Advice to walk after meals is more effective for lowering postprandial glycaemia in type 2 diabetes mellitus than advice that does not specify timing: a randomised crossover study.
Level 2 - randomized trial
Individual randomized crossover trial
PubMed 27747394 · doi:10.1007/s00125-016-4085-2
What was done
In a randomized crossover trial, 41 adults with type 2 diabetes mellitus (mean age 60 ± 9.9 years, mean diabetes duration 10 years) were randomized to two 2-week intervention periods separated by a 30-day washout. Participants received advice to either walk for 30 minutes once per day or walk for 10 minutes after each main meal. Physical activity was tracked by accelerometry, and glucose was assessed via continuous glucose monitoring in 5-minute intervals across 7 days. The primary outcome was 3-hour postprandial glycaemia assessed by incremental area under the blood glucose curve (iAUC).
What was found
Postprandial glucose iAUC across all meals was significantly lower with post-meal walking advice compared to single daily walking advice (ratio of geometric means 0.88, 95% CI 0.78, 0.99). The reduction was most pronounced after the evening meal (ratio of geometric means 0.78, 95% CI 0.67, 0.91). One participant died during the 30-day washout period, which was judged unrelated to study participation.
Why it matters
Prescribing short walks immediately following meals improves postprandial glycaemic control more effectively than standard once-daily walking advice, despite matching the total prescribed exercise duration.
Limits
Small sample size (41 participants) and short duration of continuous glucose monitoring (7 days per 2-week period). The intervention evaluated behavioral advice rather than strictly supervised exercise sessions, and long-term clinical outcomes such as HbA1c or vascular complications were not measured.
Cited by
- partial Performing 10 to 15 minutes of physical activity immediately following a meal reduces the postprandial glucose excursion by 50% or more.