Evidence Summary
A 2012 study on the affect of walking after a meal found that walking significantly improves post prandial glucose control – incremental glucose area under the curve for those with type 1 diabetes were 7.5 mmol/L/270 min and 18.4 mmol/L/270 min, for walking and inactivity post meal respectively (P < 0.001). [1]
At 2020 randomised crossover study involving 10 type one diabetics found that interrupting sitting for a 5 minute light walk every 30 minutes for four hours (SIT-LESS) post prandially improved glycemic control compared to uninterrupted sitting (SIT) with no episodes of hypoglycemia in either group. Postprandial glucose concentrations increased with SIT whereas this rise was tempered with SIT-Less (SIT: DELTA2.7+/-2.6 vs. SIT-Less DELTA0.4 +/-1.2 mmol/L p=.043). With SIT-Less, Time in Range (3.9-10 mmol/L) was significantly increased (SIT 114+/-114 vs. SIT-Less 288+/-36 minutes p=.008), time spent in hyperglycaemia was significantly reduced (SIT 94 +/-86 vs. SIT-Less 9.5+/-24 minutes, p=.043), and glucose peak was significantly lower (SIT: DELTA5.8+/-4.1 vs. SIT-Less 2.0+/-1.4 mmol/L p=.047). There were no episodes of hypoglycaemia in either condition. [2]
Quality of evidence
B – Moderate
Strength of Recommendation
1 – Strong recommendation
Conclusion
Although the power of these studies is difficult to ascertain due to either low reported sample sizes or unclear methodologies. Different studies reporting similar conclusions lends weight to the recommendation that interrupted sitting postprandially is a reasonable recommendation to improve glycemic control in type 1 diabetics.
References
[1] – Manohar, C., Levine, J. A., Nandy, D. K., Saad, A., Man, C. D., McCrady-Spitzer, S. K., … Kudva, Y. C. (2012). The effect of walking on postprandial glycemic excursion in patients with type 1 diabetes and healthy people. Diabetes Care, 35(12), 2493–2499.
[2] – Interrupted sitting improves 24-hour glucose control in people with type 1 diabetes. Campbell MDingena CMarsh A et al. Diabetologia, (2020), S197-S198, 63(SUPPL 1). ISSN 1432-0428 DOI http://dx.doi.org/10.1007/s00125-020-05221-5