Effect of Morning and Afternoon Exercise on the Improvement of Endothelial Dysfunction in Type-2 Diabetes Mellitus Patients

Abstract

Introduction: Endothelial dysfunction, an early precursor to cardiovascular complications in Diabetes Mellitus (DM) patients, can be effectively managed through exercise, a non-pharmacological approach. However, it is significant to consider the timing of exercise as it can influence the benefits obtained in the management of vascular complications. This is because various systems in the body, including endothelial function, undergo fluctuations according to the circadian rhythm. This study aimed to explore the differences between morning and afternoon exercise in improving vascular endothelial dysfunction in the production of endothelial Nitric Oxide Synthase (eNOS) and Endothelin-1 (ET-1). Methods: Twenty two Type-2 Diabetes Mellitus (T2DM) patients were randomly divided into morning and afternoon exercise groups, and they were administered 10 weeks of Persadia diabetes gymnastics treatment. Before treatment, venous blood was taken as pre-exercise data, and after 10 weeks, it was obtained again for post-exercise examination. The examined data consisted of blood glucose, eNOS, and ET-1 levels. The data was processed statistically using the t-test. Results: eNOS level increased significantly in both samples at 6.66 ± 0.56 ng/ml and 5.46 ± 0.9 ng/ml (p<0.001). However, the increment was higher in the morning group. Whereas, the level of ET-1 decreased significantly in both samples at 58.08 ± 4.01 pg/ml vs. 34.84 ± 4.75 pg/ml (p<0.001), but the decrement was greater in the morning group. Conclusion: This study indicates that morning exercise is more influential in improving endothelial dysfunction by increasing the eNOS enzyme and significantly decreasing ET-1 in T2DM patients.