The Effect of Exercises Performed According to Circadian Rhythm in Type 2 Diabetes
Condition: Type 2 Diabetes
MeSH terms: Diabetes Mellitus; Diabetes Mellitus, Type 2
Study type: Interventional

Summary: 
      Type 2 diabetes is a metabolic disease characterized by partial insulin deficiency or insulin
      resistance in peripheral tissue. Type 2 diabetes, which has a very high prevalence worldwide,
      is a socially serious health problem. Exercise has beneficial effects on the glycemic
      profile, such as decreased glycemic hemoglobin (HbA1c) level, increased maximum oxygen
      consumption (VO2max) and improved insulin sensitivity in diabetes patients. When the
      literature is examined, it is seen that exercise is also effective in improving metabolic
      health. Although the metabolic benefits of exercise have been shown, there is no study of
      which type of exercise is more beneficial in what time of day in individuals with Type 2
      diabetes. Circadian rhythm plays an important role in clarifying this issue because the
      circadian rhythm is impaired in the glucose metabolism of individuals with type 2
      diabetes.The aim of this study is to investigate which exercise is more effective in which
      time period for individuals with Type 2 diabetes
    

Detailed description: 
      INTRODUCTION: Type 2 diabetes is a metabolic disease characterized by partial insulin
      deficiency or insulin resistance in peripheral tissue. Type 2 diabetes, which has a very high
      prevalence worldwide, is a socially serious health problem. Complications seen with the
      disease negatively affect human health. Physical activity and regular exercise are shown in
      the first place with pharmacological treatment and diet approaches in the treatment of Type 2
      diabetes. Exercise has beneficial effects on the glycemic profile, such as decreased glycemic
      hemoglobin (HbA1c) level, increased maximum oxygen consumption (VO2max) and improved insulin
      sensitivity in diabetes patients. When the literature is examined, it is seen that exercise
      is also effective in improving metabolic health. Although the metabolic benefits of exercise
      have been shown, there is no study of which type of exercise is more beneficial in what time
      of day in individuals with Type 2 diabetes. Circadian rhythm plays an important role in
      clarifying this issue because the circadian rhythm is impaired in the glucose metabolism of
      individuals with type 2 diabetes.

      AIM: The aim of this study is to evaluate the effectiveness of structured exercises given in
      accordance with the circadian rhythm of individuals with type 2 diabetes.

      METHOD: 30 people with Type 2 diabetes in accordance with the criteria for inclusion in the
      Department of Endocrine and Metabolism Diseases of Medipol University Hospital in Istanbul
      will be included in this study. Individuals who have been diagnosed with Type 2 diabetes
      between the ages of 35-65, who have body mass index between 25 and 30, who have HbA1c value>
      6.5%, who have fasting blood glucose>126 mg/dl, who have Type 2 diabetes between 5-10 years,
      who have inactive physical activity, who independently can walk and volunteer to exercise for
      at least 3 days a week will be included in our study. Type 1 diabetes individuals, diagnosed
      with Latent Autoimmune Diabetes in Adults (LADA), having diabetic Ketoacidosis coma,
      orthopedic or surgical problems to prevent walking and exercising, foot ulcers, individuals
      have any neurologıcal problem and individuals with cardiac, pulmonary or systematic diseases
      that will cause contraindications will not be included in the study. Blood sample
      evaluations, circadian rhythm evaluation, 6-minute walking test, 30-second sit to stand test,
      quality of life assessment with Ferrans&Powers Quality of Life Index of the individuals
      included will be carried out at the beginning of the study (T0) and at 6 (T1), 12 (T2) and 18
      (T3) weeks after the study started Participants will be divided into two groups, morning (MC)
      and evening chronotypes (EC), according to their circadian rhythms. In both groups, there was
      a 6-week control period in which the participants continued to their routine treatment and
      did not perform any specific exercises. In the MC group, exercises were applied in the
      morning hours for the first 6 weeks and in the evening hours for the next 6 weeks. The EC
      exercises were applied in the evening hours for the first 6 weeks and in the morning hours
      for the next 6 weeks. A structured exercise program with aerobic and strengthening exercises
      was carried out in both groups for 3 days a week over 12 weeks. . Individuals were evaluated
      in terms of the blood test, functional capacity and quality of life at the baseline, 6 weeks
      before the exercise, 6 and 12 weeks after the exercises.
    

Intervention name(s): Morning Chronotype group; Evening Chronotype group
Intervention type(s): Other; Other
Intervention description(s): Total of 12 weeks aerobic and strengthening exercises in different timing of the day.; Total of 12 weeks aerobic and strengthening exercises in different timing of the day.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Circadian Rhthym; Exercise; Type 2 Diabetes