The Effect of Exercise With or Without Metformin on Glucose Profiles in Type 2 Diabetes.
Bibliographic record
Abstract
The glucose lowering effect of exercise is one of the most well documented finding in diabetes. However, recent studies suggest that this effect may be impaired when people with type 2 diabetes (T2D) are treated with metformin (MET). PURPOSE: 1- to confirm the previously observed increase in postprandial glucose immediately after exercise in T2D individuals treated with MET, 2- to determine how long the increased glucose persists, 3- to examine if skipping a dose of MET before or after exercise could help further improve glycemic control. METHODS: People with T2D taking MET were recruited. After a baseline assessment that included a graded exercise test, participants were assigned to randomly complete four experimental conditions: 1- morning and evening MET doses without exercise (M-M), 2- morning and evening MET doses with exercise (M-Ex-M), 3- exercise with evening MET dose only (Ex-M) and 4- morning MET dose only with exercise (M-Ex). Exercise consisted of walking continuously for 50 minutes at a moderate intensity starting at 11AM on the first day of the 72 hours experimental conditions. Standardized breakfasts, lunch and dinners were provided on the first day. Glucose profiles were assessed by continuous glucose monitoring. RESULTS: 10 participants with a mean (SD) age of 60(11)yr and a body mass index of 29.5(4.7)kg/m2 completed all four conditions. The 55-mins exercise significantly lowered glucose concentrations in every condition (respectively -2.8±3.0, -2.3±1.8, -2.4±2.4 mmol/L, all p<0.02). Compared to M-M, M-Ex-M didn’t improve daily mean glucose concentrations (dMEAN) (7.2±1.3 vs 7.0±1.4 mmol/L, p=0.32), fasting (6.6 ± 1.1 vs 6.8 ± 1.4 mmol/L, p=0.69), mean amplitude of glycemic excursion (MAGE) (3.1±1.5 vs 3.6±1.4 mmol/L, p=0.11) and deteriorated the average 2-hrs incremental postprandial area under the curve (I-pAUC) (153±39 vs 238±38 mmol/L/min, p<0.01). M-Ex (7.5 ± 1.6, p<0.05), but not Ex-M (7.5 ± 1.5, p=0.08) increased dMEAN compare to M-Ex-M. There were no differences among the three exercise conditions for fasting, MAGE and I-pAUC. CONCLUSION: The addition of exercise to MET led to an increase in postprandial glucose without increasing dMEAN glucose concentrations. Removing a MET dose before/after exercise did not attenuate this negative effect and even tended to worsen it.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".