The effect of brief intermittent stair climbing exercise on glycemic control in people with type 2 diabetes

Abstract

Physical activity is important for the management and treatment of type 2 diabetes (T2D). Interval exercise training has been shown to improve glycemic control in people with T2D; however, studies have generally utilized high volume protocols and/or specialized equipment that limit translation to a “real world” setting. The present proof-of-concept study examined the efficacy of brief, intermittent stair climbing exercise to improve indices of glycemic control in adults with T2D, using continuous glucose monitoring (CGM) under controlled dietary conditions. Each session involved 3 x 60-s bouts of vigorously ascending and slowly descending a single flight of stairs. This was set within a 10-min period, which otherwise involved walking for a warm-up, cool-down and recovery in between bouts. Data are reported for n=5 participants (52 ± 18 y, BMI: 31 ± 5 kg/m2, HbA1c: 6.6 ± 0.7 %; mean ± SD) who performed 18 training sessions over 6 weeks. Mean 24-h glucose and time spent in hyperglycemia (> 10 mmol/L) were unchanged after an acute session of stair climbing (p=0.38 and p=0.42, respectively) or after 6 weeks of training (p=0.15 and p=0.47, respectively). Measures of glycemic variability were improved in the 24-h period following a single session of stair climbing, based on reductions in the mean amplitude of glycemic excursions (MAGE) (4.4 ± 1.5 vs. 3.5 ± 1.0 mmol/L, p =0.02) and the standard deviation (SD) around the mean (1.7 ± 0.5 vs. 1.4 ± 0.5 mmol/L, p=0.02). There was a meal-specific improvement in postprandial hyperglycemia after training, with the incremental area under the curve (iAUC) of the lunchtime meal reduced by 36 ± 42 % (p=0.01). These preliminary results demonstrate the feasibility of stair climbing as a physical activity option for people with T2D, although the acute and chronic effects of this training on indices of glycemic control remain equivocal.