Exercise Snacks for Type 2 Diabetes
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of British Columbia
Must not be taking: Beta-blockers
Disqualifiers: Cardiac disease, Hypertension, Psychiatric disorder, others
No Placebo Group
Trial Summary
What is the purpose of this trial?
To conduct a pilot randomized control trial to determine the feasibility of a 12-week, technology-enabled exercise snacks intervention in adults living with type 2 diabetes in a real-world setting. We will also assess preliminary efficacy based on measures of glycemic control and fitness.
Will I have to stop taking my current medications?
The trial does not specify if you need to stop taking your current medications. However, you must be on a stable dose of up to 3 glucose-lowering medications (not including insulin) and up to 2 cardiovascular medications for more than 6 months to participate.
What data supports the effectiveness of the treatment 'Exercise Snacks' for Type 2 Diabetes?
Research shows that regular physical exercise, including small doses of intense exercise before meals, can improve blood sugar control and increase insulin sensitivity in people with type 2 diabetes. Exercise is also known to reduce body fat, improve heart health, and enhance overall fitness, making it a beneficial treatment for managing diabetes.12345
Is it safe for humans to participate in exercise snacks or similar physical activity interventions?
Exercise snacks and similar physical activities are generally safe for humans, but it's important to monitor glucose levels, especially for people with diabetes. Light to moderate exercise is recommended, while high-intensity exercise may cause wide glucose fluctuations. People with diabetes should consult healthcare providers to tailor exercise plans to their specific needs and conditions.12678
How is the 'Exercise Snacks' treatment different from other treatments for type 2 diabetes?
The 'Exercise Snacks' treatment is unique because it involves short, intense bursts of exercise before meals, which can improve blood sugar control more effectively than longer, moderate exercise sessions. This approach is convenient, easy to implement, and helps reduce sedentary time, making it a practical option for people with busy schedules.124910
Research Team
JL
Jonathan Little, PhD
Principal Investigator
University of British Columbia
Eligibility Criteria
Adults aged 30-75 with type 2 diabetes, HbA1c ≤8.5%, physically inactive, and not on extreme diets or certain medications can join this study. They must be able to use technology for the program and not have conditions like severe heart disease, recent cardiovascular events, or psychiatric disorders that interfere with exercise.Inclusion Criteria
HbA1c ≤8.5%
Able to maintain current physical activity patterns during the study
Physically inactive (performing <150 min moderate-to-vigorous physical activity per week)
See 8 more
Exclusion Criteria
I am taking beta-blockers that may affect heart rate tests.
Angina upon exertion assessed by the Rose Angina Questionnaire
I have a heart or lung condition that stops me from exercising.
See 12 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Pre-intervention Meeting
Participants have a meeting to document physical limitations and discuss the prescribed intervention
1 week
1 visit (in-person or virtual)
Treatment
Participants perform either vigorous-intensity bodyweight exercises or low-intensity stretching exercises for 12 weeks
12 weeks
Delivered via app or web platform
Follow-up
Participants are monitored for safety and effectiveness after treatment
4 weeks
1 visit (in-person)
Treatment Details
Interventions
- Exercise Snacks (Behavioural Intervention)
Trial OverviewThe trial is testing 'exercise snacks,' short bursts of physical activity facilitated by technology over a period of 12 weeks. Participants are randomly placed into two groups: one doing these exercises and another performing placebo activities to compare effects on blood sugar control and fitness.
Participant Groups
2Treatment groups
Experimental Treatment
Active Control
Group I: Exercise SnacksExperimental Treatment1 Intervention
Vigorous-intensity bodyweight exercises performed 4 times per day on at least 5 days per week.
Group II: Placebo ExerciseActive Control1 Intervention
Low-intensity stretching exercises performed 4 times per day on at least 5 days per week.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
University of British Columbia OkanaganKelowna, Canada
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Who Is Running the Clinical Trial?
University of British Columbia
Lead Sponsor
Trials
1506
Patients Recruited
2,528,000+
McMaster University
Collaborator
Trials
936
Patients Recruited
2,630,000+
References
'Exercise snacks' before meals: a novel strategy to improve glycaemic control in individuals with insulin resistance. [2022]The aim of this study was to investigate whether small doses of intense exercise before each main meal ('exercise snacks') would result in better blood glucose control than a single bout of prolonged, continuous, moderate-intensity exercise in individuals with insulin resistance.
