Study Patients Design and type of CGMS Type of Exercise Diet Effect on blood glucose During exercise After exercise Praet et al. [21] 11 overweight  and obese (males); insulin treated 24-h before and 24-h after exercise Day-time of ex: 11.00 CGMS:  microdialysis - RES ex (50% 1RM) plus high-intensity interval ex: whole-body warm-up; two leg exercises, 2 set, 10 rep; and four 30-s high- intensity interval exercises on a bicycle, alternated with 60-s recovery Subjects asked to closely match their daily nutritional intake Blood glucose ↓RESex vs pre-ex Mean 24-h glucose No difference Glucose variability (CONGA) No difference Hyperglycemia (duration) ↓day after ex Hypoglycemia (duration) No difference Manders et al. [28] 9 overweight (males); non-insulin treated 24-h after exercise Day-time of ex: 09.00 CGMS: microdialysis - Low-intensity ex: 60 min of cycling (35% Wmax); - High-Intensity ex: 60 min of cycling (70% Wmax); - Non-ex: seated for 60 min Meals in pre-weighed packages - Mean 24-h glucose and AUC ↓low-intensity ex vs non-ex  Hyperglycemia (duration, 24-h) ↓low-intensity ex vs non-ex Hyperglycemia (after dinner) ↓low- and-high intensity ex vs non-ex Van Dijk et al. [22] 30 overweight and obese (males); either insulin treated or non-insulin treated 24-h after exercise with Day-time of ex: 11.00 CGMS: microdialysis - AER ex: 45 min of cycling (50% Wmax); - RES ex: 45 min, upper body ex,  3 set, 10 rep, 20-40% bodyweight; plus lower body ex 5 set, 10 rep at 55-75% 1RM; - Non-ex: seated for 45 min Meals in pre-weighed packages Mean glucose No difference Hyperglycemia (duration) No difference Mean 24-h glucose ↓AER and RES ex vs non-ex No difference AER ex vs RES ex Hyperglycemia (duration, 24-h) ↓AER and RES ex vs non-ex No difference AER ex vs RES ex Hyperglycemia (time periods) ↓AER ex during afternoon and evening ↓RES ex during nocturnal period ↓AER and RES ex during following morning period Hypoglycemia (duration, 24-h) No difference Hypoglycemia (time periods) ↑AER ex during evening Van Dijk et al. [23] 30 overweight  and obese (males); either insulin treated or non-insulin-treated 48-h after exercise with Day-time of ex: 10.00 (after breakfast) CGMS: microdialysis - AER ex “60”: 60 min of cycling (50% Wmax) the first day; - AER ex “30+30”: 30 min of cycling (50% Wmax) each day; - Non-ex: habitual sedentary condition Meals in pre-weighed packages Mean glucose - First day: ↓both AER ex vs non-ex; ↓AERex “60” vs AERex ”30+30”. - Second day: ↓both AER ex vs non-ex; ↓AERex “30+30” vs AERex “60”. Mean 24-h glucose ↓both AER ex on the first and second day Hyperglycemia (% of the time) ↓both AER ex on the first and second day Van Dijk et al. [29] 60 overweight  and obese (males); either insulin treated or non-insulin-treated 24-h after exercise with Day-time of ex: 10.00 (after breakfast) CGMS: microdialysis - AER ex: 45-60 min of cycling (35-50% Wmax); - Non-ex:  seated for 45-60 min Meals in pre-weighed packages - Mean 24-h glucose ↓AER ex in both insulin and non-insulin treated; Hyperglycemia (duration, 24-h) ↓AER ex Hypoglycemia (duration, 24-h) No difference Glucose variability (CONGA) ↓AER ex Van Dijk et al. [30] 20 overweight and obese (males); non-insulin treated 72-h, exercise on the second day with Day-time of ex: - 9.15 for AER-ex (after breakfast); - 9.15, 12.15, and 16.45 for DLA (after the main meals) CGMS: microdialysis - AER ex: 45-min of cycling (~6 METs) - DLA: three 15-min bouts of  postmeal strolling (~3 METs) - Non-ex: habitual sedentary condition Standardized dietary conditions - Mean 24-h glucose ↓AER ex Hyperglycemia (duration, 24-h) ↓AER