Post-dinner resistance exercise improves postprandial risk factors more effectively than pre-dinner resistance exercise in patients with type 2 diabetes

Abnormally elevated postprandial glucose and triacylglycerol (TAG) concentrations are risk factors for cardiovascular disease in type-2 diabetes. The most effective time to exercise to lower postprandial glucose and TAG concentrations is unknown. Thus, the aim of this study was to determine what time is more effective, either pre- or post-dinner resistance exercise (RE), at improving postprandial risk factors in patients with type-2 diabetes. Thirteen obese-patients with type-2 diabetes completed three trials in a random order in which they consumed a dinner meal with 1) no RE (NoRE), 2) pre-dinner RE (RE->M), and 3) post-dinner RE beginning 45-min after dinner (M->RE). Clinical outcome measures included postprandial glucose and TAG concentrations. In addition, postprandial acetaminophen (gastric emptying), endocrine responses, FFA, and beta-cell function (mathematical modeling) were measured to determine if these factors were related to changes in glucose and TAG. The TAG incremental-AUC (iAUC) was ~92% lower (P<=0.02) during M->RE compared to NoRE and RE->M, an effect due in part to lower VLDL-1 TAG concentrations. The glucose iAUC was reduced (P=0.02) by ~18% and 30% during the RE->M and M->RE trials, respectively, compared to NoRE, with no difference between RE trials. RE->M and M->RE reduced the insulin iAUC by 35% and 48%, respectively, compared to NoRE (P<0.01). The GLP-1 iAUC was ~50% lower (P<=0.02) during M->RE compared to NoRE and RE->M. Given that pre-dinner RE only improves postprandial glucose concentrations, whereas post-dinner RE improves both postprandial glucose and TAG concentrations, post-dinner RE may lower the risk of cardiovascular disease more effectively.