Background and purpose: Exercise is widely perceived to benefit glycemic control through remodeling metabolic pathways in patients with type 2 diabetes mellitus (T2DM) . Circadian clock-regulated metabolic pathways could be reprogrammed by dietary challenges, timing of exercise relevant to feeding may also create a divergent effect. Nowadays, the optimal time of day to amplify training-mediated benefits remains unknown. Here, we aimed to evaluate the effects of different exercise timing on glucometabolic response in patients with T2DM.

Data sources and study selection: PubMed/MEDLINE, EMBASE, and Cochrane Library were systematically reached on June 30, 2021 for randomized controlled trials investing the effects of exercise timing on glucometabolic response in patients with T2DM.

Data extraction and data synthesis: Reporting postprandial glucose (PPG) , or fasting blood glucose (FBG) , or incremental area under the blood glucose curve (iAUC) , or glycosylated hemoglobin (HbA1c) , or 24-hours average glucose concentrations, or insulin sensitivity index (HOMA-IS) , or insulin resistance index (HOMA-IR) were extracted. Random effects models were used to calculate the standardized mean differences (SMD) and 95% confidence intervals (CI) . A total of 29 studies were included, involving 516 individuals for analysis. Post-meal exercise improved PPG, iAUC, HbA1c, 24-h average glucose (SMD: -4.03, -1.15, -0.43, -0.83 respectively) , but not in HOMA-IS (SMD: 0.76) and HOMA-IR (SMD: 0.01) . Within 30-120 min after meal consumption lowered PPG, iAUC, HbA1c, and 24-h average glucose by a greater amount (SMD: -4.31, -1.25, -0.46, -0.75, respectively) .

Conclusion: Post-meal exercise exerted the most significant and consistent effects on glucometabolic respons. Within 30-120 min after meal is the optimal exercise timing for glycemic control. Promoting timely post-meal exercise would be of tremendous benefits to patients with T2DM.


Y.Fu: None. X.Tang: None. B.Qin: None. X.Guo: None. Y.Huang: None. Y.Chen: None. Y.Zhu: None.

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