diabetes?

The 'Exercise Snacks' treatment involves short, intense bursts of exercise before meals, which is different from traditional exercise routines that are longer and less frequent. This approach is designed to improve blood sugar control more effectively by integrating exercise into daily routines in a convenient and time-efficient manner. ^{2 5 6 10 11}

Research Team

Jonathan Little, PhD

Principal Investigator

University of British Columbia

Eligibility Criteria

This trial is for inactive individuals aged 30-75 with type 2 diabetes, a BMI of 18.5-40 kg/m2, stable medication doses for the past 6 months, and an HbA1c of ≤8.5%. They must exercise less than 150 minutes per week and can maintain their current activity level and medication during the study.

Inclusion Criteria

I have been diagnosed with type 2 diabetes by a doctor.

Currently participating in less than 150 minutes of moderate-to-vigorous intensity aerobic exercise per week

Able to maintain current physical activity patterns during the study

Exclusion Criteria

Currently participating in another clinical trial that interferes with the study procedures

Currently pregnant or planning on becoming pregnant during the intervention (i.e., within the next 3-4 months)

Have a psychiatric disorder that could prevent you from completing the study procedures or visits

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Exercise Condition (EX)

Participants perform four 1-minute exercise snacks per day on two consecutive days

2 days

Continuous glucose monitoring

Control Condition (CON)

Participants refrain from any structured exercise on two consecutive days

2 days

Continuous glucose monitoring

Washout Period

A one-day washout period between the completion of both trials

1 day

Follow-up

Participants are monitored for safety and effectiveness after the trial

1 week

Treatment Details

Interventions

• Exercise Snacks

Trial Overview The trial is testing 'exercise snacks'—short bursts of physical activity—to see how they affect blood sugar levels in people with type 2 diabetes. It's a randomized crossover trial using continuous glucose monitoring to track changes.

Participant Groups

Group I: Exercise (EX): exercise snacks condition Experimental Treatment 1 Intervention

Bodyweight-style exercise snacks lasting 1-minute each performed with vigorous effort 4 times per day on two consecutive days.

Group II: Control (CON): Non-exercise condition Active Control 1 Intervention

No structured exercise on two consecutive days.

Who Is Running the Clinical Trial?

University of British Columbia

Lead Sponsor

Trials

1,506

Recruited

2,528,000+

McMaster University

Collaborator

Trials

936

Recruited

2,630,000+

Findings from Research

Regular physical activity can significantly reduce the risk of developing type 2 diabetes (T2D) by 50% in individuals with high metabolic risk and improve glycemic control by lowering HbA1c levels by an average of 0.7%.

The benefits of physical activity extend beyond just one-time exercise sessions, as consistent training leads to long-term improvements in blood pressure, lipid profiles, and insulin resistance, with recommendations tailored to fit individual preferences and lifestyles.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physical activity and type 2 diabetes. Recommandations of the SFD (Francophone Diabetes Society) diabetes and physical activity working group. Duclos, M., Oppert, JM., Verges, B., et al.[2013]

In a study involving six patients with type 2 diabetes, three types of 20-minute moderate-intensity exercises (WB-EMS, RES, and END) were found to reduce postprandial glucose levels after meals, indicating that exercise can help manage blood sugar spikes.

While all exercise types showed similar effects on glucose levels over time, cycling endurance exercise (END) suggested a potential superior effect during the post-exercise recovery phase, although this was not statistically significant.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Acute Resistance Exercise with and without Whole-Body Electromyostimulation and Endurance Exercise on the Postprandial Glucose Regulation in Patients with Type 2 Diabetes Mellitus: A Randomized Crossover Study. Holzer, R., Schulte-Körne, B., Seidler, J., et al.[2022]

In a 3-year study involving 300 patients with type 2 diabetes, behavioral counseling led to significant increases in physical activity and decreases in sedentary time, which were associated with improved physical fitness and reduced cardiovascular risk factors.

Modest increases in moderate- to vigorous-intensity physical activity (MVPA) resulted in clinically meaningful improvements, such as a decrease in HbA1c levels and enhanced cardiorespiratory fitness, highlighting the importance of even small changes in activity levels.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Relationships of Changes in Physical Activity and Sedentary Behavior With Changes in Physical Fitness and Cardiometabolic Risk Profile in Individuals With Type 2 Diabetes: The Italian Diabetes and Exercise Study 2 (IDES_2). Balducci, S., Haxhi, J., Sacchetti, M., et al.[2023]

High-intensity training has been shown to significantly improve metabolic parameters in patients with pre-diabetes and type 2 diabetes, highlighting the importance of exercise therapy for glycemic control.

For patients unable to engage in traditional exercise due to complications, non-exercise activity thermogenesis (NEAT) can be beneficial, providing an alternative way to enhance metabolic health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise Therapy for Patients With Type 2 Diabetes: A Narrative Review. Yanai, H., Adachi, H., Masui, Y., et al.[2020]

Regular physical exercise is crucial for both preventing and treating type 2 diabetes, leading to benefits such as improved insulin sensitivity, better glycemic control, and enhanced cardiovascular health.

