More movement tied to blunted glycaemic levels

In a study evaluating individuals without diabetes, increasing the overall level of physical activity was associated with reduced glucose maximum peaks the following day.

“[I]t is key to identify lifestyle-related drivers to reduce glycaemic variability and improve glycaemic control, [as this] may contribute to an improvement of cardiometabolic health in the general population,” said the researchers. “[As such, we aimed] to explore the associations of device-measured physical activity … with various glycaemic control and variability indices derived from 13 days of continuous glucose monitoring in adults without diabetes.”

Using data from the Food & You digital cohort, device*-based daily step count (DSC) was tracked for 2 weeks in 85 individuals (mean age 40 years, 56 percent female). Participants were instructed to log photos of all their meals into a smartphone app, as well as their daily physical activities and sleep duration. A flash glucose monitor** was used to continuously measure glucose concentrations. [Diabetes Technol Ther 2022;24:167-177]

While there were no associations between DSC and glycaemic indices from the same day, assessments for the following day showed that every 1,000 steps/day increase in DSC was tied to reductions in maximum glucose values (–0.3588 mg/dL; p=0.035), mean glucose (–0.0917 mg/dL; p=0.04), and glucose management indicator (–0.0022 percent; p=0.04).

“Thus, increasing the total volume of physical activity may be linked to slightly blunted glycaemic excursions during the next day,” said the researchers.

For the day after next, glycaemic control and variability indices was not associated with DSC except for the standard deviation (SD) of glucose – every 1,000 steps/day increase in DSC was associated with a 0.0623-mg/dL drop in SD of glucose 2 days later (p=0.04).

Acute exercise sessions were reportedly tied to reduced SD of glucose during the 12–18 hours after exercise sessions compared with pre-exercise values. [Biol Sport 2019;36:141-148] “[As such,] our result could suggest that positive benefits of physical activity could be visible beyond 18 hours after an exercise session,” they said.

A leverage to meet guidelines

Despite the benefits of physical activity, more than a quarter of adults do not meet the WHO physical activity guidelines. [Lancet Glob Health 2018;6:e1077-e1086; www.who.int/publications/i/item/9789240015128, accessed May 31, 2022] “One of the possible reasons that could explain why individuals do not follow the guidelines would be that the reward (eg, decreased chronic disease risk) associated with physical activity is not tangible and appears too far in the future,” the researchers explained.

“Thus, being able to display to individuals some short-term health benefits or positive physiological consequences of people’s physical behaviours as the ones observed in this [study] can be of high interest for motivation and could serve as a leverage to meet physical activity guidelines,” they continued.

Going the ‘smart’ way

Today, ‘smart’ devices (eg, smartphones, wearable activity trackers) have integrated applications that allow for easy monitoring of health parameters, with increasing use owing to accessibility, affordability, and constant upgrades. [J Med Internet Res 2020;22:e22443; Prev Med Rep 2017;5:124-126; Am J Manag Care 2019;25:SP123-SP126]

The benefits of certain movements can be incorporated into health-related apps and represented as personalized feedback. “This may motivate more individuals to follow public health guidelines and/or to engage in healthy movement behaviours and maintain them over time,” they said.

“[Moreover, these] systems can give researchers access to more accurate, objective, and continuous measurements, which opens new research perspectives,” they added. Data may then be used in large epidemiologic or surveillance studies to better monitor physical activity and contribute to the deep digital phenotyping of populations in real-life settings. [J Med Internet Res 2020;22:e16770]

The researchers called for larger studies to shed light on the correlation between physical behaviours and glycaemic measures, both in normoglycaemic cohorts and individuals with diabetes.