Impact of free-living pattern of sedentary behaviour on intra-day glucose regulation in type 2 diabetes

Aye C Paing,Sebastien F M Chastin,Alison F Kirk,Andrew Collier,Kathryn A Mcmillan,Allan Hewitt

doi:10.1007/s00421-019-04261-z

Aye C Paing, Sebastien F M Chastin + Show 4 more

Open Access

https://doi.org/10.1007/s00421-019-04261-z

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Abstract

PurposeTo investigate how the pattern of sedentary behaviour affects intra-day glucose regulation in type 2 diabetes.MethodsThis intensive longitudinal study was conducted in 37 participants with type 2 diabetes (age, 62.8 ± 10.5 years). Glucose and sedentary behaviour/physical activity were assessed with a continuous glucose monitoring (Abbott FreeStyle Libre) and an activity monitor (activPAL3) for 14 days. Multiple regression models with generalised estimating equations (GEEs) approach were used to assess the associations of sedentary time and breaks in sedentary time with pre-breakfast glucose, pre-lunch glucose, pre-dinner glucose, post-breakfast glucose, post-lunch glucose, post-dinner glucose, bedtime glucose, the dawn phenomenon, time in target glucose range (TIR, glucose 3.9–10 mmol/L) and time above target glucose range (TAR, glucose > 10 mmol/L).ResultsSedentary time was associated with higher pre-breakfast glucose (p = 0.001), pre-dinner glucose (p < 0.001), post-lunch glucose (p = 0.005), post-dinner glucose (p = 0.013) and the dawn phenomenon (p < 0.001). Breaks in sedentary time were associated with lower pre-breakfast glucose (p = 0.023), pre-dinner glucose (p = 0.023), post-breakfast glucose (p < 0.001) and the dawn phenomenon (p = 0.004). The association between sedentary time and less TIR (p = 0.022) and the association between breaks in sedentary time and more TIR (p = 0.001) were also observed.ConclusionsReducing sedentary time and promoting breaks in sedentary time could be clinically relevant to improve intra-day glucose regulation in type 2 diabetes.

Highlights

Sedentary time is highly prevalent in people with type 2 diabetes
Breaks in sedentary time, defined as short period of standing or walking in between two periods of sitting/reclining, have beneficial associations with fasting glucose, 2-h postprandial glucose after a test meal and insulin resistance in those with type 2 diabetes (Healy et al 2008; Sardinha et al 2017; Tremblay et al 2017). These findings suggest that sedentary time and breaks in sedentary time may impact intra-day glucose regulation, such as pre-breakfast glucose, pre-lunch glucose, pre-dinner glucose, post-breakfast glucose, postlunch glucose, post-dinner glucose, bedtime glucose, the dawn phenomenon, time in target glucose range (TIR, glucose 3.9–10 mmol/L) and time above target glucose range (TAR, glucose > 10 mmol/L)
This study aimed to explore if sedentary time and breaks in sedentary are associated with pre-breakfast glucose, pre-lunch glucose, pre-dinner glucose, post-breakfast glucose, post-lunch glucose, post-dinner glucose, bedtime glucose, the dawn phenomenon, TIR and TAR in people with type 2 diabetes with habitual diet and physical activity patterns

Summary

Introduction

Sedentary time (time spent sitting or reclining during waking hours) is highly prevalent in people with type 2 diabetes. Breaks in sedentary time, defined as short period of standing or walking in between two periods of sitting/reclining, have beneficial associations with fasting glucose, 2-h postprandial glucose after a test meal and insulin resistance in those with type 2 diabetes (Healy et al 2008; Sardinha et al 2017; Tremblay et al 2017) These findings suggest that sedentary time and breaks in sedentary time may impact intra-day glucose regulation, such as pre-breakfast glucose (fasting glucose), pre-lunch glucose, pre-dinner glucose, post-breakfast glucose, postlunch glucose, post-dinner glucose, bedtime glucose, the dawn phenomenon, time in target glucose range (TIR, glucose 3.9–10 mmol/L) and time above target glucose range (TAR, glucose > 10 mmol/L). This study aimed to explore if sedentary time and breaks in sedentary are associated with pre-breakfast glucose, pre-lunch glucose, pre-dinner glucose, post-breakfast glucose, post-lunch glucose, post-dinner glucose, bedtime glucose, the dawn phenomenon, TIR and TAR in people with type 2 diabetes with habitual diet and physical activity patterns

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