Before starting an exercise program, individuals with type 2 diabetes should undergo a thorough medical evaluation to assess their cardiovascular health and any complications, ensuring a safe and effective exercise plan that gradually increases in intensity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Diet and exercise in type 2 diabetes mellitus. Hamdy, O., Goodyear, LJ., Horton, ES.[2019]

Short bursts of intense exercise ('exercise snacks') before meals significantly improved blood glucose control in individuals with insulin resistance, showing a reduction in post-meal glucose levels compared to traditional continuous exercise.

Both exercise snacking and a combination of exercise snacking with resistance training were equally effective in lowering overall glucose levels, suggesting that brief, intense workouts can be a practical strategy for managing blood sugar.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

'Exercise snacks' before meals: a novel strategy to improve glycaemic control in individuals with insulin resistance. Francois, ME., Baldi, JC., Manning, PJ., et al.[2022]

In a study involving five insulin-dependent diabetics, exercising after fasting led to stable plasma glucose levels during exercise, but hypoglycemia occurred 1 to 2 hours post-exercise, highlighting the need for effective pre-exercise snacks.

Three different pre-exercise snacks (orange juice, whole milk, and skim milk) containing 13 g of carbohydrates were effective in preventing hypoglycemia, with orange juice and skim milk providing quicker glucose absorption and higher plasma glucose levels during exercise.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Programming pre-exercise snacks to prevent post-exercise hypoglycemia in intensively treated insulin-dependent diabetics. Nathan, DM., Madnek, SF., Delahanty, L.[2019]

Exercise can greatly benefit people with diabetes, but it's crucial to measure glucose levels before starting to ensure safety during workouts.

Guidelines have been developed to help exercise specialists determine when to start or stop exercise based on glucose levels, with specific contraindications such as low glucose (<4.0 mmol/L) or high glucose (>15.0 mmol/L with symptoms).

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Resources to Guide Exercise Specialists Managing Adults with Diabetes. Turner, G., Quigg, S., Davoren, P., et al.[2020]

Light aerobic exercise for 60 minutes or moderate exercise for 20-30 minutes, starting 30 minutes after a meal, can effectively reduce postmeal glucose surges with minimal risk of hypoglycemia, based on a review of 39 studies over 30 years.

Incorporating moderate-intensity resistance exercise 2-3 times a week can further help in managing glucose levels, while high-intensity exercise may lead to unpredictable glucose fluctuations and requires further investigation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercising Tactically for Taming Postmeal Glucose Surges. Chacko, E.[2023]

Exercise snacks, which are short bursts of physical activity, can effectively reduce sedentary behavior and promote regular exercise habits, making them a practical solution for overcoming barriers to physical activity.

Research shows that exercise snacks are safe and beneficial for various populations, including the elderly and individuals with obesity or diabetes, as they improve physical function, reduce fall risk, and enhance cardiorespiratory fitness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Applying an Exercise Snack-Based Health Promotion Strategy]. Huang, CH., Yen, M.[2023]

Individuals with impaired fasting glucose (IFG) had consistently higher glucose levels compared to healthy individuals after consuming different preexercise snacks, indicating a potential risk for glucose management in this population.

Raisins as a preexercise snack resulted in lower post-exercise glucose and insulin responses compared to a glucose solution, suggesting that they may be a better option for managing blood sugar levels in people with IFG.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Glycemic and insulinemic responses to different preexercise snacks in participants with impaired fasting glucose. Byrne, HK., Kim, Y., Hertzler, SR., et al.[2019]

References

1. France pubmed.ncbi.nlm.nih.gov

Physical activity and type 2 diabetes. Recommandations of the SFD (Francophone Diabetes Society) diabetes and physical activity working group. [2013]

2. Switzerland pubmed.ncbi.nlm.nih.gov

Effects of Acute Resistance Exercise with and without Whole-Body Electromyostimulation and Endurance Exercise on the Postprandial Glucose Regulation in Patients with Type 2 Diabetes Mellitus: A Randomized Crossover Study. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Relationships of Changes in Physical Activity and Sedentary Behavior With Changes in Physical Fitness and Cardiometabolic Risk Profile in Individuals With Type 2 Diabetes: The Italian Diabetes and Exercise Study 2 (IDES_2). [2023]

4. Canada pubmed.ncbi.nlm.nih.gov

Exercise Therapy for Patients With Type 2 Diabetes: A Narrative Review. [2020]

5. United States pubmed.ncbi.nlm.nih.gov

Diet and exercise in type 2 diabetes mellitus. [2019]

6. Germany pubmed.ncbi.nlm.nih.gov

'Exercise snacks' before meals: a novel strategy to improve glycaemic control in individuals with insulin resistance. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Programming pre-exercise snacks to prevent post-exercise hypoglycemia in intensively treated insulin-dependent diabetics. [2019]

8. Switzerland pubmed.ncbi.nlm.nih.gov

Resources to Guide Exercise Specialists Managing Adults with Diabetes. [2020]

9. Egypt pubmed.ncbi.nlm.nih.gov

Exercising Tactically for Taming Postmeal Glucose Surges. [2023]

10. China (Republic : 1949- ) pubmed.ncbi.nlm.nih.gov

[Applying an Exercise Snack-Based Health Promotion Strategy]. [2023]

11. United States pubmed.ncbi.nlm.nih.gov

Glycemic and insulinemic responses to different preexercise snacks in participants with impaired fasting glucose. [2019]