PURPOSE Exercise-nutrient timing is of interest for people with type 2 diabetes (T2D) as a potential method to optimize glycemic control. However, the optimal nutritional environment for exercise is not well understood over the long term. The Fasted Exercise for Type 2 Diabetes (FED) Trial compared 16 wk of fasted versus postprandial morning exercise on glycated hemoglobin (HbA1c) and liver proton density fat fraction (PDFF). METHODS Twenty adults with T2D were recruited and randomized to complete exercise after an overnight fast versus after their morning meal. Participants walked three mornings per week, progressing to 180 min·wk -1 over 16 wk. RESULTS Groups were balanced with five males and five females each. Sixteen participants completed the trial (8 in each group, 50% female). Age, HbA1c, and PDFF were 59.8 ± 9.0 yr, 7.2 ± 0.7%, and 9.3 ± 4.1%, respectively. On average, both groups completed 98% of their walking sessions but there was no change in HbA1c (-0.2%, P = 0.588). However, one participant from each group had changes in their glucose-lowering medication during the trial, and when excluded, the fasted training group had greater improvements in HbA1c compared with the postprandial group (-0.3% vs 0.0%, P = 0.033). There was no difference in changes in liver PDFF between groups (-1.6% vs 0.3%, P = 0.221) but visceral fat and intramuscular fat decreased to a greater extent after fasted exercise. CONCLUSIONS Although our study had a small sample size, it suggests that exercise after an overnight fast can have high adherence and represents an option for people with T2D to improve longer-term indicators of glycemia and ectopic fat depots.

中文翻译：

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2 型糖尿病成人禁食 16 周与进食运动训练后的 HbA1c 和肝脏脂肪。


目的 运动营养时间对于 2 型糖尿病 （T2D） 患者来说是一种优化血糖控制的潜在方法。然而，从长远来看，运动的最佳营养环境并不十分了解。2 型糖尿病禁食运动 （FED） 试验比较了 16 周禁食与餐后晨练对糖化血红蛋白 （HbA1c） 和肝质子密度脂肪分数 （PDFF） 的影响。方法 招募了 20 名患有 T2D 的成年人，并随机分配在禁食过夜后和早餐后完成运动。参与者每周步行 3 个早晨，在 16 周内进展到 180 分钟·周 -1。结果 各组平衡，每组 5 名男性和 5 名女性。16 名参与者完成了试验 （每组 8 名，50% 为女性）。年龄、 HbA1c 和 PDFF 分别为 59.8 ± 9.0 岁、7.2 ± 0.7% 和 9.3 ± 4.1%。平均而言，两组都完成了 98% 的步行训练，但 HbA1c 没有变化 （-0.2%，P = 0.588）。然而，在试验期间，每组有一名参与者的降糖药物发生了变化，当被排除在外时，与餐后组相比，禁食训练组的 HbA1c 改善更大 （-0.3% vs 0.0%，P = 0.033）。两组之间肝脏 PDFF 的变化没有差异 （-1.6% vs 0.3%，P = 0.221），但空腹运动后内脏脂肪和肌内脂肪减少的程度更大。结论 尽管我们的研究样本量小，但它表明禁食过夜后的运动可以具有很高的依从性，并且代表了 T2D 患者改善血糖和异位脂肪库的长期指标的一种选择。