POSTPRANDIAL EXERCISE IS SUPERIOR TO REGULAR CONTINUOUS EXERCISE IN HBA1C REDUCTION FOR TYPE 2 DIABETICS IN SAUDI ARABIA

Abstract

ABSTRACT

BACKGROUND AND OBJECTIVES: Exercise helps people on diet to lose weight, also helps having better Blood Pressure. The aim of the study is to compare the response of glycosylated hemoglobin (HbA1c), body mass index (BMI) and incidence of hypoglycemia to continue running exercise (group A) and intermittent postprandial exercise (group B)  for individuals with type 2 diabetes in Jeddah – Saudi Arabia

DESIGN AND SETTINGS: Out of 44 enrolled patients from Jeddah region, 24 patients were group A, who were asked to run daily for 45 minutes at any time of the day, continuous running without stopping -as much as they can, and 20 other patients were group B, who were asked to run 60-90 minutes after main meals for 15 minutes three times daily. The study involves mandatory baseline visit then follow up, once after 12 weeks.

Results: The mean age was 42.1 (2.8) [Mean (SD)] years for group A, whereas it was 43.8 (1.7) years for group B. 17% were males and 83% were females for group A whereas all patients were females for group B. The main BMI was 26.2 (1.2) kg/m² (group A), while it was 26.9 (1.0) kg/m² (group B).

The mean Postprandial Blood Glucose (PPG) was 150.4 (7.5) mg/dl (group A), while it was 144.5 (11.2) mg/dl (group B). There was no statistically significant difference in the mean PPG between group A and group B (P > 0.05).

50 % were house wives (group A), whereas 100% were house wives (group B). There was statistically significant difference in patients’ jobs for group A compared to group B (P < 0.05 and > 0.01)

All patients on metformin and statin for both groups, and There was no statistically significant difference in Current Medication between group A and group B (P > 0.05), but There was statistically significant difference in the mean dose between group A and group B (P < 0.05 and > 0.01).The mean time of exercise was 33.6 (14.1) min/day (group A), while it was 33.5 (8.3) min/day (group B). There was no statistically significant difference in time of exercise groups between group A and group B (P > 0.05).

Both groups resulted in a decline in HbA1c. However, the mean of HbA1c was dropped from 8 % (at baseline visit) to 7% (at the end of the study. There was a very high statistically significant decrease of 1% (P < 0.001) and percent change was -12.5%.for group A, whereas the mean of HbA1c was dropped from 7.9% (at baseline visit) to 6.4% (at end of the study)..There was a very high statistically significant decrease of 1.5% (P < 0.001) and percent change was -19.1%for group B.

There was a very high statistically significant difference in HbA1c reduction from baseline visit to end of the study between group A and group B (P < 0.001).

At follow up visit after 12 weeks, 12(50%) of group A were controlled (HbA1c < 7%), while 18 (90) % of group B were controlled (HbA1c < 7%). There was high statistically significant difference in controlled patients (HbA1c < 7%) between group A and group B (P < 0.01 and > 0.001).

Group A resulted in a decline in mean of BMI which was the percentage decrease in BMI was 1.7% with group A. There was statistically significant decrease in mean BMI from baseline visit to the end of the study for group A of 0.4 kg/m² (p < 0.05 and > 0.01), while there was no statistically significant difference for group B (P > 0.05).

There was high statistically significant difference in BMI reduction from baseline visit to the end of the study between group A and group B (P < 0.01 and > 0.001).

The mean number of episodes of hypoglycemia was 1.8 (3.7) times (group A), while it was 3.9 (3.8) times (group B). There was no statistically significant difference in number of episodes of hypoglycemia in group A compared to group B (P > 0.05).

Conclusion: The reduction of HbA1c levels with continuous running exercise is less than its levels with intermittent postprandial exercise during both exercises in individuals with type 2diabetes, while the reduction of BMI levels with intermittent postprandial exercise is less than its levels with continuous running exercise However, No significant change in incidences of hypoglycemia was found in both groups.

Key Words: Exercise, Type 2 Diabetes, HbA1c, BMI and Hypoglycemia.