Skip to main content
  • More from ADA
    • Diabetes
    • Clinical Diabetes
    • Diabetes Spectrum
    • ADA Standards of Medical Care
    • ADA Scientific Sessions Abstracts
    • BMJ Open Diabetes Research & Care
  • Subscribe
  • Log in
  • My Cart
  • Follow ada on Twitter
  • RSS
  • Visit ada on Facebook
Diabetes Care

Advanced Search

Main menu

  • Home
  • Current
    • Current Issue
    • Online Ahead of Print
    • Special Article Collections
    • ADA Standards of Medical Care
  • Browse
    • By Topic
    • Issue Archive
    • Saved Searches
    • Special Article Collections
    • ADA Standards of Medical Care
  • Info
    • About the Journal
    • About the Editors
    • ADA Journal Policies
    • Instructions for Authors
    • Guidance for Reviewers
  • Reprints/Reuse
  • Advertising
  • Subscriptions
    • Individual Subscriptions
    • Institutional Subscriptions and Site Licenses
    • Access Institutional Usage Reports
    • Purchase Single Issues
  • Alerts
    • E­mail Alerts
    • RSS Feeds
  • Podcasts
    • Diabetes Core Update
    • Special Podcast Series: Therapeutic Inertia
    • Special Podcast Series: Influenza Podcasts
    • Special Podcast Series: SGLT2 Inhibitors
    • Special Podcast Series: COVID-19
  • Submit
    • Submit a Manuscript
    • Journal Policies
    • Instructions for Authors
    • ADA Peer Review
  • More from ADA
    • Diabetes
    • Clinical Diabetes
    • Diabetes Spectrum
    • ADA Standards of Medical Care
    • ADA Scientific Sessions Abstracts
    • BMJ Open Diabetes Research & Care

User menu

  • Subscribe
  • Log in
  • My Cart

Search

  • Advanced search
Diabetes Care
  • Home
  • Current
    • Current Issue
    • Online Ahead of Print
    • Special Article Collections
    • ADA Standards of Medical Care
  • Browse
    • By Topic
    • Issue Archive
    • Saved Searches
    • Special Article Collections
    • ADA Standards of Medical Care
  • Info
    • About the Journal
    • About the Editors
    • ADA Journal Policies
    • Instructions for Authors
    • Guidance for Reviewers
  • Reprints/Reuse
  • Advertising
  • Subscriptions
    • Individual Subscriptions
    • Institutional Subscriptions and Site Licenses
    • Access Institutional Usage Reports
    • Purchase Single Issues
  • Alerts
    • E­mail Alerts
    • RSS Feeds
  • Podcasts
    • Diabetes Core Update
    • Special Podcast Series: Therapeutic Inertia
    • Special Podcast Series: Influenza Podcasts
    • Special Podcast Series: SGLT2 Inhibitors
    • Special Podcast Series: COVID-19
  • Submit
    • Submit a Manuscript
    • Journal Policies
    • Instructions for Authors
    • ADA Peer Review
Online Letters: Comments and Responses

Response to Comment on: van Dijk et al. Exercise Therapy in Type 2 Diabetes: Is Daily Exercise Required to Optimize Glycemic Control? Diabetes Care 2012;35:948–954

  1. Jan-Willem van Dijk, MSC and
  2. Luc J.C. van Loon, PHD
  1. Department of Human Movement Sciences, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
  1. Corresponding author: Luc J.C. van Loon, l.vanloon{at}maastrichtuniversity.nl.
Diabetes Care 2013 May; 36(5): e74-e74. https://doi.org/10.2337/dc12-2652
PreviousNext
  • Article
  • Info & Metrics
  • PDF
Loading

We thank Thosar and Wallace (1) for their interest and constructive comment related to our recent work published in Diabetes Care (2). As this was the first study that investigated the impact of the frequency of exercise (within a fixed volume) on glycemic control, we specifically designed a short-term intervention study during which glycemic control was assessed over 48 h with exercise and dietary conditions being strictly standardized. The short-term nature of our study allowed for the assessment of the effects of exercise per se, without changes in dietary intake and habitual physical activity, or changes in body weight and/or composition. As discussed by Thosar and Wallace (1), such a strictly controlled study is difficult to perform and requires a high level of commitment from the subjects participating in the study. Inherent in the short-term nature of the study, we cannot exclude the possibility that the beneficial effects of daily (two 30-min exercise bouts per 48 h) or nondaily (one 60-min exercise bout per 48 h) exercise were present beyond the 48-h assessment period. Given the equal impact of both exercise regimens on glycemic control during the second 24 h of the entire 48-h monitoring period (Fig. 3 in ref. 2), we speculate that possible differences between both exercise frequencies beyond the 48-h monitoring period are likely small or absent. Nonetheless, it is possible that the glucoregulatory effects of more frequent short bouts of exercise as opposed to less frequent longer bouts of exercise may accumulate in a different manner over time. Therefore, we agree with Thosar and Wallace (1) that future studies should investigate the impact of the frequency of exercise on glycemic control over a long-term period.

