Post-meal glucose response
Evidence basis: randomised trials
Across small randomized crossover trials, exercise after eating reduced acute glucose excursions compared with no exercise and with exercise before eating.
Population: Adults with and without type 2 diabetes in short laboratory crossover studies.
Research details
Summary
Across small randomized crossover trials, exercise after eating reduced acute glucose excursions compared with no exercise and with exercise before eating. In the same synthesis the meal-to-exercise interval significantly moderated the glucose response (estimate -0.0151; standard error 0.00473; Z = -3.19; p = 0.001), with shorter intervals doing better, and pre-meal exercise did not significantly lower postprandial glucose compared with inactive control (SMD -0.13; 95% CI -0.42 to 0.17). The synthesis pooled post-meal exercise of unstated type; its authors state that the most appropriate form of activity is not sufficiently clarified, so a walking-specific effect is not established.
Why this certainty
The direction was consistent in a meta-analysis of randomized crossover trials, but small samples, short follow-up, high risk of bias and the absence of any modality breakdown reduce confidence; the pooled interventions were exercise of unstated type, so the estimate cannot be read as walking-specific.
Limitations
Only 116 participants were included across eight three-armed crossover trials, the trials were short and rated at high risk of bias, the pooled interventions were exercise of unstated type rather than walking specifically, and the finding does not establish a long-term clinical benefit.
Effect estimate
Post-meal exercise vs inactive control: standardized mean difference 0.55 (95% CI 0.34 to 0.75); post-meal exercise vs pre-meal exercise: SMD 0.47 (95% CI 0.23 to 0.70); pre-meal exercise vs inactive control: SMD -0.13 (95% CI -0.42 to 0.17, not significant). Meal-to-exercise interval as a moderator: estimate -0.0151 (SE 0.00473; Z = -3.19; p = 0.001).



