Type 2 diabetes mellitus (T2DM) is characterized by impaired glycemic control, which increases the risk of cardiovascular and metabolic complications. Exercise is a key non-pharmacological intervention known to improve blood glucose regulation, but the acute effects of different exercise modalities on glycemic control in T2DM remain unclear. The aim of this systematic review was to critically analyze and synthesize the existing body of research on the acute effects of various exercise modalities on glycemic control in patients with T2DM. This systematic review included studies involving adults (≥ 18 years) with T2DM where structured exercise program is the primary or significant intervention, assessing outcomes related to glycemic control (HbA1c, and fasting glucose). A comprehensive search was conducted across two electronic databases (Web of Science and PubMed) using structured search terms like "acute", "exercise", "type 2 diabetes", and "glycemic control". Study selection involved two independent reviewers screening articles, with disagreements resolved through discussion or third-party consultation, followed by detailed data extraction on study characteristics, intervention details, and outcomes. Ten studies were identified that met all inclusion criteria. This systematic review highlights that moderate intensity continuous training and high-intensity interval training have positive acute effects on glycemic control in individuals with T2DM. These findings suggest that both modalities are effective non-pharmacological strategies for optimizing glycemic control in patients T2DM.
Monnier L, Colette C. Postprandial and basal hyperglycaemia in type 2 diabetes: Contributions to overall glucose exposure and diabetic complications. Diabetes & Metabolism. 2015;41(6):6S9–15.
2.
Koopman R, Manders RJF, Zorenc AHG, Hul GBJ, Kuipers H, Keizer HA, et al. A single session of resistance exercise enhances insulin sensitivity for at least 24 h in healthy men. European Journal of Applied Physiology. 2005;94(1–2):180–7.
3.
Larsen JJS, Dela F, Kjær M, Galbo H. The effect of moderate exercise on postprandial glucose homeostasis in NIDDM patients. Diabetologia. 1997;40(4):447–53.
4.
Ivy JL, Holloszy JO. Persistent increase in glucose uptake by rat skeletal muscle following exercise. American Journal of Physiology-Cell Physiology. 1981;241(5):C200–3.
5.
Liubaoerjijin Y, Terada T, Fletcher K, Boulé NG. Effect of aerobic exercise intensity on glycemic control in type 2 diabetes: a meta-analysis of head-to-head randomized trials. Acta Diabetologica. 2016;53(5):769–81.
6.
Grace A, Chan E, Giallauria F, Graham PL, Smart NA. Clinical outcomes and glycaemic responses to different aerobic exercise training intensities in type II diabetes: a systematic review and meta-analysis. Cardiovascular Diabetology. 2017;16(1).
7.
Kemps H, Kränkel N, Dörr M, Moholdt T, Wilhelm M, Paneni F, et al. Exercise training for patients with type 2 diabetes and cardiovascular disease: What to pursue and how to do it. A Position Paper of the European Association of Preventive Cardiology (EAPC). European Journal of Preventive Cardiology. 2019;26(7):709–27.
8.
Gillen J, Little J, Punthakee Z. Acute high-intensity interval exercise reduces the postprandial glucose response and prevalence of hyperglycaemia in patients with type 2.
9.
Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nature Reviews Endocrinology. 2017;14(2):88–98.
10.
Praet SFE, Manders RJF, Meex RCR, Lieverse AG, Stehouwer CDA, Kuipers H, et al. Glycaemic instability is an underestimated problem in Type II diabetes. Clinical Science. 2006;111(2):119–26.
11.
Boulé NG, Haddad E, Kenny GP, Wells GA, Sigal RJ. Effects of Exercise on Glycemic Control and Body Mass in Type 2 Diabetes Mellitus. JAMA. 2001;286(10):1218.
12.
Umpierre D. Physical Activity Advice Only or Structured Exercise Training and Association With HbA1cLevels in Type 2 Diabetes. JAMA. 2011;305(17):1790.
13.
Sparks JR, Kishman EE, Sarzynski MA, Davis JM, Grandjean PW, Durstine JL, et al. Glycemic variability: Importance, relationship with physical activity, and the influence of exercise. Sports Medicine and Health Science. 2021;3(4):183–93.
14.
Babir FJ, Riddell MC, Adamo LM, Richards DL, Gibala MJ. The effect of bodyweight exercise on 24-h glycemic responses determined by continuous glucose monitoring in healthy inactive adults: a randomized crossover study. Scientific Reports. 2023;13(1).
15.
Colberg SR, Sigal RJ, Yardley JE, Riddell MC, Dunstan DW, Dempsey PC, et al. Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care. 2016;39(11):2065–79.
16.
Erickson ML, Little JP, Gay JL, McCully KK, Jenkins NT. Effects of postmeal exercise on postprandial glucose excursions in people with type 2 diabetes treated with add-on hypoglycemic agents. Diabetes Research and Clinical Practice. 2017;126:240–7.
17.
Li Z, Hu Y, Yan R, Li H, Zhang D, Li F, et al. Twenty Minute Moderate-Intensity Post-Dinner Exercise Reduces the Postprandial Glucose Response in Chinese Patients with Type 2 Diabetes. Medical Science Monitor. 2018;24:7170–7.
18.
Macleod S, Terada T, Chahal B, Boule N. Exercise lowers postprandial glucose but not fasting glucose in type 2 diabetes: a meta-analysis of studies using continuous glucose monitoring. Diabetes/metabolism research Res. 2013;(8):593–603.
19.
