Improved Glycemic Control in Adults with Type 2 Diabetes is More Strongly Associated with Exercise Duration Than with Volume, Frequency, or Consistency

Low, JL, Hesketh, K, Falkenhain, K, Jung, ME, Singer, J, Jones, CA, Russon, C, Cocks, M ORCID: 0000-0003-1671-8714, McManus, A and Little, JP (2025) Improved Glycemic Control in Adults with Type 2 Diabetes is More Strongly Associated with Exercise Duration Than with Volume, Frequency, or Consistency. Medicine & Science in Sports & Exercise. ISSN 0195-9131

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Abstract

Purpose: – Exercise interventions play a pivotal role in managing type 2 diabetes (T2D), yielding significant benefits in glycemic control. Despite the recognized role of exercise duration, volume, frequency, and consistency, the literature remains discrepant on which exerts the greatest effect. The purpose of this secondary analysis was to determine the relationship between exercise duration, volume, frequency, and consistency and markers of glycemic control [HbA1c and continuous glucose monitoring (CGM) metrics] following a 26-week mHealth intervention. Methods: – Inactive adults with newly diagnosed (<2 years) T2D (n = 58) completed blood and 14-day CGM testing before and after a 26-week personalized exercise intervention. Raw exercise data from fitness watches were extracted for each session. Duration, volume, frequency, and consistency were calculated for the full intervention and for the first 13 weeks (greater support) and last 13 weeks (reduced support). Results: – Average session duration (57 ± 36 minutes) significantly predicted HbA1c (β = -0.23 (0.07), P = 0.002), 24-hour mean glucose (β = -0.03 (0.01), P = 0.01), and glycemic variability (SD; β = -0.01 (0.0), P = 0.003; Beta coefficients are reported with standard errors). Total exercise time during the first 13 weeks (2931 ± 3362 minutes) also predicted HbA1c (β = -0.001 (0.0), P = 0.01), mean glucose (β = -0.002 (0.0), P = 0.01), and glycemic variability (β = -0.005 (0.0), P = 0.03). No other exercise metrics significantly predicted outcomes. Conclusions: – Average session duration and exercise time accumulated early in the intervention were the only significant predictors of improvements in HbA1c, mean glucose, and glucose variability. These findings suggest that promoting increased exercise duration, independent of type or intensity, may improve glycemic control among individuals with newly diagnosed T2D. TRIAL REGISTRATION: – ClinicalTrials.gov NCT04653532.

Item Type:	Article
Uncontrolled Keywords:	MOTIVATE T2D Team; continuous glucose monitoring; exercise prescription; insulin sensitivity; mHealth intervention; type 2 diabetes management; 32 Biomedical and Clinical Sciences; 3202 Clinical Sciences; 42 Health Sciences; Clinical Trials and Supportive Activities; Diabetes; Prevention; Physical Activity; Clinical Research; 6.7 Physical; Metabolic and endocrine; 3 Good Health and Well Being; 1106 Human Movement and Sports Sciences; 1116 Medical Physiology; 1117 Public Health and Health Services; Sport Sciences; 3202 Clinical sciences; 3208 Medical physiology; 4207 Sports science and exercise
Subjects:	R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions:	Sport and Exercise Sciences
Publisher:	Wolters Kluwer Health
Date of acceptance:	16 December 2025
Date of first compliant Open Access:	26 March 2026
Date Deposited:	25 Mar 2026 13:18
Last Modified:	26 Mar 2026 00:50
DOI or ID number:	10.1249/MSS.0000000000003922
URI:	https://researchonline.ljmu.ac.uk/id/eprint/28291

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