ex Post-prandial glucose ↓AER ex, at each meal ↓AER and DLA, for the cumulative glucose response to meals Bacchi et al. [20] 25 overweight  and obese (both males and females); non-insulin treated 48-h during and after exercise with Day-time of ex: 18.30 CGMS: glucose oxidase - AER ex  (n=13): 60min, 60-65% HRR; - RES ex (n=12): 60 min, 9 ex, 3 series, 10 repetitions at 70-80% 1RM;  -Non-ex: corresponding time periods in non-ex day Subjects asked to closely match their daily nutritional intake Glucose AUC ↓AER ex vs RES ex and Non-ex 24-h glucose AUC No difference 48-h glucose AUC No difference Nocturnal glucose AUC ↓AER ex vs Non-ex Hyperglycemia (HBGI) No difference Hypoglycemia (LBGI) ↑AER ex during nocturnal period vs Non-ex day Figueira et al. [24] 14 overweight  and obese (both males and females); non-insulin treated 24-h before and 48-h after exercise with Day-time of ex:12.00 CGMS: glucose oxidase - AER ex: 40 min at 70% peak heart rate - COMB ex: 20 min at 70% peak heart rate and 4 RES exercises, 3 sets of 12 rep at 65% 1RM Subjects asked to closely match their daily nutritional intake Blood glucose ↓AER and COMB ex vs pre-ex 24-h glucose AUC No difference 48-h glucose AUC No difference Hyperglycemia (episodes) No difference between AER and COMB ex and vs pre-ex Glucose variability (MAGE, variance, CV and SD) ↓COMB ex vs pre-ex Mikus et al. [31] 13 overweight and obese (both males and females); non-insulin treated 72-h before exercise, and 72-h in the last 3 days of seven consecutive days of training Day-time of ex: not specified CGMS:  glucose oxidase -AER ex: 60 min, (20 min treadmill walking, 20 min stationary cycling, 20 min treadmill walking) at 60-75% HRR -Non-ex: habitual sedentary condition Standardized dietary conditions. Additional snacks during training days matched for exercise energy cost - Mean 24-h glucose No difference Hyperglycemia (duration, 24-h) ↓AER ex Post-prandial glucose ↓AER ex Hypoglycemia (duration, 24-h) ↓AER ex Glucose variability (glucose excursions) ↓AER ex Gillen et al. [35] 7 overweight and obese (gender not specified); non-insulin treated 24-h after exercise Day-time of ex: 08.00 (1.5 h after breakfast) CGMS:  glucose oxidase - High intensity interval ex: ten 60-s cycling efforts at 89% Wmax, alternated with 60-s recovery; -Non-ex: corresponding time periods in non-ex day Individualized diets - Mean 24-h glucose No difference Hyperglycemia (duration, 24-h) ↓HIT ex Post-prandial glucose ↓HIT ex Oberlin et al. [32] 9 obese (both males and females); non-insulin treated 48-h after exercise Day-time of ex: 06.30 CGMS:  glucose oxidase -AER ex: 60 min, (20 min treadmill walking, 20 min stationary cycling, 20 min treadmill walking) at 60-75% HRR -Non-ex: habitual sedentary condition Standardized dietary conditions - Mean 24-h glucose ↓AER ex during the first day Post-prandial glucose ↓AER ex for the cumulative glucose response to meals over the two days AER: Aerobic Training; AUC: Area Under The Curve; COMB: Combined Aerobic and Resistance Exercise Training; CONGA: Continuous Overall Net Glycemic Action; CV: Coefficient of Variation; DLA: Daily Living Activities; ex: Exercise; HBGI: High Blood Glucose Index; HIT: High-Intensity Interval Training; HRR: Heart Rate Reserve; LBGI: Low Blood Glucose Index; MAGE: Mean Amplitude of Glycemic Excursion; Rep: Repetitions; RES: Resistance Training; SD: Standard Deviation; W:Watt; Wmax: Maximal Watt; ↓:Significantly Reduced; ↑: Significantly Increased

Table 1: Summary of studies assessing the effect of a single bout of exercise on blood glucose in type 2 diabetes subjects by CGMS.