Diet and exercise in type 2 diabetes mellitus. [2019]The question is no longer whether diet and exercise can benefit the individual with type 2 diabetes. Rather, the type and duration of exercise the magnitude of the effects on glycemic control, insulin sensitivity, and on risk factors for cardiovascular disease must be considered in determining the feasibility and acceptability of an intervention program. It is now clear that regular physical exercise is important in both the prevention and treatment of type 2 diabetes. The benefits of exercise are many and include increased energy expenditure, which, combined with dietary restriction, leads to decreased body fat, increased insulin sensitivity, improved long-term glycemic control, improved lipid profiles, lower blood pressure, and increased cardiovascular fitness. Persons with type 2 diabetes often find it difficult to exercise and are at increased risk for injury or exacerbation of underlying diseases or diabetic complications. Therefore, before starting an exercise program, all patients with type 2 diabetes should have a complete history and physical examination, with particular attention to evaluation of cardiovascular disease, medications that may affect glycemic control during or after exercise, and diabetic complications including retinopathy, nephropathy, and neuropathy. Exercise programs should be designed to start slowly, build up gradually, and emphasize moderately intense exercise performed at least three times a week and preferably five to seven times a week for best results.
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]In the Italian Diabetes and Exercise Study_2 (IDES_2), behavioral counseling promoted a sustained increase in physical activity (PA) volume (+3.3 MET h ⋅ week-1), moderate- to vigorous-intensity PA (MVPA) (+6.4 min ⋅ day-1), and light-intensity PA (LPA) (+0.8 h ⋅ day-1) and decrease in sedentary time (SED-time) (-0.8 h ⋅ day-1). Here, we investigated the relationships of changes in PA/SED-time with changes in physical fitness and cardiometabolic risk profile in individuals with type 2 diabetes.
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]Long hyperglycemic episodes trigger complications in type 2 diabetes mellitus (T2DM) patients. Postprandial glucose excursions can be reduced by acute physical activity. However, it is not yet clear which type of exercise has the best effect on postprandial glucose levels.
Exercise Therapy for Patients With Type 2 Diabetes: A Narrative Review. [2020]To achieve excellent glycemic control in patients with type 2 diabetes, an adequate prescription of exercise therapy is required. The meta-analyses proposed that high-intensity training improves metabolic parameters in patients with pre-diabetes or type 2 diabetes and low physical activity is associated with an increased risk of incident type 2 diabetes. Here, we would introduce literatures about effects of physical activity on mortality, cardiovascular events, and metabolic parameters, to encourage understanding of exercise therapy, and then describe how to prescribe exercise therapy for patients with type 2 diabetes. We also show the usefulness of non-exercise activity thermogenesis for diabetic patients who cannot perform volitional sporting-like exercise because of diabetic complication and/or comorbidity, by presenting results of our previous studies.
Exercising Tactically for Taming Postmeal Glucose Surges. [2023]This review seeks to synthesize data on the timing, intensity, and duration of exercise found scattered over some 39 studies spanning 3+ decades into optimal exercise conditions for controlling postmeal glucose surges. The results show that a light aerobic exercise for 60 min or moderate activity for 20-30 min starting 30 min after meal can efficiently blunt the glucose surge, with minimal risk of hypoglycemia. Exercising at other times could lead to glucose elevation caused by counterregulation. Adding a short bout of resistance exercise of moderate intensity (60%-80% VO2max) to the aerobic activity, 2 or 3 times a week as recommended by the current guidelines, may also help with the lowering of glucose surges. On the other hand, high-intensity exercise (>80% VO2max) causes wide glucose fluctuations and its feasibility and efficacy for glucose regulation remain to be ascertained. Promoting the kind of physical activity that best counters postmeal hyperglycemia is crucial because hundreds of millions of diabetes patients living in developing countries and in the pockets of poverty in the West must do without medicines, supplies, and special diets. Physical activity is the one tool they may readily utilize to tame postmeal glucose surges. Exercising in this manner does not violate any of the current guidelines, which encourage exercise any time.
