The influence of hypoglycemic drugs on exercise-mediated hypoglycemic effects in elderly type 2 diabetic patients

Background: To evaluate the impact of different hypoglycemic drugs on exercise-mediated blood glucose (BG) reduction. Methods: One-hundred and five retirees who were diagnosed with type 2 diabetes mellitus (T2DM) within a two-year period were included in this study. The participants were instructed to walk for 20 to 30 minutes at a moderate-speed (4.0 to 4.5 km/h) after breakfast. Blood pressure and fingertip BG were measured before and after walking. Results: The rate of BG reduction was significantly higher in all exercise groups when compared to that of non-exercised patients. Among all groups, BG declined the most in the un-medicated group, while the lowest BG reduction was observed in the acarbose group. Surprisingly, the BG reduction in acarbose group was significantly lower when compared with non-acarbose groups (P<0.0001). Interestingly, after further correcting for sex, age, BMI, diabetes history, walking time, walking speed and walking distance, only age was found to be an influencing factor (t=-3.304, P=0.001). Pearson correlation of age and BG reduction showed that correlation coefficient of age was only 0.183 and revealed no statistical significance. Conclusions: Walking at a moderate speed for 20 to30 minutes after breakfast provided a beneficial BG reduction effect in elderly T2DM patients. Among the medicated groups, the smallest BG reduction rate was observed in patients taking acarbose. We suggest that acarbose might influence hypoglycemic effects of exercise. The results of this study will be helpful for determining the best clinical usage of hypoglycemic medications in elderly T2DM patients.