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Improvements in Glycemic Control After Acute ModerateIntensity Continuous or HighIntensity Interval Exercise Are Greater in South Asians Than White Europeans With Nondiabetic Hyperglycemia: A Randomized Crossover Study

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posted on 06.11.2020, 21:41 by Jack A. Sargeant, Charlotte Jelleyman, Nicole A. Coull, Charlotte L. Edwardson, Joseph Henson, James A. King, Kamlesh Khunti, Matthew McCarthy, Alex V. Rowlands, David J. Stensel, Helen L. Waller, David R. Webb, Melanie J. Davies, Thomas Yates
Objective: To examine whether circulating metabolic responses to low-volume high-intensity interval (LV-HIIE) or continuous moderate-intensity aerobic (CME) exercise differ between white Europeans and South Asians with nondiabetic hyperglycaemia (NDH).

Research Design and Methods: 13 white Europeans and 10 South Asians (combined median (IQR) age 67 (60–68) years, HbA1c 5.9 (5.8–6.1)% [41.0 (39.9–43.2) mmol·mol-1]) completed three 6-hour conditions (sedentary control [CON], LV-HIIE, CME) in a randomised order. Exercise conditions contained a single bout of LV-HIIE and CME respectively (each ending at 2h), with meals provided at 0 and 3h. Circulating glucose (primary outcome), insulin, insulin resistance index (IRI), triglyceride and non-esterified fatty acids were measured at 0, 0.5, 1, 2, 3, 3.5, 4, 5 and 6h. Data were analysed as post-exercise time-averaged area under the curve (AUC), adjusted for age, sex and pre-exercise AUC.

Results: Glucose was similar in each condition and ethnicity, with no condition-by-ethnicity interaction (P≥0.28). However, insulin was lower in LV-HIIE (mean [95% CI]: -44.4 [-23.7, -65.1] mU·L-1) and CME (-33.8 [-13.7, -53.9] mU·L-1) compared to CON. Insulin responses were greater in South Asians (interaction P=0.03) such that values were similar in each ethnicity during exercise conditions, despite being 33% higher in South Asians during CON. IRI followed a similar pattern to insulin. Lipids were unaffected by exercise.

Conclusions: Reductions in insulin and insulin resistance after acute LV-HIIE and CME are greater in South Asians than white Europeans with NDH. Further trials are required to examine longer-term impact of LV-HIIE and CME on cardiometabolic health.


Funding

This research was supported by the NIHR Leicester Biomedical Research Centre and the NIHR Applied Research Collaboration East Midlands.

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