Degree Name

Doctor of Philosophy


School of Medical, Indigenous and Health Sciences


This thesis investigates the short- and longer-term feasibility and effectiveness of prescribing an individualised time to exercise, based on continuous glucose monitoring (CGM) derived time of peak hyperglycaemia, in individuals with type 2 diabetes (T2D). The Timing Exercise Prescription (TEP) study was designed to examine the impact of personalising the current aerobic physical activity guidelines (i.e., ≥150 min/week moderate-intensity aerobic activity) by prescribing a time to exercise on cardiometabolic health, adherence, and quality of life. Chapter 2 details the TEP Study design and protocol. The overarching aim was to compare the effects of prescribing exercise at the time-of-day when peak hyperglycaemia occurs (ExPeak) to exercise not at time of peak hyperglycaemia (NonPeak) and standard-care control (CTL) in individuals with T2D. Participants in ExPeak and NonPeak were prescribed 22 min/day of moderate-intensity aerobic exercise. ExPeak began daily exercise sessions 30 min before time of peak hyperglycaemia and NonPeak began 90 min after time of peak hyperglycaemia. Time of peak hyperglycaemia was determined from a two-week baseline CGM period. All exercise sessions were home-based (free-living), and participants maintained normal diet and medication throughout the trial. Changes in glycaemic and metabolic control, vascular function, body composition, quality of life and physical activity were examined.

Chapter 3 examined the feasibility of using CGM to prescribe an individualised time to exercise. The primary outcome was adherence to two weeks of ExPeak or NonPeak between groups and compared to habitual activity (i.e., baseline). Adherence was determined by the amount of total moderate to vigorous intensity activity (MVPA) participants accumulated per week, measured via accelerometry. Secondary outcomes examined changes in glycaemic control from CGM. Participants wore CGMs and accelerometers for two weeks before and during the intervention. Compared to habitual activity, participation in MVPA increased by 26% when an exercise time was prescribed (p<0.01), with no differences observed between intervention groups (p>0.26). Change in peak blood glucose was similar between groups, and not significantly lower compared to baseline (ExPeak by -0.44 ± 1.6 mmol/L and NonPeak by -0.39 ± 1.5 mmol/L, p=0.92).

FoR codes (2008)


This thesis is unavailable until Thursday, May 07, 2026



Unless otherwise indicated, the views expressed in this thesis are those of the author and do not necessarily represent the views of the University of Wollongong.