Munan M, Oliveira CLP, Marcotte-Chénard A, Rees JL, Prado CM, Riesco E, et al. Acute and Chronic Effects of Exercise on Continuous Glucose Monitoring Outcomes in Type 2 Diabetes: A Meta-Analysis. Frontiers in Endocrinology. 2020;11.
20.
Nathan DM, Kuenen J, Borg R, Zheng H, Schoenfeld D, Heine RJ, et al. Translating the A1C Assay Into Estimated Average Glucose Values. Diabetes Care. 2008;31(8):1473–8.
21.
Henderson GC, Fattor JA, Horning MA, Faghihnia N, Johnson ML, Luke-Zeitoun M, et al. Glucoregulation is more precise in women than in men during postexercise recovery. The American Journal of Clinical Nutrition. 2008;87(6):1686–94.
22.
Henderson GC, Fattor JA, Horning MA, Faghihnia N, Johnson ML, Mau TL, et al. Lipolysis and fatty acid metabolism in men and women during the postexercise recovery period. The Journal of Physiology. 2007;584(3):963–81.
23.
Tushuizen ME, Diamant M, Heine RJ. Postprandial dysmetabolism and cardiovascular disease in type 2 diabetes. Postgraduate Medical Journal. 2005;81(951):1–6.
24.
Gillen JB, Little JP, Punthakee Z, Tarnopolsky MA, Riddell MC, Gibala MJ. Acute high‐intensity interval exercise reduces the postprandial glucose response and prevalence of hyperglycaemia in patients with type 2 diabetes. Diabetes, Obesity and Metabolism. 2012;14(6):575–7.
25.
Rees JL, Chang CR, François ME, Marcotte-Chénard A, Fontvieille A, Klaprat ND, et al. Minimal effect of walking before dinner on glycemic responses in type 2 diabetes: outcomes from the multi-site E-PAraDiGM study. Acta Diabetologica. 2019;56(7):755–65.
26.
VAN DIJK JW, MANDERS RJF, CANFORA EE, MECHELEN WV, HARTGENS F, STEHOUWER CDA, et al. Exercise and 24-h Glycemic Control. Medicine & Science in Sports & Exercise. 2013;45(4):628–35.
27.
Iida Y, Takeishi S, Fushimi N, Tanaka K, Mori A, Sato Y. Effect of postprandial moderate-intensity walking for 15-min on glucose homeostasis in type 2 diabetes mellitus patients. Diabetology International. 2020;11(4):383–7.
28.
Zhang Q. Effects of Acute Exercise with Different Intensities on Glycemic Control in Patients with Type 2 Diabetes Mellitus. Acta Endocrinologica (Bucharest). 2021;17(2):212–8.
29.
Metcalfe RS, Fitzpatrick B, Fitzpatrick S, McDermott G, Brick N, McClean C, et al. Extremely short duration interval exercise improves 24-h glycaemia in men with type 2 diabetes. European Journal of Applied Physiology. 2018;118(12):2551–62.
30.
Marcotte-Chénard A, Tremblay R, Deslauriers L, Geraldes P, Gayda M, Christou D, et al. Comparison of 10 × 1-minute high-intensity interval training (HIIT) versus 4 × 4-minute HIIT on glucose control and variability in females with type 2 diabetes. Applied Physiology, Nutrition, and Metabolism. 2024;49(4):487–500.
31.
Terada T, Wilson BJ, Myette-Côté E, Kuzik N, Bell GJ, McCargar LJ, et al. Targeting specific interstitial glycemic parameters with high-intensity interval exercise and fasted-state exercise in type 2 diabetes. Metabolism. 2016;65(5):599–608.
32.
Erickson M, Little J, Gay J. Effects of postmeal A. Lazić et al. AFMN. Biomedicine. 2025;(3):328–38.
33.
Praet SFE, Manders RJF, Meex RCR, Lieverse AG, Stehouwer CDA, Kuipers H, et al. Glycaemic instability is an underestimated problem in Type II diabetes. Clinical Science. 2006;111(2):119–26.
34.
van Dijk JW, Manders RJF, Hartgens F, Stehouwer CD, Praet SFE, van Loon LJC. Postprandial hyperglycemia is highly prevalent throughout the day in type 2 diabetes patients. Diabetes Research and Clinical Practice. 2011;93(1):31–7.
35.
Adams P. The impact of brief high-intensity exercise on blood glucose levels. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 2013;113.
36.
Ceriello A, Esposito K, Piconi L, Ihnat MA, Thorpe JE, Testa R, et al. Oscillating Glucose Is More Deleterious to Endothelial Function and Oxidative Stress Than Mean Glucose in Normal and Type 2 Diabetic Patients. Diabetes. 2008;57(5):1349–54.
37.
Esposito K, Nappo F, Marfella R, Giugliano G, Giugliano F, Ciotola M, et al. Inflammatory Cytokine Concentrations Are Acutely Increased by Hyperglycemia in Humans. Circulation. 2002;106(16):2067–72.
38.
BELLINI A, NICOLÒ A, BAZZUCCHI I, SACCHETTI M. Effects of Different Exercise Strategies to Improve Postprandial Glycemia in Healthy Individuals. Medicine & Science in Sports & Exercise. 2021;53(7):1334–44.
39.
Lu J, Wang C, Shen Y, Chen L, Zhang L, Cai J, et al. Time in Range in Relation to All-Cause and Cardiovascular Mortality in Patients With Type 2 Diabetes: A Prospective Cohort Study. Diabetes Care. 2020;44(2):549–55.
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