The second point raised by Thosar and Wallace (1) concerns the importance of the postbreakfast plasma glucose and insulin concentrations presented in Fig. 2. We certainly agree that these variables are of interest, though from a clinical perspective less relevant than (postprandial) glycemic control measured over the entire 48-h period (Fig. 3). It is important to keep in mind that the blood glucose and insulin concentrations measured directly following exercise are highly dependent on the timing of exercise (i.e., time of day, time before or after meal, before or after postprandial glucose/insulin peak) and do not necessarily translate to glycemic control over a longer time frame. Therefore, we believe that the glucoregulatory effects of exercise observed over the subsequent hours or day(s) after each exercise bout (2–4) are of greater relevance than the blood glucose concentrations measured immediately after exercise. Irrespective of the acute reductions in glucose concentration during exercise, we can conclude that short bouts of exercise performed on a daily basis are equally effective as more prolonged bouts of exercise performed every other day to improve glycemic control in type 2 diabetic patients.

Acknowledgments

No potential conflicts of interest relevant to this article were reported.

  • © 2013 by the American Diabetes Association.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

References

  1. 1.↵
    1. Thosar SS,
    2. Wallace JP
    . Comment on: van Dijk et al. Exercise therapy in type 2 diabetes: is daily exercise required to optimize glycemic control? Diabetes Care 2012;35:948–954 (Letter). Diabetes Care 2013;36:e73. DOI: 10.2337/dc12-0879
  2. 2.↵
    1. van Dijk J-W,
    2. Tummers K,
    3. Stehouwer CD,
    4. Hartgens F,
    5. van Loon LJ
    . Exercise therapy in type 2 diabetes: is daily exercise required to optimize glycemic control? Diabetes Care 2012;35:948–954
    OpenUrlAbstract/FREE Full Text
  3. 3.
    1. van Dijk JW,
    2. Manders RJ,
    3. Tummers K,
    4. et al
    . Both resistance- and endurance-type exercise reduce the prevalence of hyperglycaemia in individuals with impaired glucose tolerance and in insulin-treated and non-insulin-treated type 2 diabetic patients. Diabetologia 2012;55:1273–1282
    OpenUrlCrossRefPubMed
  4. 4.↵
    1. van Dijk JW,
    2. Manders RJ,
    3. Canfora EE,
    4. et al
    . Exercise and 24-h glycemic control: equal effects for all type 2 diabetic patients? Med Sci Sports Exerc. 27 November 2012 [Epub ahead of print]
View Abstract
PreviousNext
Back to top
Diabetes Care: 36 (5)

In this Issue

May 2013, 36(5)
  • Table of Contents
  • About the Cover
  • Index by Author
  • Podcast
Sign up to receive current issue alerts
View Selected Citations (0)
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word about Diabetes Care.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Response to Comment on: van Dijk et al. Exercise Therapy in Type 2 Diabetes: Is Daily Exercise Required to Optimize Glycemic Control? Diabetes Care 2012;35:948–954
(Your Name) has forwarded a page to you from Diabetes Care
(Your Name) thought you would like to see this page from the Diabetes Care web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Response to Comment on: van Dijk et al. Exercise Therapy in Type 2 Diabetes: Is Daily Exercise Required to Optimize Glycemic Control? Diabetes Care 2012;35:948–954
Jan-Willem van Dijk, Luc J.C. van Loon
Diabetes Care May 2013, 36 (5) e74; DOI: 10.2337/dc12-2652

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Add to Selected Citations
Share

Response to Comment on: van Dijk et al. Exercise Therapy in Type 2 Diabetes: Is Daily Exercise Required to Optimize Glycemic Control? Diabetes Care 2012;35:948–954
Jan-Willem van Dijk, Luc J.C. van Loon
Diabetes Care May 2013, 36 (5) e74; DOI: 10.2337/dc12-2652
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Acknowledgments
    • References
  • Info & Metrics
  • PDF

Related Articles

Cited By...

More in this TOC Section

  • Comment on Khunti et al. Clinical Inertia in People With Type 2 Diabetes: A Retrospective Cohort Study of More Than 80,000 People. Diabetes Care 2013;36:3411–3417
  • Response to Comment on Khunti et al. Clinical Inertia in People With Type 2 Diabetes: A Retrospective Cohort Study of More Than 80,000 People. Diabetes Care 2013;36:3411–3417
  • Comment on Lázaro-Martínez et al. Antibiotics Versus Conservative Surgery for Treating Diabetic Foot Osteomyelitis: A Randomized Comparative Trial. Diabetes Care 2014;37:789–795
Show more Online Letters: Comments and Responses

Similar Articles

Navigate

  • Current Issue
  • Standards of Care Guidelines
  • Online Ahead of Print
  • Archives
  • Submit
  • Subscribe
  • Email Alerts
  • RSS Feeds

More Information

  • About the Journal
  • Instructions for Authors
  • Journal Policies
  • Reprints and Permissions
  • Advertising
  • Privacy Policy: ADA Journals
  • Copyright Notice/Public Access Policy
  • Contact Us

Other ADA Resources

  • Diabetes
  • Clinical Diabetes
  • Diabetes Spectrum
  • Scientific Sessions Abstracts
  • Standards of Medical Care in Diabetes
  • BMJ Open - Diabetes Research & Care
  • Professional Books
  • Diabetes Forecast

 

  • DiabetesJournals.org
  • Diabetes Core Update
  • ADA's DiabetesPro
  • ADA Member Directory
  • Diabetes.org

© 2021 by the American Diabetes Association. Diabetes Care Print ISSN: 0149-5992, Online ISSN: 1935-5548.