Programming pre-exercise snacks to prevent post-exercise hypoglycemia in intensively treated insulin-dependent diabetics. [2019]Five intensively treated, insulin-dependent diabetics exercised for 45 minutes after fasting while receiving basal insulin injections. Plasma glucose concentrations remained stable during exercise but then declined, resulting in clinical hypoglycemia 1 to 2 hours later. Efficacies of three pre-exercise snacks in preventing the hypoglycemia were compared in a randomized crossover design. Orange juice, whole milk, and skim milk, each containing 13 g of carbohydrate, all prevented postexercise hypoglycemia. However, the more rapidly absorbed snacks, orange juice and skim milk, caused a greater increase in plasma glucose concentrations and the area under the glucose curve during exercise. From the recognized glucose profiles that occur after consumption of different carbohydrates, snacks as well as exercise and insulin can now be programmed for intensively treated, insulin-dependent diabetics. Because plasma glucose levels remain stable during exercise done after fasting and only fall late after exercise, a "lente" carbohydrate snack, such as whole milk, is an appropriate pre-exercise snack.
Resources to Guide Exercise Specialists Managing Adults with Diabetes. [2020]Exercise is an important element to optimize health and well-being, though navigating exercise safely can be challenging for exercise specialists working with people with diabetes. Measuring glucose levels before an exercise session assists in the determination of whether exercise is safe for a person with diabetes. A number of organizations have recently developed guidelines to provide exercise and diabetes recommendations based on glucose levels and other relevant factors. However, there are limited easy-to-use resources to assist exercise specialists to determine whether exercise should be started and continued by people with diabetes. The type of diabetes, pre-exercise glucose level, medications and their timing, recent food intake and general sense of wellness all warrant consideration when determining the approach to each exercise session. An expert group was convened to review the published literature and develop resources to guide exercise specialists in assessing the safety of an adult with diabetes starting exercise, and indications to cease exercise, based upon glucose levels and other factors. Contraindications to people with diabetes starting or continuing exercise are (1) glucose 15.0 mmol/L with symptoms of weakness/tiredness, or with ketosis; (3) hypoglycaemic event within the previous 24 h that required assistance from another person to treat and (4) feeling unwell. To optimize diabetes and exercise safety, recommendations (stratified by pre-exercise glucose level) are provided regarding carbohydrate ingestion, glucose monitoring and medication adjustment.
Glycemic and insulinemic responses to different preexercise snacks in participants with impaired fasting glucose. [2019]To compare serum glucose and insulin responses to 3 preexercise snacks before, during, and after exercise in individuals with impaired fasting glucose (IFG) and healthy (H) men. In addition, in an IFG population, the authors sought to determine whether a natural fruit snack (i.e., raisins) yields more desirable glucose and insulin concentrations than an energy bar or a glucose solution.
[Applying an Exercise Snack-Based Health Promotion Strategy]. [2023]Lack of time, lack of access to equipment, and environmental constraints are generally perceived as barriers to regular physical activity. Moreover, insufficient activity is known to promote sedentary behavior, which is a factor in many chronic diseases, negatively affects mental health, and reduces quality of life. Exercise snacks, defined as short and efficient bursts of exercise, are convenient and easy to implement, reduce sedentary time, increase physical activity, and promote the development of good exercise habits. Previous studies have found exercise snacks to be safe and feasible for the elderly, promoting physical function and reducing the incidence of falls and metabolic diseases. Exercise snacks have also been found to be effective in healthy adults as well as in patients with obesity and diabetes, helping decrease blood sugar and promoting cardiorespiratory fitness. Depending on the participant's age and tolerance, exercise snack patterns may be extended and distinguished into two forms: 10-minute bouts of gentle intermittent exercise twice a day and 60-second bouts of vigorous exercise 3 to 8 times a day. The main considerations for exercise snacks include: multi-joint exercise is better than single-joint exercise, lower body exercise is better than upper body exercise, and dynamic and rapid movement that pushes away from the ground promotes osteogenesis and helps prevent osteoporosis and fractures. Exercise snacks may be applied in healthcare practice and related research to promote health and improve quality of life for all.